Current understanding of pineal gland structure and function in headache

Cephalalgia. 2019 Nov;39(13):1700-1709. doi: 10.1177/0333102419868187. Epub 2019 Aug 1.

Abstract

Purpose: The pineal gland plays an important role in biological rhythms, circadian and circannual variations, which are key aspects in several headache disorders.

Overview: Melatonin, the main pineal secreting hormone, has been extensively studied in primary and secondary headache disorders. Altered melatonin secretion occurs in many headache syndromes. Experimental data show pineal gland and melatonin both interfere in headache animal models, decreasing trigeminal activation. Melatonin has been shown to regulate CGRP and control its release.

Discussion: Melatonin has been used successfully as a treatment for migraine, cluster headaches and other headaches. There is a rationale for including the pineal gland as a relevant brain structure in the mechanisms of headache pathophysiology, and melatonin as a treatment option in primary headache.

Keywords: Pineal gland; headache disorders; melatonin.

Publication types

  • Review

MeSH terms

  • Adult
  • Animals
  • Calcitonin Gene-Related Peptide / physiology
  • Case-Control Studies
  • Child
  • Circadian Rhythm / physiology
  • Clinical Trials as Topic
  • Disease Models, Animal
  • Double-Blind Method
  • Headache / diagnostic imaging
  • Headache / drug therapy
  • Headache / pathology
  • Headache / physiopathology*
  • Humans
  • Melatonin / physiology
  • Melatonin / therapeutic use
  • Oxidation-Reduction
  • Paraventricular Hypothalamic Nucleus / physiopathology
  • Pineal Gland / metabolism
  • Pineal Gland / pathology
  • Pineal Gland / physiopathology*
  • Receptors, Melatonin / agonists
  • Receptors, Melatonin / physiology
  • Serotonin / metabolism
  • Superior Cervical Ganglion / physiopathology

Substances

  • Receptors, Melatonin
  • Serotonin
  • Calcitonin Gene-Related Peptide
  • Melatonin