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
Reads0
Chats0
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
Citations
More filters
Journal ArticleDOI
Pathophysiology of Migraine: A Disorder of Sensory Processing
Peter J. Goadsby,Philip R. Holland,Margarida Martins-Oliveira,Jan Hoffmann,Christoph J. Schankin,Simon Akerman +5 more
TL;DR: Investment in understanding migraine leaves us at a new dawn, able to transform its impact on a global scale, as well as understand fundamental aspects of human biology.
Journal ArticleDOI
Migraine pathophysiology: Anatomy of the trigeminovascular pathway and associated neurological symptoms, cortical spreading depression, sensitization, and modulation of pain
Rodrigo Noseda,Rami Burstein +1 more
TL;DR: Scientific evidence supports the notion that migraine pathophysiology involves inherited alteration of brain excitability, intracranial arterial dilatation, recurrent activation, and sensitization of the trigeminovascular pathway, and consequential structural and functional changes in genetically susceptible individuals.
Journal ArticleDOI
CGRP as the target of new migraine therapies — successful translation from bench to clinic
Lars Edvinsson,Lars Edvinsson,Kristian Agmund Haanes,Karin Warfvinge,Karin Warfvinge,Diana N. Krause,Diana N. Krause +6 more
TL;DR: Treatments that target calcitonin gene-related peptide (CGRP) and its receptor are proving effective for migraine treatment, and the hypothesis that CGRP has a major role in migraine pathophysiology is strongly supported.
Journal ArticleDOI
The pathophysiology of migraine: implications for clinical management.
TL;DR: The identification of new migraine-associated genes, the visualisation of brain regions that are activated at the earliest stages of a migraine attack, and the recognition of the crucial role for neuropeptides are among the advances that have led to novel targets for migraine therapy.
Journal ArticleDOI
Cortical spreading depression and migraine
Andrew Charles,Serapio M. Baca +1 more
TL;DR: Current concepts of CSD and its potential roles in migraine are summarized, and ongoing studies aimed at a clearer understanding of this fundamental brain phenomenon are addressed.
References
More filters
Journal ArticleDOI
Migraine headache is not associated with cerebral or meningeal vasodilatation--a 3T magnetic resonance angiography study.
Guus G. Schoonman,J. van der Grond,C. Kortmann,R.J. van der Geest,Gisela M. Terwindt,Michel D. Ferrari +5 more
TL;DR: In contrast to widespread belief, migraine attacks are not associated with vasodilatation of cerebral or meningeal blood vessels and future anti-migraine drugs may not require vasoconstrictor action.
Journal ArticleDOI
Arterial responses during migraine headache.
TL;DR: The use of a new, high-resolution ultrasound machine to measure arterial size in 25 migraine patients with unilateral head pain showed that the lumen was wider on the painful than on the non-painful side during a migraine attack, suggesting that cephalic arteries may play a role in migraine pathogenesis.
Journal ArticleDOI
The vascular theory of migraine--a great story wrecked by the facts.
TL;DR: This issue of Brain describes a study with exactly the type of result that lead Wolff to think of migraine as vascular; yet, taken in context, it provides evidence that leads to precisely the opposite conclusion.
Journal ArticleDOI
Sensory innervation of the calvarial bones of the mouse.
TL;DR: Meningeal nerves that infiltrate the periosteum through the calvarial sutures may be positioned to mediate migraine headache triggered by pathophysiology of extracranial tissues, such as muscle tenderness and mild trauma to the skull.
Journal ArticleDOI
Extracranial vascular changes and the source of pain in migraine headache
Peter D. Drummond,James W. Lance +1 more
TL;DR: The extracranial circulation of 66 migrainous patients was assessed during unilateral headache by recording the pulse amplitude of the superficial temporal artery and its main frontal branch, by facial thermography, and by changes in the intensity of headache when temporal or carotid arteries were compressed.
Related Papers (5)
The International Classification of Headache Disorders, 3rd edition (beta version)
Jes Olesen,André Bes,Robert S. Kunkel,James W. Lance,Giuseppe Nappi,V Pfaffenrath,Frank Clifford Rose,Bruce S. Schoenberg,D. Soyka,Peer Tfelt-Hansen,K. Michael A. Welch,Marica Wilkinson,Marie-Germaine Bousser,Hans-Christoph Diener,David W. Dodick,Michael First,Peter J. Goadsby,Hartmut Göbel,Miguel J. A. Láinez,Richard B. Lipton,Fumihiko Sakai,Jean Schoenen,Stephen D. Silberstein,Timothy J. Steiner,Lars Bendtsen,Anne Ducros,Stefan Evers,Andrew D. Hershey,Zaza Katsarava,Morris Levin,Julio Pascual,Michael Bjørn Russell,Todd J. Schwedt,Cristina Tassorelli,Gisela M. Terwindt,Maurice Vincent,Shuu Jiun Wang,Andrew Charles,R. Lipton,Hayrunnisa Bolay,Michel Lantéri-Minet,E. A. Macgregor,T. Takeshima,Henrik Winther Schytz,S. Ashina,M. T. Goicochea,K. Hirata,Kenneth A. Holroyd,Christian Lampl,Dimos-Dimitrios Mitsikostas,P. Goadsby,C. Boes,C. Bordini,E. Cittadini,Andrew I. Cohen,M. Leone,A. May,L. Newman,J. Pareja,J. W. Park,T. Rozen,E. Waldenlind,Jong Ling Fuh,Aynur Özge,J. A. Pareja,Mario Fernando Prieto Peres,William B. Young,S. Y. Yu,Ishaq Abu-Arafeh,J. Gladstone,S. J. Huang,Rigmor Jensen,J.M. Láinez,D. Obelieniene,Peter S. Sandor,A. I. Scher,Marcel Arnold,Martin Dichgans,E. Houdart,José M. Ferro,Elizabeth Leroux,Y. S. Li,Aneesh B. Singhal,Gretchen E. Tietjen,Deborah I. Friedman,S. Kirby,B. Mokri,A. Purdy,K. Ravishankar,W. Schievink,R. Stark,F. Taylor,A. V. Krymchantowski,A. Tugrul,N. J. Wiendels,E. Marchioni,V. V. Osipova,Lidia Savi,J. R. Berger,Marcelo E. Bigal,J. González Menacho,Federico Mainardi,J. Pereira-Monteiro,M. Serrano-Dueñas,Roger Cady,C. Fernandez de las Peñas,Vincenzo Guidetti,J. Lance,Peter Svensson,Elizabeth Loder,A. E. Lake,Françoise Radat,J. I. Escobar,R. Benoliel,Claudia Sommer,A. Woda,Joanna M Zakrzewska,V. Aggarwal,L. Bonamico,Dominik A Ettlin,S. Graff-Radford,Jean-Paul Goulet,S. Jääskeläinen,Volker Limmroth,Ambra Michelotti,Donald R. Nixdorf,Mark Obermann,Richard Ohrbach,Paul Pionchon,Tara Renton,S. De Siqueira,Çiçek Wöber-Bingöl +131 more