Key result
Active cluster periods were associated with higher 24-hour mean and maximal cortisol levels, delayed cortisol minimum, and lower nocturnal melatonin maximum compared to remission.
Why the study?
Are the 24-hour rhythms of serum cortisol and melatonin altered in patients with cluster headache during active periods compared to remission and healthy controls?
Observational
Are the 24-hour rhythms of serum cortisol and melatonin altered in patients with cluster headache during active periods compared to remission and healthy controls?
Cortisol and melatonin circadian rhythms are altered during active cluster headache periods, potentially reflecting an adaptive response to pain and a change in vegetative tone.
Does not support practice changes in cluster headache; leaves open causal role of circadian alterations for targeted interventions.
The cyclic nature of cluster headache warranted a study of the 24-hour rhythms of serum cortisol and melatonin. They were both altered during cluster periods as compared with periods of remission and healthy controls. The 24-hour mean and maximal cortisol levels were higher and the timing of the cortisol minimum was delayed as compared to the same patients in remission. Although there was no relation between the cortisol and melatonin levels and headaches, the rise of cortisol following many attacks might in part represent an adaptive response to pain. The nocturnal melatonin maximum was lower during cluster periods than in remission. This finding, and the dysautonomic signs during attacks, may reflect a change of the vegetative tone in a hyposympathetic direction.
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Waldenlind et al. (1987) conducted an observational in Cluster headache. Active cluster periods vs. Periods of remission and healthy controls was evaluated on 24-hour rhythms of serum cortisol and melatonin. Active cluster periods were associated with higher 24-hour mean and maximal cortisol levels, delayed cortisol minimum, and lower nocturnal melatonin maximum compared to remission.
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