How Do Neurosteroids Affect Migraines and Headaches? – Chromatography Investigates

Migraines and cluster headaches can severely affect the quality of life for sufferers, stopping them from carrying out their normal daily activities. Migraine is described as a chronic disease and can have clinical and social implications. It is more prevalent than diabetes and was recently revealed by the Global Burden of Disease initiative - a global study quantifying health effects of more than 100 diseases - to be the fifth leading chronic disease on the planet.

With no known cure for migraines, treatments including painkillers try to alleviate the symptoms. Some migraines are thought to be triggered by stress or a certain type of food, and avoiding these triggers is one method of reducing a migraines impact. A greater understanding of migraines and cluster headaches is the goal of researchers. And a recent paper published in The Journal of Headache and Pain - Migraine and cluster headache show impaired neurosteroids patterns - has shown how some neurosteroids change when patients suffer a migraines or cluster headache. And chromatography is again at the forefront of medical research.

Steroids - not just for the gym

One of the factors related to the pathogenesis - how a disease develops - of migraine appears to be the impaired control of neuronal excitability. As the researchers from Italy discuss in the paper - ‘unravelling the trans-synaptic and/or intracellular mechanisms that alter neuronal firing in migraine and cluster headache may provide new insights into the pathophysiology of these disorders and pave the way to novel therapeutic interventions.’

Neurosteroids are natural steroids produced in the central nervous system. They act by regulating neuronal excitability, interacting with ɣ-aminobutyric acid A or N-methyl-d-aspartate receptors. It is thought that neurosteroids also play a role in epilepsy. It is thought that an imbalance between excitatory and inhibitory neurotransmission leading to activation of key receptors plays a role in the development of migraneous aura and sensitization leading to migraine pain.

Pinpointing the cause of pain?

The researchers on the above paper were interested in measuring the levels of the circulating neurosteroids in the patients with a diagnosis of migraine, medication overuse headache and cluster headache. They wanted to see if they could explore any connections between the clinical characteristics and the neurosteroid levels.

The team recruited patients between 18-80 years old of both sexes alongside healthy control subjects. Blood samples were taken and treated before levels of neurosteroids were measured using liquid chromatography-mass spectrometry. The use of mass spectrometry to analyse difficult samples is discussed in the article, ionRocket: An innovative Thermal Desorption and Pyrolysis Device for Direct Analysis in Real Time-Mass  Spectrometry (DART-MS) for Rapid Characterisation of Difficult Samples.

The team report that

we have shown for the first time that large and disease-specific changes in circulating neurosteroid levels are associated with chronic headache disorders, raising the interesting possibility that fluctuations of neurosteroids at their site of action might shape the natural course of migraine and CH.