Headache and prolonged dilatation of the middle meningeal artery by PACAP38 in healthy volunteers

Abstract

PACAP38-induced headache is associated with prolonged dilatation of the MMA but not of the MCA. Sumatriptan relieves headache in parallel with contraction of the MMA but not of the MCA.

Pituitary Adenylate Cyclase-Activating Polypeptide (PACAP) Induces Relaxations of Peripheral and Cerebral Arteries, which are Differentially Impaired by Aging

“…Nevertheless, more studies are necessary to further reveal the vasomotor effects of PACAP in various age groups. It is important to elucidate whether it has protective or deleterious effects, since previous studies assigned clinical significance for PACAP in headache due to prolonged dilation of cerebral arteries to PACAP (Amin et al 2012 ). In contrast, other studies demonstrated increased vascular contractile activity in older age (Ivic et al 2012 ), when relaxations to PACAP was less affected.…”

Role of pituitary adenylate cyclase-activating polypeptide (pacap) in the trigeminovascular system: preclinical and clinical results

“…Our results draw attention to a possible influence between the PACAP and CGRP systems in migraine pathogenesis [125,220,221]. In addition there are evidence that PACAP shares expression and regulation simultaneous with CGRP [27,155,222].…”

“…• An MRI angiographic study has revealed that PACAP-38 infusion-induced headache is related to significant dilatation of middle meningeal arteries (MMAs), in contrast with middle cerebral arteries [155]. A PAC1 receptor antagonist can influence the vasodilating action of PACAP-38 on pressurized MMAs.…”

“…It is evidenced that PACAP induces neurogenic inflammation, mast cell degranulation, neuronal activation and sensitization [27,160]. Participation of PACAP in processes of migraine can be confirmed by administration of serotonin 5-HT1B and 5-HT1D receptor agonist sumatriptan, which attenuates the PACAP-induced MMA vasodilation and headache pain [27,155].…”

Role of VIP/PACAP in primary headaches

“…This group has in addition reported that PACAP-38 results in a related increase in the diameter of cranial arteries (2,3). They propose that PACAP-38 caused vasodilation, which resulted in the headache, providing support for the vascular theory of migraine (4).…”