Reduced testosterone levels in cluster headache: a stress-related phenomenon?

Area of Science:

• Endocrinology
• Chronobiology
• Neurology

Background:

• Cluster headache (CH) is a debilitating neurological disorder characterized by severe head pain.
• Circadian rhythms of hormones like testosterone (T) and cortisol play crucial roles in physiological regulation.
• Disruptions in these rhythms have been implicated in various health conditions.

Purpose of the Study:

• To investigate the circadian patterns of testosterone, cortisol, and luteinizing hormone (LH) in patients with episodic cluster headache during their active phase.
• To compare these hormonal profiles and their circadian rhythms with those of healthy controls.

Main Methods:

• Blood samples were collected every 2 hours over a 24-hour period from nine episodic cluster headache patients and seven healthy volunteers.
• Hormone levels (testosterone, cortisol, LH) were analyzed.
• Circadian rhythm parameters, including mesor, acrophase, and rhythm absence, were assessed using single cosinor analysis.

Main Results:

• Cluster headache patients showed a significant reduction in the 24-hour mean testosterone level (mesor) compared to controls.
• While both groups exhibited a circadian rhythm for testosterone, three CH patients lacked a significant rhythm, and a delay in acrophase was observed in CH patients.
• CH patients displayed a delayed cortisol acrophase and elevated cortisol levels during the afternoon and evening, despite similar morning LH levels between groups.

Conclusions:

• Reduced testosterone secretion and delayed circadian rhythms for both testosterone and cortisol are associated with cluster headache during its active phase.
• Elevated cortisol levels in CH patients may be linked to stress from attack anticipation, potentially suppressing testosterone production.
• These findings support the hypothesis that cluster headache is fundamentally a disorder of internal chronoorganization (dyschronic disorder).