Sara Bottiroli (Pavia/ IT; Benevento/ IT), Rosaria Greco (Pavia/ IT), Annamaria Zanaboni (Pavia/ IT), Marta Allena (Pavia/ IT), Elena Guaschino (Pavia/ IT), Natascia Ghiotto (Pavia/ IT), Roberto De Icco (Pavia/ IT), Grazia Sances (Pavia/ IT), Cristina Tassorelli (Pavia/ IT)
Abstract text (incl. figure legends and references)
Objectives: The understanding of factors involved in the prognosis of chronic migraine (CM) has become a topic of interest in the current debate. Compelling evidence has suggested a negative prognostic value for psychopathological disorders. Dysfunctions of the endocannabinoid system can underlie several psychiatric disorders. To date, no data is available for CM. Hence, the present study aims to evaluate the association existing between psychopathological disorders and endocannabinoid system in CM.
Method: Thirty-four patients (mean age=44.9±11.9) with CM (operationally defined according to ICHD-III) who failed at least three preventive therapies were enrolled and received full psychological evaluation according to DSM-V criteria for mood, anxiety, and personality disorders. Gene expression of enzymes involved in the synthesis and degradation of endocannabinoids and their receptors (CB1 and CB2) was assessed in peripheral blood mononuclear cells.
Results: Among enrolled patients, 53% (n=18) presented mood disorders (MD), 79% (n=27) anxiety disorders (AD). In addition, 53% (n=18) resulted positive for personality (PD) disorders (Cluster C - predominantly obsessive-compulsive disorder). Interestingly, different associations between these psychopathological disturbances and mRNA levels of cannabinoid receptors were found. Specifically, higher CB1 (2.97 ± 2.05 vs 1.66 ± 1.00, p=.018) and NAPE (2.09 ± 0.62 vs 1.63 ± 0.50, p=.04) receptor gene expression was found in MD when compared to non-MD. A tendency to higher FAAH values was found in AD when compared with non-AD (2.09 ± 0.62 vs 1.63 ± 0.50, p=.04). Finally, lower CB1 gene expression (1.48 ± 0.78 vs 2.52 ± 1.76, p=.027) was detected in PD when compared to non-PD.
Discussion: These preliminary findings provide knowledge regarding the association existing between psychopathological disorders and alterations in the endocannabinoid activity in CM.