Abstract
Basal and throughout-the-day variations of B-lipotropin (BLPH), B-endorphin (BEP), ACTH and cortisol plasma levels were studied in seven prepubertal children who had been affected by common migraine for periods of 6–26 months and in six healthy volunteers. Despite normal cortisol concentrations, children with migraine show higher BLPH (15.1 ± 2.7 fmol/ml, M ± SE), ACTH (25 ± 2.7) and BEP (9.1 ± 1.1) levels than controls. In both groups of children, evening values (8 p.m.) were significantly lower than morning values, but in migraineurs the decrease of the three peptides was less. The raised proopiocortin-related peptide plasma levels found in children suffering from migraine cannot be explained at present, although the discomfort experienced by the patients may create a situation of chronic stress which could explain such a finding. Whatever the explanation is, these findings differentiate prepubertal migraine from the most severe forms of headache occurring in adult life where lower than normal opioid levels have been demonstrated.
Chez 7 enfants en phase prepuberale, souffrants de maladie migraineusedepuis 6–26 mois, ont été etudiés les taux plasmatiques de base et le variations spontaneés pendant les 24 heurs de B-Lipotropine (BLPH), B-Endorphine (BEP), ACTH et Cortisol. De la meme façon ont été étudiés 6 garçons sains, de la meme age. Malgré les taux de la Cortisol soient normaux, les petits patients presentent des niveaux plasmatiques de BLPH (15.1 ± 2.7 fmol/ml, M ± ES), BEP (9.1 ± 1.1) et de ACTH (25 ± 2.7) significativement plus élévées que le group témoin. Chez touts les sujets les taux plasmatiques des differantes hormones étaient plus bas le soir que le matin, ce phenomène phisiologique étant moin evident chez les patients. Les raisons des taux élévés des peptides liés a la proopiocortine sont pas connues, a present, meme si l'on peut hypothiser l'existance d'une situation de stress chronique chez les enfants souffrants de maladie migraineuse. En tous cas, on peut fair une distinction très nette entre la forme prepuberale de la maladie migraineuse et celle de l'adulte qui est caracterizée par des taux pathologiquement reduit de opioides endogènes.
Sono state studiate le concentrazioni basali e le variazioni circadiane della beta-lipotropina (BLPH), beta-endorfina (BEP). ACTH and Cortisolo in 7 bambini prepuberi affetti da emicrania comune da 6–26 mesi ed in 6 controlli. Sebbene le concentrazioni del Cortisolo fossero nell'ambito della norma, i bambini mostravano livelli di B-LPH (15.1 ± 2.7 fmol/ml, M ± ES), di B-EP (9.1 ± 1.1) ed ACTH (25 ± 2.7) significativamente superiori ai bambini di controllo. Entrambi i gruppi hanno mostrato le normali oscillazioni circadiane dei quattro ormoni, con valori ridotti la sera, sebbene tale fenomeno fosse resultato meno evidente nei pazienti. Questi dati indicano che l'emicrania comune dell'infanzia decorre con un peculiare assetto oppioide (forse dovuto allo stress cronico, indotto dal dolore cefalico) che la differenzia dalle cefalee dell'età adulta dove nelle forme più gravi i suddetti peptidi oppioidi risultano significativamente ridotte.
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