BETA-ENDORPHIN IN PLASMA AND MONOCYTES IN JUVENILE HEADACHE

Interictal serum levels of serotonin and plasma and mononuclear cell c oncentrations of ss-endorphin were measured in 20 juvenile patients (1 3 suffering from migraine without aura and 7 from episodic tension-typ e headache) before and after 3 months of L-5-hydroxytryptophan treatme nt (5 mg/kg/day) and compared with a control group of 17 headache-free healthy subjects. While no significant differences in serum serotonin levels emerged between the three groups (migraine 104.6 +/- 26 mu g/L , tension-type headache 90.7 +/- 26.2 mu g/L, controls 96 +/- 32.9 mu g/L), significantly lower plasma and mononuclear cell concentrations o f ss-endorphin were found in both patient groups by comparison with th e healthy controls (ss-endorphin in plasma: migraine sufferers 16.2 +/ - 4.2 pmol/L [P<0.05], tension-type headache subjects 14.5 +/- 1.7 pmo l/L [P<0.001] vs controls 21.3 +/- 4.6 pmol/L and respectively. ss-end orphin in mononuclear cells: migraine sufferers 110.5 +/- 16.4 pmol/10 (6) GB/L [P<0.001], tension-type headache subjects 142.3 +/- 22.7 pmol /10(6) GB/L [P<0.001] vs controls 359.3 +/- 31.6 pmol/10(6) GB/L). No differences emerged between the two clinical forms of headache for the plasma and mononuclear cell concentrations of ss-endorphin. After L-5 -hydroxytryptophan treatment, serum serotonin and both plasma and mono nuclear cell ss-endorphin levels tended to be higher, though not signi ficantly so, than prior to treatment, and the clinical score (frequenc y x intensity of headache attacks) was significantly lower in both hea dache groups than at the baseline. This study supports the theory that opiate analgesic system function is abnormally low in juvenile primar y headache as in adults, and confirms that administering serotoninergi c precursor drugs increases ss-endorphin, even in the peripheral blood , and may favorably affect clinical symptoms.