BRIEF REPORT
PLASMA TESTOSTERONE LEVELS IN CLUSTER HEADACHE PRELIMINARY RESULTS Lee Kudrow, M.D. Submitted for publication - 8/6/75 Accepted - 10/27/75 SYNOPSIS Plasma testosterone values were obtained by the RIA method from two groups of cluster headache male patients in separate laboratories. In each group testosterone levels were compared between controls and cluster patients in active and remission periods. Significantly lower values were found in active cluster patients when compared to either cluster-remission or controls. The results are preliminary and suggest a possible association of lowered plasma testosterone levels with active cluster period in cluster headache male patients. IN CHILDREN the male to female ratio of migraine is 1:11 but in adults it varies from 1:4 to 1:6.2 It is likely that this changing ratio is due to the introduction of estrogens in adulthood. The role of changes in levels of estrogen in women with migraine has been studied by Somerville.3 An influence of extrinsic estrogen on migraine frequency has also been reported.4 Significant histologic changes in the uterine vasculature in migrainous women associated with alterations in estrogen levels have been found.5 In cluster headache males predominate approximately 6:1.6 The role of testosterone in cluster headache has not been elucidated but the vasomotor changes of estrogen in females are similar to those of testosterone in males.7 These considerations may account for some similarities between migraine and cluster headache and led to the present study. METHODS Two groups of cluster headache males were studied. All had episodic pain and had been observed through at least two cluster and remission periods. The diagnosis of cluster headache was based on criteria of the Ad Hoc Committee for the Study of Headache.8 In Group I there were 9 males, 3 in cluster period and 6 in remission. Their average ages were 43 and 51 respectively (Table 1). Group 2 included 6 males in active cluster and 4 in remission. The mean ages were 41 and 44 respectively (Table 2). Blood samples from each group (1 and 2) were obtained at the same time of the day and analyzed at separate laboratories, designated Lab A and Lab B. Plasma testosterone levels were measured by the radioimmunoassay (RIA) procedure. RESULTS Normal control values for males in Laboratory A range from 310-850 ng/100 ml. (mean 530 ng/100 ml.). The mean plasma testosterone concentration for males in an active cluster was 283 ng/100 ml. compared to 401 ng/100 ml. for those in remission (Table 3). Plasma testosterone levels of Group 2 active cluster males ranged from 380 to 480 ng/100 ml. (mean of 425 ng/100 ml.). The results for cluster males in remission ranged from 440 to 790 ng/100 ml. (mean 675 ng/100 ml.). Normal male values for Lab B are 650 ng/100 ml. (Table 4). The results from both groups are illustrated in Figure 1, Mean testosterone values for active cluster males in Group I
TABLE 1 Plasma Testosterone Values and Ages of Group 1 Males In Active and Remission Stages of Cluster Headache Patient Plasma Testosterone Cluster No. Age (ng /100 ml) Stage 1 43 200 Active 2 53 200(m) Active 3 34 450 Active 4 38 290 Remission 5 59 350 Remission 6 68 400 Remission 7 50 400 Remission 8 52 450 Remission 9 41 520 Remission
(m) = Prophylactic Treatment with Methysergide were significantly lower than the mean level for those in remission (t(7) = -1.896; P
PLASMA TESTOSTERONE LEVELS IN CLUSTER HEADACHE PRELIMINARY RESULTS Lee Kudrow, M.D. Submitted for publication - 8/6/75 Accepted - 10/27/75 SYNOPSIS Plasma testosterone values were obtained by the RIA method from two groups of cluster headache male patients in separate laboratories. In each group testosterone levels were compared between controls and cluster patients in active and remission periods. Significantly lower values were found in active cluster patients when compared to either cluster-remission or controls. The results are preliminary and suggest a possible association of lowered plasma testosterone levels with active cluster period in cluster headache male patients. IN CHILDREN the male to female ratio of migraine is 1:11 but in adults it varies from 1:4 to 1:6.2 It is likely that this changing ratio is due to the introduction of estrogens in adulthood. The role of changes in levels of estrogen in women with migraine has been studied by Somerville.3 An influence of extrinsic estrogen on migraine frequency has also been reported.4 Significant histologic changes in the uterine vasculature in migrainous women associated with alterations in estrogen levels have been found.5 In cluster headache males predominate approximately 6:1.6 The role of testosterone in cluster headache has not been elucidated but the vasomotor changes of estrogen in females are similar to those of testosterone in males.7 These considerations may account for some similarities between migraine and cluster headache and led to the present study. METHODS Two groups of cluster headache males were studied. All had episodic pain and had been observed through at least two cluster and remission periods. The diagnosis of cluster headache was based on criteria of the Ad Hoc Committee for the Study of Headache.8 In Group I there were 9 males, 3 in cluster period and 6 in remission. Their average ages were 43 and 51 respectively (Table 1). Group 2 included 6 males in active cluster and 4 in remission. The mean ages were 41 and 44 respectively (Table 2). Blood samples from each group (1 and 2) were obtained at the same time of the day and analyzed at separate laboratories, designated Lab A and Lab B. Plasma testosterone levels were measured by the radioimmunoassay (RIA) procedure. RESULTS Normal control values for males in Laboratory A range from 310-850 ng/100 ml. (mean 530 ng/100 ml.). The mean plasma testosterone concentration for males in an active cluster was 283 ng/100 ml. compared to 401 ng/100 ml. for those in remission (Table 3). Plasma testosterone levels of Group 2 active cluster males ranged from 380 to 480 ng/100 ml. (mean of 425 ng/100 ml.). The results for cluster males in remission ranged from 440 to 790 ng/100 ml. (mean 675 ng/100 ml.). Normal male values for Lab B are 650 ng/100 ml. (Table 4). The results from both groups are illustrated in Figure 1, Mean testosterone values for active cluster males in Group I
TABLE 1 Plasma Testosterone Values and Ages of Group 1 Males In Active and Remission Stages of Cluster Headache Patient Plasma Testosterone Cluster No. Age (ng /100 ml) Stage 1 43 200 Active 2 53 200(m) Active 3 34 450 Active 4 38 290 Remission 5 59 350 Remission 6 68 400 Remission 7 50 400 Remission 8 52 450 Remission 9 41 520 Remission
(m) = Prophylactic Treatment with Methysergide were significantly lower than the mean level for those in remission (t(7) = -1.896; P
