Progressive impairment of CSF β-EP levels in migraine sufferers

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Abstract
Common migraine (CM) is an evolutive disease characterized by a progressive increase in the number of attacks and a consequent reduction in the free periods, eventually reaching a state of continuous migraine with interparoxysmal headache (MIH). To evaluate the role of central pro-opiocortin-related peptides in the pathogenesis of the disease, CSF levels of .beta.-lipotropin (.beta.-LPH), .sbd.endorphin (.beta.-EP) and ACTH were measured in 2 groups of migraine sufferers with increasing severity of the disease (CM and MIH), and in healthy controls. ACTH values were similar in the 3 groups, while .beta.-LPH levels were significantly lower (P < 0.005) in patients affected by MIH (10.4 .+-. 8.6 fmol/ml) than in patients with CM (35.7 .+-. 8.3) and in controls (32.9 .+-. 15.33). .beta.-EP levels were closely correlated with the severity of the disease: they decreased significantly from those found in healthy controls (86.1 .+-. 37 fmol/ml) to those of CM sufferers (38.5 .+-. 3.5; P < 0.005) and showed a further significant fall (P < 0.01) to the lowest levels which were found in MIH patients (14.8 .+-. 9.8). The progressive evolution of migraine is concomitant with a progressive impairment in the CSF levels of .beta.-EP. Non-organic central pain is related to a reduced activity of the neurons responsible for the CSF content of .beta.-EP.