Calcitonin gene-related peptide triggers migraine-like attacks in patients with migraine with aura.

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 µg/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.

• Authors: Jakob Møller Hansen, Anne Werner Hauge, Jes Olesen, Messoud Ashina
• Journal: Cephalalgia : an international journal of headache (Cephalalgia) Vol. 30 Issue 10 Pg. 1179-86 (Oct 2010) ISSN: 1468-2982 [Electronic] England
• PMID: 20855363 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Calcitonin Gene-Related Peptide

Topics

• Adult
• Area Under Curve
• Calcitonin Gene-Related Peptide (adverse effects, metabolism)
• Female
• Humans
• Male
• Middle Aged
• Migraine with Aura (chemically induced, physiopathology)