Orexin A in migraine: associations with clinical features of disease and comorbid disorders

Objective. To study possible associations of migraine symptoms and comorbid disorders with serum orexin A. Material and methods. A cross-sectional single-stage study included 68 migraine patients with headache. Clinical and psychological state of patients was assessed. Serum orexin A was determined using enzyme-linked immunosorbent assay. The control group included 19 people. The results were analyzed using the SPSS Statistics software. Results. Migraine patients with abnormal fatigue accompanying paroxysmal headache had lower orexin A compared to other patients (medians 0.070 and 0.210 at p=0.042). Patients with skipped meals and low fluid intake as triggers had higher neuropeptide levels than those without such provocation (median 0.265 vs. 0.185, p=0.029; 0.535 vs. 0.190, p=0.017, respectively). Orexin A was lower in migraine patients with prodromal depressed mood (median 0.172 vs. 0.290 in migraineurs without such a feature, p=0.022). Orexin A was lower in patients with headache-associated abdominal pain (median 0.105 vs. 0.220 in those without such pain, p=0.023). We found an inverse relationship between orexin A concentration and severity of constipation as irritable bowel syndrome (rs=–0.257, p=0.035, N=68). Conclusion. Altered orexin A concentrations may lead to imbalance of orexin-related mechanisms involved in regulation of nociception.