Involvement of calcitonin gene-related peptide in migraine: regional cerebral blood flow and blood flow velocity in migraine patients

• Published in: Journal of headache and pain 2008-06, Vol.9 (3), p.151-157
• Main Authors: Lassen, L. H., Jacobsen, V. B., Haderslev, P. A., Sperling, B., Iversen, H. K., Olesen, J., Tfelt-Hansen, P.
• Format: Article
• Language: English
• Subjects: Adult; Biological and medical sciences; Blood Flow Velocity - drug effects; Blood Flow Velocity - physiology; Blood Pressure - drug effects; Blood vessels; Brain; Calcitonin Gene-Related Peptide - administration & dosage; Cerebral circulation. Blood-brain barrier. Choroid plexus. Cerebrospinal fluid. Circumventricular organ. Meninges; Cerebrovascular Circulation - drug effects; Cerebrovascular Circulation - physiology; Cross-Over Studies; Double-Blind Method; Female; Fundamental and applied biological sciences. Psychology; Heart Rate - drug effects; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Middle Cerebral Artery - diagnostic imaging; Middle Cerebral Artery - drug effects; Migraine; Migraine Disorders - diagnostic imaging; Migraine Disorders - drug therapy; Migraine Disorders - pathology; Migraine Disorders - physiopathology; Multivariate Analysis; Neurology; Original; Pain Medicine; Pathology; Peptides; Regional Blood Flow - drug effects; Regional Blood Flow - physiology; Time Factors; Tomography, Emission-Computed, Single-Photon - methods; Ultrasonography, Doppler, Transcranial; Vascular diseases and vascular malformations of the nervous system; Vertebrates: nervous system and sense organs
• ISSN: 1129-2369; 1129-2377
• DOI: 10.1007/s10194-008-0036-8

Calcitonin gene-related peptide (CGRP)-containing nerves are closely associated with cranial blood vessels. CGRP is the most potent vasodilator known in isolated cerebral blood vessels. CGRP can induce migraine attacks, and two selective CGRP receptor antagonists are effective in the treatment of migraine attacks. It is therefore important to investigate its mechanism of action in patients with migraine. We here investigate the effects of intravenous human alpha-CGRP (hαCGRP) on intracranial hemodynamics. In a double-blind, cross-over study, the effect of intravenous infusion of hαCGRP (2 μg/min) or placebo for 20 min was studied in 12 patients with migraine without aura outside attacks. Xenon-133 inhalation SPECT-determined regional cerebral blood flow (rCBF) and transcranial Doppler (TCD)-determined blood velocity ( V mean ) in the middle cerebral artery (MCA), as well as the heart rate and blood pressure, were the outcome parameters. No change of rCBF was observed at the end of infusion [1.2% ± 1.7 with hαCGRP, vs. −1.6% ± 3.1 with placebo (mean ± SD)] ( P  = 0.43). V mean in MCA decreased to 13.5% ± 3.6 with hαCGRP versus 0.6% ± 1.8 with placebo ( P