Platelet and plasma catecholamine levels in migraine patients: Evidence for a menstrual related variability of the noradrenergic tone

In order to study the possible relationship between migraine, menstrual cycle, and activity of the sympathetic nervous system (SNS), we compared the platelet and plasma catecholamine (CA) levels of subjects suffering from migraine without aura, including a sub-group of women with exclusively menstrual migraine, with those of a group of healthy volunteers. All the women were studied in both the follicular and the luteal phase of their menstrual cycle. Both controls and non-menstrual migraineurs showed a marked luteal increase in platelet noradrenaline. This increase was absent in menstrual migraineurs, who also showed a decrease in platelet adrenaline in the luteal phase. Plasma CA levels followed the same trend, although the differences were not as marked as for platelet CA. As it is known that sex hormones are capable of influencing either SNS activity or platelet function, this finding may indicate a differential responsiveness of SNS or platelet (or both) to the menstrual-related hormonal changes in women with pure menstrual migraine. Such dysfunction, together with other neuroendocrine changes (i.e. failure of premenstrual opioid tonus), may determine the peculiar premenstrual vulnerability to migraine attacks and may contribute to elucidate the pathogenesis of this particular type of migraine.