Migraine pain associated with middle cerebral artery dilatation: reversal by sumatriptan
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Migraine pain associated with middle cerebral artery dilatation : reversal by sumatriptan. / Friberg, L; Olesen, J; Iversen, Helle Klingenberg; Sperling, B.
I: Lancet, Bind 338, Nr. 8758, 06.07.1991, s. 13-7.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Migraine pain associated with middle cerebral artery dilatation
T2 - reversal by sumatriptan
AU - Friberg, L
AU - Olesen, J
AU - Iversen, Helle Klingenberg
AU - Sperling, B
PY - 1991/7/6
Y1 - 1991/7/6
N2 - The combination of measurements of regional cerebral blood flow (rCBF) and blood velocity in the middle cerebral arteries (MCA) by transcranial doppler sonography was used to investigate cerebrovascular involvement in migraine. Ten migraine patients with unilateral headache were studied during an attack and when they had been free of attacks for 5 days (non-attack). On both occasions they were given as intravenous infusion of sumatriptan (2 mg), a 5-HT1-like receptor agonist, which relieved the symptoms within 30 min without affecting rCBF. The MCA velocity was normal on both sides on the non-attack day and on the unaffected side during the attack. However, during the attack the MCA velocity on the headache side was significantly lower than that on the non-headache side (45 vs 61 cm/s:mean difference 16.3 [95% confidence interval 10.3-22.3]; p = 0.02). The MCA velocity on the headache side returned to normal after treatment with sumatriptan and recovery. Since rCBF in the MCA supply territory was unaffected, the lower velocity can be explained only by dilatation of the MCA. The mean MCA diameter increase was estimated to be 20%. Thus, headache was associated with intracranial large arterial dilatation on the headache side. Sumatriptan predominantly had effects on the distended artery, which suggests that the 5-HT receptor system has a role in the pathogenesis of migraine.
AB - The combination of measurements of regional cerebral blood flow (rCBF) and blood velocity in the middle cerebral arteries (MCA) by transcranial doppler sonography was used to investigate cerebrovascular involvement in migraine. Ten migraine patients with unilateral headache were studied during an attack and when they had been free of attacks for 5 days (non-attack). On both occasions they were given as intravenous infusion of sumatriptan (2 mg), a 5-HT1-like receptor agonist, which relieved the symptoms within 30 min without affecting rCBF. The MCA velocity was normal on both sides on the non-attack day and on the unaffected side during the attack. However, during the attack the MCA velocity on the headache side was significantly lower than that on the non-headache side (45 vs 61 cm/s:mean difference 16.3 [95% confidence interval 10.3-22.3]; p = 0.02). The MCA velocity on the headache side returned to normal after treatment with sumatriptan and recovery. Since rCBF in the MCA supply territory was unaffected, the lower velocity can be explained only by dilatation of the MCA. The mean MCA diameter increase was estimated to be 20%. Thus, headache was associated with intracranial large arterial dilatation on the headache side. Sumatriptan predominantly had effects on the distended artery, which suggests that the 5-HT receptor system has a role in the pathogenesis of migraine.
KW - Adult
KW - Aged
KW - Blood Flow Velocity
KW - Cerebral Arteries
KW - Cerebrovascular Circulation
KW - Dilatation, Pathologic
KW - Female
KW - Humans
KW - Indoles
KW - Male
KW - Middle Aged
KW - Migraine Disorders
KW - Sulfonamides
KW - Sumatriptan
KW - Vasoconstrictor Agents
M3 - Journal article
C2 - 1676084
VL - 338
SP - 13
EP - 17
JO - The Lancet
JF - The Lancet
SN - 0140-6736
IS - 8758
ER -
ID: 128984686