Journal ArticleDOI
Magnetic resonance angiography of intracranial and extracranial arteries in patients with spontaneous migraine without aura: a cross-sectional study
Faisal Mohammad Amin,Mohammad Sohail Asghar,Anders Hougaard,Adam E. Hansen,Vibeke Andrée Larsen,Patrick J.H. de Koning,Henrik Larsson,Jes Olesen,Messoud Ashina +8 more
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TLDR
Migraine pain was not accompanied by extracranial arterial dilatation, and by only slight intracranial dilated arteries, and future migraine research should focus on the peripheral and central pain pathways rather than simple arterial Dilatation.Abstract:
Summary Background Extracranial arterial dilatation has been hypothesised to be the cause of pain in patients who have migraine without aura. To test that hypothesis, we aimed to measure extracranial and intracranial arteries during attacks of migraine without aura. Methods In this cross-sectional study, we recruited patients aged 18–60 years from the Danish Headache Centre and via announcements on a Danish website. We did magnetic resonance angiography during spontaneous unilateral migraine attacks. Primary endpoints were difference in circumference of extracranial and intracranial arterial segments comparing attack and attack-free days and the pain and the non-pain side. The extracranial arterial segments measured were the external carotid (ECA), the superficial temporal (STA), the middle meningeal (MMA), and the cervical part of the internal carotid (ICA cervical ) arteries. The intracranial arterial segments were the cavernous (ICA cavernous ) and cerebral (ICA cerebral ) parts of the internal carotid, the middle cerebral (MCA), and the basilar (BA) arteries. This study is registered at Clinicaltrials.gov, number NCT01471314. Findings Between Oct 12, 2010, and Feb 8, 2012, we recruited 78 patients, of whom 19 women had a scan during migraine and were included in the final analysis. On migraine compared with non-migraine days, we detected no statistically significant dilatation of the extracranial arteries on the pain side (ECA, mean difference 1·2% [95% CI −5·7 to 8·2] p=0·985, STA 3·6% [–3·7 to 11·0] p=0·532, MMA 1·7% [–1·7 to 5·2] p=0·341, and ICA cervical 2·3% [–0·3 to 4·9] p=0·093); the intracranial arteries were more dilated during attacks (MCA, 13·0% [6·4 to 19·6] p=0·001, ICA cerebral 11·5% [5·6 to 17·3] p=0·0004, and ICA cavernous 11·4% [5·3 to 17·5] p=0·001), except for the BA (1·6% [–2·7 to 5·9] p=0·621). Compared with the non-pain side, during attacks we detected dilatation on the pain side of the intracranial arteries (MCA, mean difference 10·5% [0·7–20·3] p=0·044, ICA cerebral (14·4% [4·6–24·1] p=0·013), and ICA cavernous (9·1% [3·9–14·4] p=0·003) but not of the extracranial arteries (ECA, 2·1% [–3·8 to 9·2] p=0·238, STA, 3·6% [–3·7 to 10·8] p=0·525, MMA, 2·7% [–1·3 to 5·6] p=0·531, and ICA cervical , 5·0% [–0·5 to 10·4] p=0·119). Interpretation Migraine pain was not accompanied by extracranial arterial dilatation, and by only slight intracranial dilatation. Future migraine research should focus on the peripheral and central pain pathways rather than simple arterial dilatation. Funding University of Copenhagen, the Lundbeck Foundation, the Research Foundation of the Capital Region of Denmark, Danish Council for Independent Research-Medical Sciences, and the Novo Nordisk Foundation.read more
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Journal ArticleDOI
Perivascular neurotransmitters: Regulation of cerebral blood flow and role in primary headaches.
Simona Denise Frederiksen,Kristian Agmund Haanes,Karin Warfvinge,Karin Warfvinge,Lars Edvinsson,Lars Edvinsson +5 more
TL;DR: A literature review with particular emphasis on the role of perivascular neurotransmitters supports a role for the vasculature in primary headache disorders.
Journal ArticleDOI
The migraine postdrome.
Pyari Bose,Peter J. Goadsby +1 more
TL;DR: The disability related to migraine is not limited to the headache phase and pans out to include the postdrome phase, which needs to be studied more to improve overall understanding of migraine mechanisms and also treat the concurrent symptoms better.
Journal ArticleDOI
Magnetic resonance imaging in children presenting migraine with aura: Association of hypoperfusion detected by arterial spin labelling and vasospasm on MR angiography findings.
Domitille Cadiot,Romain Longuet,Bertrand Bruneau,Catherine Tréguier,Aline Carsin-Vu,Isabelle Corouge,Constantin Gomes,Maïa Proisy +7 more
TL;DR: ASL and TOF-MRA are two totally non-invasive, easy-to-use MRI sequences for children in emergency settings and hypoperfusion associated with homolateral vasospasm may suggest a diagnosis of migraine with aura.
Journal ArticleDOI
Migraine-provoking substances evoke periorbital allodynia in mice.
Francesco De Logu,Lorenzo Landini,Malvin N. Janal,Simone Li Puma,Francesco De Cesaris,Pierangelo Geppetti,Romina Nassini +6 more
TL;DR: The correspondence between substances that provoke (CGRP; PACAP, histamine, PGE2, PGI2), or do not provoke (VIP and PGF2α), migraine-like attacks in patients and periorbital allodynia in mice suggests that the study of allodynian in mice may provide information on the proalgesic mechanisms of migraine-provoking agents in humans.
Journal ArticleDOI
PACAP receptor pharmacology and agonist bias: analysis in primary neurons and glia from the trigeminal ganglia and transfected cells
TL;DR: This work states that primary cell models that closely resemble the clinically relevant in vivo site of drug action are important translational tools in drug development, but pharmacological studies in these models are generally very limited due to the methodology used.
References
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The International Classification of Headache Disorders: 2nd edition
Journal ArticleDOI
Migraine prevalence, disease burden, and the need for preventive therapy
Richard B. Lipton,Marcelo E. Bigal,Merle L. Diamond,Frederick G. Freitag,Michael L. Reed,Walter F. Stewart +5 more
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Cost of disorders of the brain in Europe 2010
Anders Gustavsson,Mikael Svensson,Frank Jacobi,Christer Allgulander,Jordi Alonso,Ettore Beghi,R. Dodel,Mattias Ekman,Carlo Faravelli,Laura Fratiglioni,Brenda Gannon,David P.H. Jones,Poul Jennum,Albena Jordanova,Linus Jönsson,Korinna Karampampa,Martin Knapp,Martin Knapp,Gisela Kobelt,Tobias Kurth,Roselind Lieb,Mattias Linde,Christina Ljungcrantz,Andreas Maercker,Beatrice Melin,Massimo Moscarelli,Amir Musayev,Fiona Norwood,Martin Preisig,Maura Pugliatti,Juergen Rehm,Luis Salvador-Carulla,Brigitte Schlehofer,Roland Simon,Hans-Christoph Steinhausen,Lars Jacob Stovner,Jean-Michel Vallat,Peter Van den Bergh,Jim van Os,Jim van Os,Pieter E. Vos,Weili Xu,Hans-Ulrich Wittchen,Bengt Jönsson,Jes Olesen +44 more
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The economic cost of brain disorders in Europe
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Journal ArticleDOI
Brain stem activation in spontaneous human migraine attacks.
Cornelius Weiller,Arne May,V. Limmroth,M Jüptner,H Kaube,R V Schayck,H H Coenen,Hans-Christoph Diener +7 more
TL;DR: Findings support the idea that the pathogenesis of migraine is related to an imbalance in activity between brain stem nuclei regulating antinociception and vascular control.
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