%0 Journal Article
%T Migraine chronification as an allostatic disorder: a proof-of-concept study.
%A Calabrò C
%A Di Tillo E
%A Pensato U
%A Zenesini C
%A Favoni V
%A Fontana C
%A Cevoli S
%A Tossani E
%A Cortelli P
%A Grandi S
%A Pierangeli G
%J Neurol Sci
%V 45
%N 6
%D 2024 Jun 23
%M 38261154
%F 3.83
%R 10.1007/s10072-023-07293-8
%X <B>OBJECTIVE: </B>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.<BR><B>METHODS: </B>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).<BR><B>RESULTS: </B>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).<BR><B>CONCLUSIONS: </B>Our study substantiates this emerging concept of migraine chronification as an allostatic disorder.