Dilation by CGRP of middle meningeal artery and reversal by sumatriptan in normal volunteers

Asghar, Mohammad Sohail; Hansen, Adam E.; Kapijimpanga, T.; Geest, Rob J. van der; Koning, Patrick van der; Larsson, Henrik; Olesen, Jes; Ashina, Messoud

doi:10.1212/wnl.0b013e3181f9626a

Cited by 137 publications

(147 citation statements)

References 31 publications

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“…Using high-resolution magnetic resonance angiography (MRA) in a study of migraine without aura patients (8), we recently showed that sumatriptan constricted the middle meningeal artery (MMA), but not the middle cerebral artery (MCA), during migraine attacks. In contrast, we have previously reported that sumatriptan constricted both the MMA and the MCA in healthy volunteers (9), but suggested that it mainly constricted the MMA. To further explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the effect of sumatriptan on the following additional arteries: the superficial temporal artery (STA), the extracranial part of the internal carotid artery (ICA extra ), the basilar artery (BA) and the intracranial part of the internal carotid artery (ICA intra ).…”

Section: Introductioncontrasting

confidence: 70%

The effect of sumatriptan on cephalic arteries: A 3T MR-angiography study in healthy volunteers

et al. 2013

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Aim To explore a possible differential effect of sumatriptan on extracerebral versus cerebral arteries, we examined the superficial temporal (STA), middle meningeal (MMA), extracranial internal carotid (ICAextra), intracranial internal carotid (ICAintra), middle cerebral (MCA) and basilar arteries (BA). Methods The arterial circumferences were recorded blindly using high-resolution magnetic resonance angiography before and after subcutaneous sumatriptan injection (6 mg) in 18 healthy volunteers. Results We found significant constrictions of MMA (16.5%), STA (16.4%) and ICAextra (15.2%) ( p ≤ 0.001). Smaller, but statistically significant, constrictions were seen in MCA (5.5%) and BA (2.1%) ( p ≤ 0.012). ICAintra change 1.8% was not significant ( p = 0.179). The constriction of cerebral arteries was significantly smaller than the constriction of extracerebral arteries ( p < 0.000001). Conclusion Sumatriptan constricts extracerebral arteries more than cerebral arteries. We suggest that sumatriptan may exert its anti-migraine action outside of the blood–brain barrier.

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Section: Introductioncontrasting

confidence: 70%

The effect of sumatriptan on cephalic arteries: A 3T MR-angiography study in healthy volunteers

et al. 2013

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“…Finally, from a pathophysiological standpoint it has to be considered that evidence suggests that CGRP does not cross the BBB as its infusion induces a dilatation of the MMA but not of the MCA (104). Therefore, if the BBB remains intact, which might be questioned in spontaneous migraine attacks, can it be evaluated in the experimental setting?…”

Section: Pitfalls Of Measuring Neuropeptide Changesmentioning

confidence: 99%

Pearls and pitfalls in experimental in vivo models of migraine: Dural trigeminovascular nociception

2013

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This review will summarize the history of the development of models of dural trigeminovascular nociception, including intravital microscopy and laser Doppler flowmetry at the level of the vasculature, and electrophysiology and Fos techniques used to observe neuronal activation at the trigeminal nucleus caudalis. It will also describe some of pitfalls of these assays and developments for the future.

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“…1,3,12,14 Because the signal intensity of arteries on MR angiograms obtained by using the TOF method depends on the flow velocities and flow directions, measurement of an MMA diameter on MR angiograms could not reflect the exact diameter of the MMA.…”

Section: Limitationsmentioning

confidence: 99%

“…6,7 Quantitative measurement of MMA diameter with MRA in patients with migraine has also been reported. 1,3,12,14 To the best of our knowledge, no previous study has elucidated alteration of the MMA in patients with CSDHs. Clarification of MMA changes associated with the development of a CSDH may lead to elucidation of the pathogenesis of CSDH and may also ameliorate treatment strategies for refractory CSDH.…”

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confidence: 99%

Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma

Takizawa¹,

Sorimachi²,

Ishizaka³

et al. 2016

JNS

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obJective The middle meningeal artery (MMA) is suspected to play an important role in the development of chronic subdural hematoma (CSDH). The aim of this study was to clarify whether the MMA was enlarged in patients with CSDHs. Methods The authors retrospectively assessed 55 patients in whom CSDH was diagnosed between 2010 and 2014 and who underwent MR angiography (MRA) after the onset of CSDH. The authors compared MMA diameters between hemispheres with and without CSDHs on MR angiograms. A case-control study was also performed with 55 sex- and age-matched patients with incidental unruptured aneurysms as controls. results In 55 patients with CSDHs, the diameters of the 79 MMAs on the CSDH side were significantly larger than the diameters of the 31 MMAs on the non-CSDH side (p < 0.05). In 24 patients with bilateral CSDHs, no significant difference was found between the MMA diameters on the larger hematoma side and those on the smaller hematoma side. In 13 patients who underwent MRA before the onset of the CSDH, the MMAs on MR angiograms acquired after onset of the CSDH were significantly larger than those on MR angiograms acquired before the CSDH onset (p < 0.05). The diameters of the MMAs in 55 patients with CSDHs were significantly larger than those of the MMAs in the 55 control patients (p < 0.05). coNclusioNs The MMA is enlarged with development of a CSDH. Information about the MMA observed on MRA in patients with CSDHs may be useful in developing a strategy for future treatment of CSDHs.

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Dilation by CGRP of middle meningeal artery and reversal by sumatriptan in normal volunteers

Abstract: This study provides Class I evidence that IV GCRP causes dilation of the MMA but not the MCA in healthy volunteers, and that sumatriptan reverses the dilation of the MMA caused by CGRP.

Cited by 137 publications

References 31 publications

The effect of sumatriptan on cephalic arteries: A 3T MR-angiography study in healthy volunteers

The effect of sumatriptan on cephalic arteries: A 3T MR-angiography study in healthy volunteers

Pearls and pitfalls in experimental in vivo models of migraine: Dural trigeminovascular nociception

Enlargement of the middle meningeal artery on MR angiography in chronic subdural hematoma

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