Orexin-A levels in episodic and chronic migraine: Implications for hypothalamic involvement? [Epizodik ve kronik migrende Orexin-A düzeyleri: Hipotalamik tutulumun etkisi Mi?]

Objective: the aim of the study was to demonstrate whether blood orexin a levels (ox-al),which are a marker of hypothalamic activity,are altered in patients with migraine and whether they differ ictally and interictally and with the chronification of migraine. materials and methods: a total of 113 patients participated in this study. orexin a blood samples were taken during a headache-free interval. in 17 patients with episodic migraine a second blood sample for orexin a was taken during an attack of migraine. results: ox-al were lower in episodic migrane compared to controls but did not differ during an attack and the interictal period. conclusion: our findings of low ox-al in episodic migrane both ictally and interictally,similar levels of ox-al in chronic migraine and tension-type headache compared to controls may suggest that ox-al is probably not released in response to acute pain but its basal levels may modulate the susceptibility to pain. basal ox-al are low in patients with episodic migrane which could reflect a suppression of the orexinergic system due to hypothalamic dysfunction but increase with chronification possibly in response to lower orexin-a receptor density secondary to neurodegeneration. further larger studies may shed more light on the role of the orexinergic system and the hypothalamus in migraine and the chronification of it. © 2016,ege university press. all right reserved.