DERANGEMENT OF LH EPISODIC SECRETION IN CLUSTER HEADACHE SUFFERERS

In patients with cluster headache (CH) testosterone plasma levels have been consinstently reported to be lower than in normal males. Thus, we studied LH pulsatile secretory pattern in a group of 29 males suffering from CH. Ten of them were studied longitudinally, while 19 were studied cross-sectionally only during active (n=9) or attack free (n=10) phases. Nine healthy, age-matched males were studied as reference group. All subjects underwent a pulsatility study of 6 hours, sampling every 15 minutes. CH patients resulted to have a lower LH pulsatile release both during active (3.6+/-0.9 peaks/6h, p<0.0001) and attack free (4.1+/-0.9 peaks/6h, p<0.004) phases than normal males (5.2+/-0.6 peaks/6h). When longitudinally studied, CH patients (n=10) showed lower LH secretory episodes during the active than during the attack free phase (3.3+/-0.9 and 4.1+/-0.7 peaks/6h, p<0.05). Testosterone plasma levels did not differ between active and free phases (4.3+/-1 and 4.7+/-0.8 ng/ml, respectively), while, in patients they were significantly lower than in controls (6.8+/-0.9 ng/ml, p<0.01)). These data demonstrate an impaired function of the hypothalamo-pituitary axis possibly due to an overactivity of the opioid neuromodulation.