Background

Reduced blood or cerebrospinal fluid levels of allopregnanolone are involved in menstrual cycle-linked CNS disorders, such as catamenial epilepsy. This condition, like menstrually-related migraine, is characterized by severe, treatment-resistant attacks. We explored whether there were differences in allopregnanolone, progesterone and testosterone serum levels between women with menstrually-related migraine (MM, n = 30) or postmenopausal migraine without aura who had suffered from menstrually-related migraine during their fertile age (PM, n = 30) and non-headache control women in fertile age (FAC, n = 30) or post-menopause (PC, n = 30).

Methods

Participants were women with migraine afferent to a headache centre; controls were female patients’ acquaintances. Serum samples obtained were analyzed by HPLC-ESI-MS/MS.

Results

In menstrually-related migraine and postmenopausal migraine groups, allopregnanolone levels were lower than in the respective control groups (fertile age and post-menopause) (p < 0.001, one-way analysis of variance followed by Tukey-Kramer post-hoc comparison test) while progesterone and testosterone levels were similar. By grouping together patients with migraine, allopregnanolone levels were inversely correlated with the number of years and days of migraine/3 months (p ≤ 0.005, linear regression analysis).

Conclusion

Decreased GABAergic inhibition, due to low allopregnanolone serum levels, could contribute to menstrually-related migraine and persistence of migraine after menopause. For the management of these disorders, a rise in the GABAergic transmission by increasing inhibitory neurosteroids might represent a novel strategy.

中文翻译：

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月经相关和绝经后偏头痛中别孕酮、孕酮和睾酮的血清水平：一项横断面研究。

背景

别孕酮的血液或脑脊液水平降低与月经周期相关的中枢神经系统疾病有关，例如月经性癫痫。这种情况与月经相关的偏头痛一样，其特征是严重的、难以治疗的发作。我们探讨了患有月经相关偏头痛的女性（MM，n = 30）或在生育年龄期间患有月经相关偏头痛的无先兆的绝经后偏头痛女性（PM，n = 30) 和非头痛对照妇女生育年龄 (FAC, n = 30) 或绝经后 (PC, n = 30)。

方法

参与者是偏头痛传入头痛中心的女性；对照组是女性患者的熟人。通过HPLC-ESI-MS/MS分析获得的血清样品。

结果

在与月经相关的偏头痛和绝经后偏头痛组中，别孕酮水平低于各自的对照组（生育年龄和绝经后）（p  < 0.001，单因素方差分析，随后进行 Tukey-Kramer 事后比较检验）而孕酮和睾酮水平相似。由偏头痛患者分组在一起，别孕烯醇酮水平呈负随着岁月天偏头痛/ 3个月（数量和相关p ≤0.005，线性回归分析）。

结论

由于别孕酮血清水平低，GABA能抑制降低，可能导致与月经相关的偏头痛和更年期后偏头痛的持续存在。对于这些疾病的治疗，通过增加抑制性神经类固醇来增加 GABA 能传递可能代表一种新策略。