Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine
Background: In migraine, high rate repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective, and β endorphin (BE) may have a role in headache relief. Objective: To report the role of BE and its μ (MOR) and δ opioid receptors (DOR) in headache relief following high rate r...
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doaj-365deb9754e64e4cbaeaa0fe0a7204ed2021-03-19T07:09:58ZengElsevierBrain Stimulation1935-861X2017-05-01103618623Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraineUsha Kant Misra0Jayantee Kalita1Gyanesh Tripathi2Sanjeev Kumar Bhoi3Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, IndiaCorresponding author. Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Raebareily Road, Lucknow 226014, India.; Department of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, IndiaDepartment of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, IndiaDepartment of Neurology, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, IndiaBackground: In migraine, high rate repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective, and β endorphin (BE) may have a role in headache relief. Objective: To report the role of BE and its μ (MOR) and δ opioid receptors (DOR) in headache relief following high rate rTMS in migraine. Methods: Ninety-three migraine patients having more than 4 attacks per month were included. 10 Hz rTMS (600 pulses in 10 trains) was delivered to left motor cortex; 3 sessions to 24 (group 1), 1 session to 22 (group II) and sham stimulation to 47 patients (group III). Plasma BE, and MOR and DOR RNA expressions were measured before and third session of rTMS. The improvement in headache frequency and severity was assessed at 1month. Results: Plasma BE level was lower in the migraine patients compared to controls (P = 0.01). Post-stimulation BE level was higher in group I compared to group III (P = 0.02). The responders had higher BE level than non-responders (P = 0.004). Post-stimulation BE level above 4 ng/ml was associated with improvement in headache frequency in 43 (81.1%) patients, whereas only 23 (57.5%) improved if BE was below 4 ng/ml (P = 0.02) irrespective of type of rTMS. Conclusion: 10 Hz rTMS relieves headache by increasing BE level. BE level above 4 ng/ml is critical in headache relief irrespective of type of rTMS.http://www.sciencedirect.com/science/article/pii/S1935861X17306137Migraineβ endorphinOpioid receptorsMigraine prophylaxisrTMSMagnetic stimulation |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Usha Kant Misra Jayantee Kalita Gyanesh Tripathi Sanjeev Kumar Bhoi |
spellingShingle |
Usha Kant Misra Jayantee Kalita Gyanesh Tripathi Sanjeev Kumar Bhoi Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine Brain Stimulation Migraine β endorphin Opioid receptors Migraine prophylaxis rTMS Magnetic stimulation |
author_facet |
Usha Kant Misra Jayantee Kalita Gyanesh Tripathi Sanjeev Kumar Bhoi |
author_sort |
Usha Kant Misra |
title |
Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine |
title_short |
Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine |
title_full |
Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine |
title_fullStr |
Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine |
title_full_unstemmed |
Role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine |
title_sort |
role of β endorphin in pain relief following high rate repetitive transcranial magnetic stimulation in migraine |
publisher |
Elsevier |
series |
Brain Stimulation |
issn |
1935-861X |
publishDate |
2017-05-01 |
description |
Background: In migraine, high rate repetitive transcranial magnetic stimulation (rTMS) has been reported to be effective, and β endorphin (BE) may have a role in headache relief. Objective: To report the role of BE and its μ (MOR) and δ opioid receptors (DOR) in headache relief following high rate rTMS in migraine. Methods: Ninety-three migraine patients having more than 4 attacks per month were included. 10 Hz rTMS (600 pulses in 10 trains) was delivered to left motor cortex; 3 sessions to 24 (group 1), 1 session to 22 (group II) and sham stimulation to 47 patients (group III). Plasma BE, and MOR and DOR RNA expressions were measured before and third session of rTMS. The improvement in headache frequency and severity was assessed at 1month. Results: Plasma BE level was lower in the migraine patients compared to controls (P = 0.01). Post-stimulation BE level was higher in group I compared to group III (P = 0.02). The responders had higher BE level than non-responders (P = 0.004). Post-stimulation BE level above 4 ng/ml was associated with improvement in headache frequency in 43 (81.1%) patients, whereas only 23 (57.5%) improved if BE was below 4 ng/ml (P = 0.02) irrespective of type of rTMS. Conclusion: 10 Hz rTMS relieves headache by increasing BE level. BE level above 4 ng/ml is critical in headache relief irrespective of type of rTMS. |
topic |
Migraine β endorphin Opioid receptors Migraine prophylaxis rTMS Magnetic stimulation |
url |
http://www.sciencedirect.com/science/article/pii/S1935861X17306137 |
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