Neuroendocrine derangement in chronic migraine

(Letter to the Editor)Two reports recently appeared almost simultaneously in the headache literature both addressed a highly topical issue, namely the relationship between chronic migraine (CM) and stressful events. Both underscore the need for scientific data regarding hormonal variations induced by stress and their relationship to disorders that may or may not evolve toward a chronic state (eg, migraine). In both the reports, the respective authors stressed the difficulty of distinguishing between cause and effect in regards to cortisol's place in CM. While cortisol hyperactivity conceivably may follow clinical worsening of migraine, simply appearing as an epiphenomenon, it is well known that chronic exposure to high levels of glucocorticoids can itself produce neurotoxic effects. In our study a method of measurement entirely noninvasive was applied measuring salivary levels that reflect better than those in plasma the hormone serum fraction that is biologically active data. Both testosterone and DHEA-s were measured in relation to levels of cortisol in order to evaluate CM in the context of 2 central parameters widely used in research involving stress. These parameters could represent important biologic markers for monitoring the general psychophysiologic well-being of the subject migraineur.