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Bentivegna E, Luciani M, Scarso F, Bruscia C, Chiappino D, Amore E, Nalli G, Martelletti P. Hormonal therapies in migraine management: current perspectives on patient selection and risk management. Expert Rev Neurother 2021; 21:1347-1355. [PMID: 34739361 DOI: 10.1080/14737175.2021.2003706] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION The link between sex hormones and migraines has long been investigated but the mechanisms underlying this altered interaction are not yet fully understood. Herein, we retrace the knowledge on this association in relationship with risk of stroke. AREAS COVERED Estrogens fluctuations could trigger migraine attacks and exogenous estrogens intake could be a risk factor for venous thromboembolism (VTE) and stroke. At the same time, ischemic heart diseases and stroke share a common substrate with migraine and other mood disorders, depression, and anxiety. EXPERT OPINION The use of hormonal therapies in the context of contraception or replacement therapy must be closely evaluated in a careful risk assessment. We highlight the complex interaction of hormone/neuroinflammation pathways underlying the pathophysiology of migraine glimpsing in mood disorders a possible common denominator of link between hormonal and neuronal systems.
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Affiliation(s)
- Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Michelangelo Luciani
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Francesco Scarso
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Clara Bruscia
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Dario Chiappino
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Emanuele Amore
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Gabriele Nalli
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
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Zeng Y, Chen R, Ma M, Liu B, Xia J, Xu H, Liu Y, Du X, Hu Z, Yang Q, Zhang L. Associations of EDNRA and EDNRB Polymorphisms with Intracerebral Hemorrhage. World Neurosurg 2019; 129:e472-e477. [PMID: 31150867 DOI: 10.1016/j.wneu.2019.05.186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Revised: 05/20/2019] [Accepted: 05/22/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The most potent vasoconstrictor, endothelin-1 and its receptors, endothelin receptor A (EDNRA) and endothelin receptor B (EDNRB) are involved in hypertension. Hypertension is a major risk factor of intracerebral hemorrhage (ICH). Recent studies have demonstrated increased plasma endothelin-1 level in ICH patients and relationships between EDNRA and EDNRB genetic variants and ischemic stroke. The aim of the current study was to investigate whether EDNRA and EDNRB polymorphisms are associated with ICH by interacting with blood pressure levels. METHODS Five EDNRA and EDNRB polymorphisms were genotyped in this case-control study. RESULTS We identified that EDNRA rs5333 T allele might be a protective factor of ICH (adjusted odds ratio [OR] = 0.638, 95% CI: 0.417-0.977, P = 0.038), while EDNRB rs5351 A allele could be a risk factor of ICH (adjusted OR = 1.476, 95% CI: 1.042-2.089, P = 0.028). Moreover, we only found that the GG genotype of EDNRA rs5335 had higher diastolic blood pressure than the GC + CC genotypes in ICH patients (91.69 ± 18.77 vs. 84.71 ± 21.48, P = 0.004). CONCLUSIONS These findings support the important role of EDNRA and EDNRB polymorphisms in ICH, and suggest that they do not interact with blood pressure levels on altering ICH risk.
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Affiliation(s)
- Yi Zeng
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - RuiJuan Chen
- Department of Geriatrics, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - MingMing Ma
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - BaoQiong Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Jian Xia
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - HongWei Xu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - YunHai Liu
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - XiaoPing Du
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - ZhiPing Hu
- Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - QiDong Yang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Le Zhang
- Department of Neurology, Xiangya Hospital, Central South University, Changsha, Hunan, China.
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Tsai CL, Chou CH, Lee PJ, Yin JH, Chen SY, Lin CC, Sung YF, Yang FC, Chung CH, Chien WC, Tsai CK, Lee JT. The potential impact of primary headache disorders on stroke risk. J Headache Pain 2016; 17:108. [PMID: 27905079 PMCID: PMC5130928 DOI: 10.1186/s10194-016-0701-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 11/22/2016] [Indexed: 01/03/2023] Open
Abstract
Background Headache such as migraine is associated with stroke. Studies focused on primary headache disorders (PHDs) as a risk factor for stroke are limited. The purpose of this population-based cohort study was to explore whether patients with PHDs were at a high risk for developing stroke. Methods A total of 1346 patients with PHDs were enrolled and compared with 5384 age-, gender- and co-morbidity-matched control cohorts. International Classification of Diseases, Clinical Modification codes were administered for the definition of PHDs, stroke, and stroke risk factors. Cox proportional-hazards regressions were performed for investigating hazard ratios (HR). Results PHDs patients exhibited a 1.49 times (95% CI :1.15–1.98, p < 0.01) higher risk for developing ischaemic stroke compared with that of control cohorts. Both migraine (HR = 1.22, 95% CI :1.13–1.97, p < 0.05) and tension-type headache (HR = 2.29, 95% CI :1.22–2.80, p < 0.01) were associated with an increased risk of ischemic stroke. Females with PHDs were at greater risk of developing ischaemic stroke (HR = 1.49, 95% CI :1.13–1.90, p < 0.01) than those without PHDs. PHDs patient aged 45 to 64 years displayed significantly higher risk to develop ischaemic stroke (HR = 1.50, 95% CI: 1.11–2.10, p < 0.05) than the matched controls. The impact of PHDs on ischaemic stroke risk became gradually apparent by different following time intervals beyond 2 years after first diagnosis. Conclusion PHDs is suggestive of an incremental risk for ischaemic stroke with gender-dependent, age-specific and time-dependent characteristics. Electronic supplementary material The online version of this article (doi:10.1186/s10194-016-0701-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Chia-Lin Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chung-Hsing Chou
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Pei-Jung Lee
- Departments of Nursing, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Jiu-Haw Yin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China.,Division of Neurology, Department of Medicine, Cheng Hsin General Hospital, Taipei, Taiwan, ROC
| | - Shao-Yuan Chen
- Department of Neurology, Cardinal Tien Hospital, New Taipei City, Taiwan, ROC.,Department of Hyperbaric Medicine, Cardinal Tien Hospital, New Taipei City, Taiwan, ROC.,School of Medicine, Fu-Jen Catholic University, New Taipei City, Taiwan, ROC
| | - Chun-Chieh Lin
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Yueh-Feng Sung
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Fu-Chi Yang
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Chi-Hsiang Chung
- Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan, ROC.,School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Wu-Chien Chien
- School of Public Health, National Defense Medical Center, Taipei, Taiwan, ROC.,Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC
| | - Chia-Kuang Tsai
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China
| | - Jiunn-Tay Lee
- Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No.325, Sec. 2, Cheng-Kung Road, 11490, Taipei, Taiwan, Republic of China. .,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan, ROC.
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