Finding the cause for chronic headaches in patients living with acromegaly

Severe headache is a symptom of acromegaly, where patients can manifest the whole range of headache disorders, which cannot be relieved by over-the-counter pain relief. Somatostatin analogues has been reported to result in control of the growth hormone excess and some amelioration of CHDs in patients living with acromegaly, but the effectiveness is limited. For example, in one study on 18 patients with acromegaly and CHD, 78% of patients living with acromegaly achieved biochemical control of growth hormone excess but 71% of these patients continued to experience headaches, indicating the headaches are a consequence of systemic alteration(s) caused by the growth hormone excess but not by growth hormone itself. Patients living with acromegaly also experience metabolic changes that are frequently not reversed following resolution of growth hormone excess. Obesity, insulin resistance, dysglycaemia and type 2 diabetes are rife worldwide and are associated with increased incidence and severity of headache disorders, with evidence suggesting that alterations in metabolism may have a role in the frequency and intensity of headaches. The aim of this project is to work on a potential link between metabolism and headaches through mechanistic studies on targets identified in a metabolomics screen on patients living with acromegaly.