Evidence for hyperprolactinemia in migraineurs: a systematic review and meta-analysis复制标题

偏头痛患者高催乳素血症的证据: 系统回顾和荟萃分析

Migraine is characterized by recurrent headaches that are often throbbing in sensation and frequently unilateral in location and severe in intensity. From the etiology aspects, it is thought that migraine is a form of neuro-vascular headache, i.e., a disorder in which during an attack, the neural abnormality occurs and results in blood vessel dilation, which, in turn, causes pain induction and brain nociceptive activation. Thus, migraine is best understood as a primary disorder of the brain tissue which is triggered by primary brain biochemical homeostasis instabilities and disturbances and vascular tone changes are known as the secondary event. Although migraine attacks may occur at any age, it is notable that they are frequently appeared in childhood, especially during puberty periods. It affects women more than men as the 1-year migraine prevalence is nearly threefold higher and the cumulative lifetime incidence is more than twofold higher in comparison with men. The most prevalent subtype is migraine without aura, including menstrual migraine in women. Interestingly, migraine is more prevalent in women during reproductive years and it is well known that there is a strong relationship between headache and endocrine homeostasis, particularly in relation to ovarian hormones. It is thought that hormones acting in the hypothalamus-pituitary-ovaries axis are critically important in the pathophysiology of migraine. Of this axis, prolactin is secreted from anterior pituitary gland and synthesized by a variety of immune system cells. Even though there is a plethora of publications describing prolactin blood concentrations from 1970s to 2010s, however, there is not any meta-analysis in the evidence-based medicine field and actually, whether prolactin circulatory concentrations can be altered during migraine pathogenesis is an open question yet. Therefore, investigating prolactin blood levels in migraineurs may pave the way to underpin our understanding about migraine pathophysiology at biochemical levels. In the current report, the prolactin blood levels in the migraine subjects investigated using meta-analysis under random-effects model and SMD as the effect size.

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