Calcitonin gene-related peptide triggers migraine-like attacks in patients with migraine with aura
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- 30 September 2010
- journal article
- research article
- Published by SAGE Publications in Cephalalgia
- Vol. 30 (10), 1179-1186
- https://doi.org/10.1177/0333102410368444
Abstract
Introduction: Calcitonin gene-related peptide (CGRP) is a key molecule in migraine pathogenesis. Intravenous CGRP infusion triggers delayed migraine-like attacks in patients with migraine without aura (MO). In contrast to patients with MO, in prior studies patients with familial hemiplegic migraine (FHM) did not report more migraine-like attacks compared to controls. Whether CGRP triggers migraine in patients with typical (non-hemiplegic) migraine with aura is (MA) unknown. In the present study we examined the migraine inducing effect of CGRP infusion in patients suffering from MA and healthy controls. Methods: Fourteen patients suffering exclusively from migraine with typical aura (MA) and 11 healthy volunteers received a continuous intravenous infusion of 1.5 mu g/min CGRP over 20 minutes. Headache and other migraine symptoms were scored every 10 minutes for one hour and self recorded hourly thereafter and until 13 hours post-infusion. Results: CGRP infusion induced significantly more delayed headaches in MA patients (12 out of 14) than in controls (2 out of 11) (p = 0.001). Furthermore, significantly more MA patients (57%; 8 out of 14) fulfilled criteria for an experimentally induced migraine attack after CGRP than controls (0%; 0 out of 11) (P = 0.003). Four patients (28%) reported aura symptoms after CGRP infusion. Conclusion: CGRP triggered migraine-like attacks without aura in patients suffering exclusively from MA. It also triggered a typical aura in 28% of the patients. These data indicate similar neurobiological pathways responsible for triggering migraine headache in MA and MO patients, and suggest differences between MA/MO and FHM.Keywords
This publication has 45 references indexed in Scilit:
- The role of CGRP in the pathophysiology of migraine and efficacy of CGRP receptor antagonists as acute antimigraine drugsPharmacology & Therapeutics, 2009
- Calcitonin gene-related peptide receptor antagonist olcegepant acts in the spinal trigeminal nucleusBrain, 2009
- Efficacy and tolerability of MK-0974 (telcagepant), a new oral antagonist of calcitonin gene-related peptide receptor, compared with zolmitriptan for acute migraine: a randomised, placebo-controlled, parallel-treatment trialThe Lancet, 2008
- Randomized controlled trial of an oral CGRP receptor antagonist, MK-0974, in acute treatment of migraineNeurology, 2008
- Calcitonin Gene–Related Peptide Receptor Antagonist BIBN 4096 BS for the Acute Treatment of MigraineNew England Journal of Medicine, 2004
- Cgrp May Play A Causative Role in MigraineCephalalgia, 2002
- Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular systemAnnals of Neurology, 1988
- Calcitonin gene-related peptide: functional role in cerebrovascular regulation.Proceedings of the National Academy of Sciences of the United States of America, 1986
- Release of the predicted calcitonin gene-related peptide from cultured rat trigeminal ganglion cellsNature, 1984
- Production of a novel neuropeptide encoded by the calcitonin gene via tissue-specific RNA processingNature, 1983