Plasma opioid levels in post-traumatic chronic headache and trigeminal neuralgia: maintained response to acupuncture

Six patients affected by post traumatic chronic headache (PTCH), six affected by typical idiopathic trigeminal neuralgia (TN) and 8 healthy volunteers were submitted to Traditional Chinese Acupuncture (TCA). Heparinized blood samples were obtained in basal conditions, and 1, 5, 20 and 60 minutes after withdrawal of the needles. In all plasma samples, ACTH was measured by RIA after glass powder extraction while both βLPH and βEP RIAs were performed after plasma silicic acid extraction and Sephadex G‐75 column chromatography. In PTCH patients, βLPH and βEP plasma levels (pg/ml: M ± SE) increased at the 5th minute (from 72.6 ± 10.9 to 111.6 ± 23.9 and from 22.2 ± 3.9 to 30.4 ± 3.8; p <0.01, respectively), decreasing to basal values at the end of the observation period. The same response was observed in TN patients (βLPH from 51.0 ± 0.91 to 93.8 ± 1.6; EP from 15.0 ± 1.4 to 30.0 ± 3.9); the basal values in this group were slightly lower than those found in PTCH patients. ACTH plasma concentrations were not modified by TCA in either group, while modifications were observed in normal healthy volunteers. In conclusion, both PTCH and TN patients respond to TCA in terms of plasma βLPH and βEP release, in a manner similar to that of healthy controls; this observation can be used to discriminate these patients from primary headache sufferers in whom impaired basal levels and stimulated plasma endorphin levels have been previously demonstrated. Copyright © 1982, Wiley Blackwell. All rights reserved