SALIVARY SUBSTANCE-P, 5-HYDROXYTRYPTAMINE, AND GAMMA-AMINOBUTYRIC-ACID LEVELS IN MIGRAINE AND TENSION-TYPE HEADACHE

Substance P, 5-hydroxytryptamine and gamma-aminobutyric acid levels in saliva were measured in 55 patients with migraine during headache att acks(15 men and 40 women, average age 37.6 years), 36 patients with mi graine in interictal periods (8 men and 28 women, average age 43.9 yea rs), 48 patients with tension-type headache during headache attacks (1 8 men and 30 women, average age 47.3 years), and 25 patients with tens ion-type headache in interictal periods (10 men and 15 women, average age 48.6 years). Forty-three normal healthy volunteers composed the co ntrol group (17 men and 26 women, average age 32.7 years). Substance P levels in saliva were determined using competitive enzyme-linked immu nosorbent assay, and were 26.9 +/- 45.1 pmol/mL in the patients with m igraine during headache attacks, 30.0 +/- 59.7 pmol/mL in the patients with migraine in interictal periods, 243.5 +/- 1137 pmol/mL in the pa tients with tension-type headache during headache attacks, 101.3 +/- 3 64 pmol/mL in the patients with tension-type headache in interictal pe riods, and 21.2 +/- 17.4 pmol/mL in the healthy controls. 5-hydroxytry ptamine levels in saliva were determined using reversed-phase high-per formance liquid chromatography with electrochemical detection, and wer e 895 +/- 1075 ng/mL in the patients with migraine during headache att acks, 758 +/- 1375 ng/mL in the patients with migraine in interictal p eriods, 1646 +/- 1945 ng/mL in the patients with tension-type headache during active headache periods, 1167 +/- 1495 ng/mL in the patients w ith tension-type in headache-free periods, and 450 +/- 405 ng/mL in th e healthy controls. Gamma-aminobutyric acid levels in saliva were dete rmined using high-performance liquid chromatography with precolumn ort ho-phthalaldehyde fluorescence detection. Gamma-aminobutyric acid leve ls in saliva were 36.8 +/- 49.8 pmol/mL in the patients with migraine during headache attacks, 17.9 +/- 25.2 pmol/mL in the patients with mi graine in interictal periods, 16.0 +/- 18.3 pmol/mL in the patients wi th tension-type headache during active headache periods, 14.1 +/- 6.8 pmol/mL in the patients with tension-type headache in headache-free pe riods, and 21.6 +/- 22.7 pmol/mL in the healthy controls. The salivary substance P and 5-hydroxytryptamine levels in the patients with tensi on-type headache during active headache periods were significantly hig her than those in healthy controls. In contrast, we found no significa nt differences between the salivary gamma-aminobutyric acid levels in the patients with tension-type headache and healthy controls. The high levels of salivary substance P and 5-hydroxytryptamine in tension-typ e headache patients during headache periods might reflect release of s ubstance P from the pain sensory system. Saliva could represent a flui d particularly suitable to the study of neuropeptide release under spe cific conditions such as migraine and tension-type headache.