Calcitonin gene‐related peptide‐induced hemodynamic changes in migraine with and without aura

2021 ◽  
Author(s):  
Matija Zupan ◽  
Marjan Zaletel ◽  
Darja Visočnik ◽  
Bojana Žvan
Keyword(s):  
Calcitonin Gene Related Peptide ◽  
Hemodynamic Changes ◽  
Related Peptide ◽  
Calcitonin Gene

scholarly journals The Influence of Calcitonin Gene-Related Peptide on Cerebral Hemodynamics in Nonmigraine Subjects with Calcitonin Gene-Related Peptide-Induced Headaches

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Matija Zupan ◽  
Marjan Zaletel ◽  
Darja Visočnik ◽  
Bojana Žvan
Keyword(s):  
Healthy Subjects ◽  
Calcitonin Gene Related Peptide ◽  
Carbon Dioxide Partial Pressure ◽  
Hemodynamic Changes ◽  
Time Points ◽  
Related Peptide ◽  
Calcitonin Gene ◽  
End Tidal ◽  
Single Response ◽  
The Relationship

Background. Calcitonin gene-related peptide (CGRP) is regarded as an important molecule in trigeminovascular sensitization (TVS). CGRP-induced headaches (CGRP-IH) are evoked by intravascular administration of CGRP in nonmigraine and migraine subjects. CGRP might be associated with vasodilatation of the middle cerebral artery (MCA). It is unclear whether CGRP-induced hemodynamic changes relate to CGRP-IH in nonmigraine subjects. Methods. Twenty healthy subjects participated in our study. Polymodal recording of mean arterial velocity in MCA (vm MCA), end-tidal carbon dioxide partial pressure (Et-CO2), mean arterial pressure (MAP), and heart rate (HR) was employed using transcranial Doppler (TCD) sonography. During the experiment, we administered intravenous infusion of CGRP at a rate of 1.5 mcg/min. The vm MCA, Et-CO2, HR, and MAP were determined at time points T 0 , T 1 , T 2 , and T 3 . We calculated the responses at different time points and combined them into a single response vm MCAtot, Et-CO2tot, HRtot, and MAPtot. Results. We found significant differences along the time points in vm MCA ( p = < 0.001 ), Et-CO2 ( p = 0.003 ), MAP ( p < 0.001 ), and HR ( p < 0.001 ). The relationship between vm MCAtot and Et-CO2tot was significant and positive ( p = 0.005 ). The t -test showed significant differences between CGRP-IH and non-CGRP-IH subjects in vm MCAtot ( p = 0.021 ) but not in Et-CO2tot ( p = 0.838 ), MAPtot ( p = 0.839 ), and HRtot ( p = 0.198 ). Only vm MCAtot showed a significant relationship with CGRP-IH ( p = 0.028 ). Conclusions. Our study provides evidence for vasodilatation of MCA in relation to CGRP-IH due to intravascular CGRP detected by multimodal TCD. In the context of TVS induced by CGRP, MCA vasodilatation seems to represent an epiphenomenon of the underlying TVS.

Monoklonale Antikörper gegen CGRP oder den CGRP-Rezeptor in der Migräneprophylaxe

2020 ◽  
Vol 39 (07/08) ◽  
pp. 490-494
Author(s):  
Borries Kukowski
Keyword(s):  
Monoklonale Antikörper ◽  
Calcitonin Gene Related Peptide ◽  
Related Peptide ◽  
Calcitonin Gene

ZUSAMMENFASSUNGDie Charakterisierung von calcitonin gene-related peptide (CGRP) als Schlüsselmolekül in der Pathophysiologie der Migräne hat nicht nur unser Verständnis der Erkrankung, sondern auch die Entwicklung neuer Therapien vorangetrieben. Seit kurzem steht mit den monoklonalen Antikörpern gegen CGRP oder den CGRP-Rezeptor eine spezifische und hoch selektive Option für die medikamentöse Prophylaxe der episodischen und chronischen Migräne zur Verfügung, die in zahlreichen klinischen Studien ihre Überlegenheit gegenüber Placebo belegt hat. Hier werden Erfahrungen aus dem praktischen Behandlungsalltag zur kurz- und mittelfristigen Wirksamkeit und Verträglichkeit mitgeteilt und weitere Aspekte wie Therapiewechsel bei Non-Response, Verlauf nach Therapieende und die Frage des Wirkungsortes unter Einbeziehung bereits publizierter Daten angesprochen.

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