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Licensed Unlicensed Requires Authentication Published by De Gruyter July 1, 2017

Effect of cocoa on endorphin levels and craniofacial muscle sensitivity in healthy individuals

A.H. Simoni, A. Randers, K. Jønsson, S. Arpe, J.N. Poulsen and P. Gazerani



Migraine headache is a recurrent incapacitating neurovascular disorder. A combination of events occurring within the trigeminovascular system has been suggested to underlie migraine pathogenesis, including release of inflammatory neuropeptides with subsequent effects on meningeal vessels and sensory transmission. Increased craniofacial muscle tenderness is also present in patients with migraine and a lower β-endorphin concentration has been observed in these patients. Several external factors have been identified, which can modulate migraine. One such factor is cocoa, though controversies still exist whether this substance exerts pro-algesic or analgesic effects. The present study evaluated effects of pure cocoa on a mechanically-induced headache model in healthy individuals. Serum β-endorphin concentrations were also measured to identify if any changes occurred in response to cocoa consumption.


Healthy volunteers (8 men and 7 women, average age: 22±1.8 years) participated in a crossover study (approval number: N-20160015) consisting of two sessions with consumption of water or cocoa. A mechanical headband (custom-made, Aalborg University) was utilized to induce a moderate headache with pain rated as 4 on a Visual Analogue Scale (VAS0–10). In each session Pressure Pain Threshold (PPT) was measured by a hand held algometer at temporalis muscles and blood samples were collected to assess β-endorphin levels by ELISA. ANOVA analysis and independent two-sample t-tests were performed for comparisons. P < 0.05 was considered as significant.


Consumption of cocoa compared to water did not change the pressure sensitivity in the craniofacial region without mechanical headband. No changes occurred in PPT with the mechanical headband either.Regardless of substance consumption (water/cocoa), endorphin levels remained unchanged.


Findings demonstrated that pure cocoa in the applied concentration and within the timeline of this study did not seem to exert any analgesic or pro-algesic effect on the mechanical sensitivity of craniofacial muscles or β-endorphin levels.

Published Online: 2017-07-01
Published in Print: 2017-07-01

© 2017 Scandinavian Association for the Study of Pain