Cortisol and migraine: A systematic literature review

Migren çok yaygın bir maluliyettir. Bu durumun başlıca tetikleyicisinin stres olduğu göründüğü ve kortizolde iyice bilinen bir stres hormonu olduğu için migren hastalarında kortizol düzeylerini değerlendiren klinik çalışmaları belirlemek için Medline, Scopus ve Web of Science tarama motorlarında araştırma yürüttük. Dört kesitsel, bir gözlemsel ve üç hem kesitsel hem de gözlemsel araştırma incelememize dahil edilmiştir. Örneklem büyüklüğüne göre heterojenlik orta derecede (%49.8), ancak örnek matrisine göre hatırı sayılır derecede yüksek (%66.0) olduğundan verilerin metaanalizini gerçekleştirmeyi olanaksızlaştırmıştır. Yedi kesitsel çalışmanın altısında kortizol konsantrasyonu olgular ve kontroller arasında farklılık göstermemiştir. Dört gözlemsel çalışma açısından, klorofenilpiperazinin aksine hem nitrogliserin, hem de insan kortikotropin serbestleştirici hormon kontrollere göre migren hastalarında daha belirgin bir kortizol salımına yol açmakta etkili olmuştur. Bir dördüncü gözlemsel çalışmada migren atağı sırasında ve migrensiz dönemde tükrükteki kortizol farklı değildi. Sonuçta, migren hastalarında kortikotropa yanıt verme yetisi bozulmuş olabilmesine rağmen bu durumun migrenin patogeneziyle ilgisi olmadığı görünmektedir

Kortizol ve migren: Bir sistematik literatür derlemesi

Migraine is a highly prevalent and disabling disorder. Because stress appears to be a prominent trigger of this condition and cortisol is a well-established stress hormone, we performed a search on Medline, Scopus, and Web of Science to identify clinical studies that assessed cortisol levels in migraineurs. Four cross-section studies, one observational study, and three both cross-sectional and observational studies were finally included in our analysis. The heterogeneity was modest for the sample size (49.8%) but was remarkably high for a sample matrix (66.0%), thus precluding the possibility to meta-analyze the data. In six of the seven cross-sectional studies, cortisol levels did not differ between the cases and controls. With regard to the four observational trials, both nitroglycerine and human corticotropin-releasing hormone but not m-chlorophenylpiperazine were effective in generating a more prominent cortisol release in migraineurs than in controls. In a fourth observation trial, salivary cortisol did not differ during the migraine attack and during the migraine free-period. In conclusion, even if altered corticotrope responsiveness exists in migraineurs, it appears to be irrelevant in the pathogenesis of migraine

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