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Cortisol and migraine: A systematic literature review
Giuseppe Lippi, Camilla Mattiuzzi1
1Service of Clinical Governance, General Hospital of Trento, Trento, Italy. camilla.mattiuzzi@apss.tn.it.
Summary
Cortisol levels, a stress hormone, do not typically differ in individuals with migraine compared to controls. While some stress-induced cortisol responses are heightened in migraineurs, this does not appear to drive the condition.
Area of Science:
- Neuroscience
- Endocrinology
- Clinical Medicine
Background:
- Migraine is a common and debilitating neurological disorder.
- Stress is a recognized migraine trigger, and cortisol is a key stress hormone.
- Understanding the relationship between cortisol and migraine is crucial for treatment strategies.
Purpose of the Study:
- To systematically review clinical studies investigating cortisol levels in individuals with migraine.
- To determine if cortisol levels or stress-induced cortisol release differs between migraineurs and healthy controls.
Main Methods:
- A comprehensive literature search was conducted across Medline, Scopus, and Web of Science.
- Included studies assessed cortisol levels in migraineurs, encompassing cross-sectional and observational designs.
- Data heterogeneity precluded meta-analysis, necessitating a narrative synthesis of findings.
Main Results:
- Six of seven cross-sectional studies found no significant difference in cortisol levels between migraineurs and controls.
- Four observational trials indicated that nitroglycerine and human corticotropin-releasing hormone elicited a greater cortisol release in migraineurs.
- One trial reported no difference in salivary cortisol during migraine attacks versus migraine-free periods.
Conclusions:
- Migraineurs may exhibit altered corticotrope responsiveness to certain stimuli.
- Despite potential differences in stress hormone response, cortisol alterations do not appear to be a primary factor in migraine pathogenesis.