Facchinetti and colleagues present epidemiological evidence regarding comorbidity between menstrual migraine and premenstrual syndrome, and suggest that premenstural symptoms should be incorporated in the diagnostic criteria for menstrual migraine (1). The crux of the matter, however, should be the concern regarding the nature or biological significance of the common neuroendocrine link of transient and cyclic failure of endogenous opioid activity in both premenstrual syndrome and menstrual migraine patients. Is this a primary event of pathogenetic importance (which would merit inclusion in the definition) or the concomitant side effect of a carefully orchestrated adaptive mechanism?
Claudia Altamura, Ilenia Corbelli, Marina de Tommaso, Cherubino Di Lorenzo, Giorgio Di Lorenzo, Antonio Di Renzo, Massimo Filippi, Tommaso B. Jannini, Roberta Messina, Pasquale Parisi, Vincenzo Parisi, Francesco Pierelli, Innocenzo Rainero, Umberto Raucci, Elisa Rubino, Paola Sarchielli, Linxin Li, Fabrizio Vernieri, Catello Vollono, Gianluca Coppola
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