Objective: The underpinning biologics of migraine chronification are not well understood. We aim to investigate the role of the cumulative burden of stress, namely the allostatic load, in migraine chronification. Methods: This was a cross-sectional study. The allostatic load was measured with a composite multi-system score (BALI: Bologna Allostatic Load Index), evaluating 20 biomarkers representing four physiological systems: immune, metabolic, cardiovascular, and neuroendocrinological systems. BALI score was subdivided into high score and low score based on the distribution in controls. Migraine patients were included and subclassified into low-frequency episodic migraine group (low-EM group), high-frequency episodic migraine group (high-EM group), and chronic migraine group (CM group). Results: The distribution of BALI high-score increased in parallel with headache attacks monthly frequency: 16% in low-EM group (n = 10), 24% in high-EM group (n = 12), and 40% in CM group (n = 21) (p = 0.017). In a multivariable analysis, the odds ratio of having a high-score BALI in CM patients (vs. low-EM patients) was 2.78 (95% CI 1.07–7.22; p = 0.036). Individual BALI biomarkers values which were significantly different among migraine subgroups included systolic blood pressure (p = 0.018), diastolic blood pressure (p < 0.001), and heart rate (p = 0.019). Conclusion: Our study substantiates this emerging concept of migraine chronification as an allostatic disorder.

Calabro C., Di Tillo E., Pensato U., Zenesini C., Favoni V., Fontana C., et al. (2024). Migraine chronification as an allostatic disorder: a proof-of-concept study. NEUROLOGICAL SCIENCES, n.a., N/A.-N/A. [10.1007/s10072-023-07293-8].

Migraine chronification as an allostatic disorder: a proof-of-concept study

Di Tillo E.;Pensato U.;Zenesini C.;Favoni V.;Fontana C.;Cevoli S.;Tossani E.;Cortelli P.;Grandi S.;Pierangeli G.
2024

Abstract

Objective: The underpinning biologics of migraine chronification are not well understood. We aim to investigate the role of the cumulative burden of stress, namely the allostatic load, in migraine chronification. Methods: This was a cross-sectional study. The allostatic load was measured with a composite multi-system score (BALI: Bologna Allostatic Load Index), evaluating 20 biomarkers representing four physiological systems: immune, metabolic, cardiovascular, and neuroendocrinological systems. BALI score was subdivided into high score and low score based on the distribution in controls. Migraine patients were included and subclassified into low-frequency episodic migraine group (low-EM group), high-frequency episodic migraine group (high-EM group), and chronic migraine group (CM group). Results: The distribution of BALI high-score increased in parallel with headache attacks monthly frequency: 16% in low-EM group (n = 10), 24% in high-EM group (n = 12), and 40% in CM group (n = 21) (p = 0.017). In a multivariable analysis, the odds ratio of having a high-score BALI in CM patients (vs. low-EM patients) was 2.78 (95% CI 1.07–7.22; p = 0.036). Individual BALI biomarkers values which were significantly different among migraine subgroups included systolic blood pressure (p = 0.018), diastolic blood pressure (p < 0.001), and heart rate (p = 0.019). Conclusion: Our study substantiates this emerging concept of migraine chronification as an allostatic disorder.
2024
Calabro C., Di Tillo E., Pensato U., Zenesini C., Favoni V., Fontana C., et al. (2024). Migraine chronification as an allostatic disorder: a proof-of-concept study. NEUROLOGICAL SCIENCES, n.a., N/A.-N/A. [10.1007/s10072-023-07293-8].
Calabro C.; Di Tillo E.; Pensato U.; Zenesini C.; Favoni V.; Fontana C.; Cevoli S.; Tossani E.; Cortelli P.; Grandi S.; Pierangeli G.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11585/955326
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