Intravenous Endothelin-1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura
Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Standard
Intravenous Endothelin-1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura. / Hougaard, Anders; Younis, Samaira; Iljazi, Afrim; Sugimoto, Kazutaka; Ayata, Cenk; Ashina, Messoud.
I: Headache, Bind 60, Nr. 4, 2020, s. 724-734.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
Harvard
APA
Vancouver
Author
Bibtex
}
RIS
TY - JOUR
T1 - Intravenous Endothelin-1 Infusion Does Not Induce Aura or Headache in Migraine Patients With Aura
AU - Hougaard, Anders
AU - Younis, Samaira
AU - Iljazi, Afrim
AU - Sugimoto, Kazutaka
AU - Ayata, Cenk
AU - Ashina, Messoud
PY - 2020
Y1 - 2020
N2 - Objective: To investigate whether intravenously infused provokes migraine aura and migraine headache in migraine patients with aura. Background: Migraine with aura has been associated with endothelial dysfunction and increased stroke risk. The initiating mechanism of migraine aura symptoms is not known. Experimental provocation of migraine headache using vasoactive peptides has provided tremendous advances in the understanding of migraine pathophysiology but substances that can induce migraine aura have not been identified. Endothelin-1 (ET-1), an endogenous, potent vasoconstrictor peptide released from the vascular endothelium, has been proposed to trigger migraine aura. This hypothesis is based on reports of increased plasma ET-1 levels early during the migraine attacks and the observation that ET-1 applied to the cortical surface potently induces the cortical spreading depolarization, the underlying electrophysiological phenomenon of migraine aura, in animals. Further, endothelial damage due to, for example, carotid puncture and vascular pathology is known to trigger aura episodes. Methods: We investigated whether intravascular ET-1 would provoke migraine aura in patients. Using a two-way crossover, randomized, placebo-controlled, double-blind design, we infused high-dose (8 ng/kg/minutes for 20 minutes) intravenous ET-1 in patients with migraine with typical aura. The primary end-point was the difference in incidence of migraine aura between ET-1 and placebo. Experiments were carried out at a public tertiary headache center (Danish Headache Center, Rigshospitalet Glostrup, Denmark). Results: Fourteen patients received intravenous ET-1. No patients reported migraine aura symptoms or migraine headache during or up to 24 hours following the ET-1 infusion. Four patients reported mild to moderate headache only on the ET-1 day, 3 patients reported moderate headache on the placebo day, and 1 patient reported mild headache on both days. No serious adverse events occurred during or after infusion. Conclusions: Provocation of migraine aura by procedures or conditions involving vascular irritation is unlikely to be mediated by ET-1.
AB - Objective: To investigate whether intravenously infused provokes migraine aura and migraine headache in migraine patients with aura. Background: Migraine with aura has been associated with endothelial dysfunction and increased stroke risk. The initiating mechanism of migraine aura symptoms is not known. Experimental provocation of migraine headache using vasoactive peptides has provided tremendous advances in the understanding of migraine pathophysiology but substances that can induce migraine aura have not been identified. Endothelin-1 (ET-1), an endogenous, potent vasoconstrictor peptide released from the vascular endothelium, has been proposed to trigger migraine aura. This hypothesis is based on reports of increased plasma ET-1 levels early during the migraine attacks and the observation that ET-1 applied to the cortical surface potently induces the cortical spreading depolarization, the underlying electrophysiological phenomenon of migraine aura, in animals. Further, endothelial damage due to, for example, carotid puncture and vascular pathology is known to trigger aura episodes. Methods: We investigated whether intravascular ET-1 would provoke migraine aura in patients. Using a two-way crossover, randomized, placebo-controlled, double-blind design, we infused high-dose (8 ng/kg/minutes for 20 minutes) intravenous ET-1 in patients with migraine with typical aura. The primary end-point was the difference in incidence of migraine aura between ET-1 and placebo. Experiments were carried out at a public tertiary headache center (Danish Headache Center, Rigshospitalet Glostrup, Denmark). Results: Fourteen patients received intravenous ET-1. No patients reported migraine aura symptoms or migraine headache during or up to 24 hours following the ET-1 infusion. Four patients reported mild to moderate headache only on the ET-1 day, 3 patients reported moderate headache on the placebo day, and 1 patient reported mild headache on both days. No serious adverse events occurred during or after infusion. Conclusions: Provocation of migraine aura by procedures or conditions involving vascular irritation is unlikely to be mediated by ET-1.
KW - endothelium
KW - human
KW - provocation
KW - trigger
KW - vascular
U2 - 10.1111/head.13753
DO - 10.1111/head.13753
M3 - Journal article
C2 - 31994720
AN - SCOPUS:85078785217
VL - 60
SP - 724
EP - 734
JO - Headache
JF - Headache
SN - 0017-8748
IS - 4
ER -
ID: 254464033