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Current Pain and Headache Reports
Published in: Current Pain and Headache Reports 4/2017

01-04-2017 | Chronic Daily Headache (SJ Wang, Section Editor)

Neuropeptides as a Marker for Chronic Headache

Authors: Nuria Riesco, Eva Cernuda-Morollón, Julio Pascual

Published in: Current Pain and Headache Reports | Issue 4/2017

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Abstract

Purpose of Review

The purpose of this review is to revise current evidence on trigemino-vascular system (TVS) neuropeptides as potential biomarkers for chronic primary headaches, mainly for chronic migraine (CM).

Recent Findings

Within sensory neuropeptides, released by an activated trigeminal nerve, calcitonin gene-related peptide (CGRP) levels seem to be a good biomarker of acute migraine and somewhat sensitive and specific for CM. CGRP, however, is not increased in 20–30% of CM patients, which suggests that CGRP is not the only neuropeptide involved in migraine pain generation and maintenance. Data for other sensory neuropeptides are inconsistent (neurokinin, substance P) or absent (amylin and cholecystokinin-8). Among parasympathetic neuropeptides, vasoactive intestinal polypeptide (VIP) is increased interictally in CM, and in at least some migraine cases ictally, pituitary adenylate cyclase-activating peptide (PACAP) has been shown to be increased ictally in jugular blood, but interictal, peripheral data do not indicate such an increase, and there are no data for other parasympathetic peptides. Finally, S100B, as a potential marker of glial TVS activation, has been studied with inconsistent results in migraine patients.

Summary

Current data on TVS neuropeptides as potential migraine biomarkers must be taken with caution, even for the promising case of CGRP. We do not know with certainty whether increased levels are the reflection of TVS activation, the reliability and homogeneity of the different laboratory tests, or what is the influence on these measurements of the short half-life of many of these peptides or of preventive treatments. One further limitation would be whether the described increases in levels of some neuropeptides such as CGRP are specific for migraine versus other headaches.
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Metadata
Title
Neuropeptides as a Marker for Chronic Headache
Authors
Nuria Riesco
Eva Cernuda-Morollón
Julio Pascual
Publication date
01-04-2017
Publisher
Springer US
Published in
Current Pain and Headache Reports / Issue 4/2017
Print ISSN: 1531-3433
Electronic ISSN: 1534-3081
DOI
https://doi.org/10.1007/s11916-017-0618-8