An acute reduction of the endocannabinoid-hydrolase fatty acid amide hydrolase (FAAH) is coupled with an improvement of the facilitation of the nociceptive pathways in medication-overuse headache is the total title of a poster presentation by A. Perrotta and colleagues from a series of scientific institutions in Italy.
Medication overuse headache (MOH) is quite a problem for patients. The headaches are terrible and the idea that these hadaches increases if painkillers are ingested is couter-intuitive. Now there are clear indications Palmitoylethanolamide might be a good idea in the substitution of less painkillers and during the period of weaning off painkillers.
The lipid signaling pathway with PEA plays a role in the antinociception by the prevention of nociceptive pathways sensitization which play a role in the development and maintaining of chronic form of migraine, including medication overuse headache, the authors state. They wanted to explore:
(1) a possible relationship between the functional activity of the endogenous lipid signaling system and the facilitation of pain processing in migraine patients with medication-overuse headache (MOH) and
(2) the effect of the withdrawal treatment (WT) on both lipid signaling autocaoid metabolism and pain processing.
They found a significant facilitation in pain processing and a reduction in FAAH activity was found in MOH before withdrawal treatment when compared to controls.
A significant FAAH activity reduction coupled with a significant improvement in facilitation of spinal cord pain processing (increased temporal summation threshold and reduced pain sensation) was found in MOH patients before WT when compared to MOH patients 7 and 60 days after withdrawal treatment.
Their conclusion was: We hypothesized a chronic reduction in lipid signaling system of PEA tone in MOH patients before WT as consequence of an adaptive response induced by chronic pain.
Furthermore, the acute reduction of the FAAH activity coupled with an improvement of the facilitation in pain processing immediately after standard withdrawal treatment and its persistence 60 days after standard withdrawal treatment could represent the consequence of a mechanism devoted to acutely reduce the degradation of endocannabinoids and aimed to increase the activity of the endogenous lipid signaling system which results in an anti-nociceptive effect.
Source: Abstract P23.18 An acute reduction of the endocannabinoid-hydrolase fatty acid amide hydrolase (FAAH) is coupled with an improvement of the facilitation of the nociceptive pathways in medication-overuse headache
A. Perrotta, V. Gasper, N. Arce Lea, E. Bazzin, G. Sances, F. Blandin, C. Tassorell, F. Pierell, G. Sandrini, G. Nappi