Migraine pain associated with middle cerebral artery dilatation: reversal by sumatriptan

Friberg, Lars; Sperling, Bjørn; Olesen, Jes; Iversen, Helle K.

doi:10.1016/0140-6736(91)90005-a

Cited by 350 publications

(240 citation statements)

References 23 publications

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“…Consistent with many TCD studies [2][3][4][5][6][7][8][9][10][11][12][13], this study detected no significant change in FV in the MCAs in patients with migraine during the headache phase. The lack of significant FV changes during the headache phase of migraine as explored by TCD has been explained by several theories including the various technical limitations of TCD [16].…”

Section: Discussionsupporting

confidence: 91%

“…These studies were largely limited to velocity measurements from middle cerebral arteries (MCA). The findings of these studies varied, with reports of increased [2,3], decreased [2,[4][5][6][7][8][9][10] or unchanged velocities [11][12][13]. These discordant findings have been attributed to technical limitations of TCD; as only discrete segments of the vessel are insonated, operator dependent measurements, variability of migraine presentation, under sensitivity of limited number of vessels insonated, and limitations of the vascular hypothesis.…”

Section: Introductionmentioning

confidence: 99%

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Transcranial Doppler measurements in migraine and nitroglycerin headache

et al. 2007

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The objective of this study was to examine the cerebral circulation during spontaneous migraine attacks and to compare changes to an experimental headache model induced by nitroglycerin (NTG) infusion. This prospective study was carried out in a tertiary care hospital on migraineurs with or without aura. Healthy volunteers served as controls. There were no interventions. Flow velocity (FV) and pulsatility index (PI) were measured in migraineurs between and during headache attacks. In controls, FV and PI of the middle cerebral arteries were performed at baseline and after each IV infusion of 0.125, 0.25 and 0.5 μg/kg/min of NTG. In migraineurs, a significant increase in the mean flow velocity (MFV) in the left vertebral artery (VA) and the V V PI of the right VA during spontaneous migraine headache was found. In controls, all FV significantly decreased after infusion of NTG. The NTG model produces expected and substantially different f f vascular effects than those seen with f f spontaneous migraine headache.

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Section: Discussionsupporting

confidence: 91%

Section: Introductionmentioning

confidence: 99%

Transcranial Doppler measurements in migraine and nitroglycerin headache

et al. 2007

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“…This is in agreement with a recent transcranial Doppler study that showed that outside of a migraine attack, sumatriptan did not modify the calibre of the middle cerebral artery. However, interestingly, during mi graine, dilation of the middle cerebral artery was found on the headache side only; this was normal ised by sumatriptan without the rCBF being affected (Friberg et al, 1991), probably due to au toregulatory changes further downstream in the cerebrovascular bed. Thus, it is possible that the vasoconstrictor effect of sumatriptan on the large surface arteries of the brain is more apparent under conditions of dilation and inflammation, as has been suggested to occur during migraine (see the intro duction).…”

Section: Discussionmentioning

confidence: 91%

“…. Furthermore, a clinically relevant dose of sumatriptan (2 mg i. v.) caused no change in rCBF in healthy volunteers (Friberg et al, 1991). We therefore investigated whether sumatriptan causes pial artery vasocon striction when administered intravenously to anaes thetised cats; the dose selected (6.…”

Section: Discussionmentioning

confidence: 99%

Effect of Sumatriptan, a Selective 5-HT₁-like Receptor Agonist, on Pial Vessel Diameter in Anaesthetised Cats

Connor

Stubbs

Feniuk

et al. 1992

J Cereb Blood Flow Metab

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Summary: The action of sumatriptan, a selective 5-HT) like receptor agonist that is effective for the acute treat ment of migraine, was compared on pial vessel diameter following perivascular or intravenous administration to anaesthetised cats. Sumatriptan (0.01-10 /J-M), when mi croinjected perivascularly, caused a decrease in pial ar tery diameter (maximum change of -19 ± 9%; mean ± SD) but had no effect on the diameter of pial veins. Suma triptan (l /J-M)-induced pial artery vasoconstriction was unaffected by coadministration of ketanserin (l /J-M) or ondansetron (l /J-M) but was significantly (p < 0.01) at tenuated by methiothepin (l/J-M). Intravenous infusion of a clinically effective dose of sumatriptan (64 /J-g/kg/l0 min) caused selective carotid vasoconstriction (22 ± 6% Sumatriptan (GR43175) is a novel, highly selec tive agonist for the 5-HT1-like receptor, which me diates vasoconstriction of certain blood vessels (Humphrey et aI., 1988). This 5-HT1 receptor sub type was first identified in dog isolated saphenous vein but appears to be largely restricted to intracra nial blood vessels (Humphrey et aI., 1988(Humphrey et aI., , 1990b. Thus, it has been shown that sumatriptan causes contraction of isolated large cerebral arteries from dog, primate, and humans (Connor et aI., 1989; Par sons et aI., 1989) and human isolated dural arteries (Humphrey et aI., 1990b) via activation of 5-HTJlike receptors but has little or no effect on tone in most peripheral isolated vascular preparations (Humphrey et aI., 1988). Similarly, in vivo, suma triptan selectively constricts the carotid vascular bed in anaesthetised dogs (Feniuk et aI., 1989) and cats (Perren et aI., 1989). This selective action of sumatriptan for the cranial vasculature reflects the Received April 15, 1991; final revision received October 10, 1991; accepted December 9, 1991.Address correspondence and reprint requests to Dr. H. E. Connor at Department of Neuropharmacology, Glaxo Group Re search Ltd., Park Road, Ware, Hertfordshire, SGl2 ODP, U. K. 514increase in carotid vascular resistance with little or no change in blood pressure or heart rate) and no change in pial artery diameter, although sumatriptan (l /J-M) admin istered perivascularly in these animals before and after the infusion caused pial artery vasoconstriction. These results demonstrate that perivascularly administered sumatriptan causes pial artery vasoconstriction via acti vation of 5-HTclike receptors. However, intravenously administered sumatriptan does not cause pial artery va soconstriction, which suggests that sumatriptan does not readily penetrate the cerebrovascular intima.

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“…Friberg et al (10) estimated that a mean 20% increase of the diameter of the middle cerebral artery using transcranial Doppler and administration of sublingual NTG resulted in a mean 30%% Ϯ 8% increase in the human coronary artery (11). The mean diameter of the MMA in healthy volunteers was 1.4 mm with an SD of 0.18 (pilot study).…”

Section: Sample Size Calculationsmentioning

confidence: 99%

Magnetic resonance angiography of the human middle meningeal artery: Implications for migraine

Schoonman

Bakker

Schmitz

et al. 2006

Magnetic Resonance Imaging

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Purpose: To describe a novel noninvasive method for studying middle meningeal artery (MMA) diameter changes in vivo in humans. Dilatation of the MMA has been implicated in the pathophysiology of migraine headache, but no direct evidence has been obtained in humans. Materials and Methods:The diameter of the MMA (the extracranial part) was measured in 19 healthy volunteers before and after administration of a vasodilator (nitroglycerin (NTG), 1.2 mg sublingually) known to provoke headache. We used magnetic resonance angiography (MRA) in combination with a 47-mm microscopy coil and a semiautomatic contour detection program. Results:The diameter of the MMA was 1.5 Ϯ 0.26 mm (mean Ϯ SD) before and 1.79 Ϯ 0.30 mm after NTG administration. This increase was 20.1% (95% CI ϭ 12.9 -27.3; P Ͻ 0.001). The mean increase in subjects who developed headache (N ϭ 11) was 0.34 Ϯ 0.19 mm as compared to 0.22 mm Ϯ 0.20 mm in the eight subjects who did not (95% CI for difference ϭ -0.07 to 0.31; P ϭ 0.188). Conclusion:MRA in combination with a 47-mm microscopy coil is a novel, noninvasive method to measure changes in the diameter of human meningeal vessels, with potential applications for migraine and other fields of neurovascular research.

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Migraine pain associated with middle cerebral artery dilatation: reversal by sumatriptan

Cited by 350 publications

References 23 publications

Transcranial Doppler measurements in migraine and nitroglycerin headache

Transcranial Doppler measurements in migraine and nitroglycerin headache

Effect of Sumatriptan, a Selective 5-HT₁-like Receptor Agonist, on Pial Vessel Diameter in Anaesthetised Cats

Magnetic resonance angiography of the human middle meningeal artery: Implications for migraine

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Migraine pain associated with middle cerebral artery dilatation: reversal by sumatriptan

Cited by 350 publications

References 23 publications

Transcranial Doppler measurements in migraine and nitroglycerin headache

Transcranial Doppler measurements in migraine and nitroglycerin headache

Effect of Sumatriptan, a Selective 5-HT1-like Receptor Agonist, on Pial Vessel Diameter in Anaesthetised Cats

Magnetic resonance angiography of the human middle meningeal artery: Implications for migraine

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Product

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Effect of Sumatriptan, a Selective 5-HT₁-like Receptor Agonist, on Pial Vessel Diameter in Anaesthetised Cats