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A pathophysiological view of primary headaches.

L Edvinsson1

  • 1Department of Internal Medicine, University Hospital, S-221 85 Lund, Sweden.

Functional Neurology
|February 24, 2001
PubMed
Summary

Primary headaches involve neurotransmitter release, particularly calcitonin gene-related peptide (CGRP) and vasoactive intestinal peptide (VIP). Sumatriptan treatment normalized neuropeptide levels and reduced head pain, indicating sensory and parasympathetic involvement.

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Area of Science:

  • Neuroscience
  • Cerebrovascular Research
  • Pain Management

Background:

  • Cerebral circulation is innervated by sympathetic, parasympathetic, and sensory nerves.
  • Neurotransmitters play a role in primary headaches, with a known association between head pain and calcitonin gene-related peptide (CGRP).

Purpose of the Study:

  • To evaluate the role of neurotransmitters in primary headaches.
  • To investigate the association between specific neuropeptides and headache symptoms, including facial autonomic features.

Main Methods:

  • Assessed neuropeptide release in patients experiencing primary headaches.
  • Monitored changes in neuropeptide levels during sumatriptan treatment for headache relief.

Main Results:

  • Demonstrated a clear association between head pain and the release of calcitonin gene-related peptide (CGRP).
  • Observed release of vasoactive intestinal peptide (VIP) alongside CGRP in cluster and chronic paroxysmal headache, correlating with facial symptoms.
  • Sumatriptan treatment led to the subsidence of head pain and normalization of neuropeptide release.

Conclusions:

  • Sensory and parasympathetic mechanisms are implicated in the pathophysiology of primary headaches.
  • Neuropeptide release, including CGRP and VIP, is a key feature in certain primary headaches.
  • Pharmacological interventions targeting these pathways, like sumatriptan, can effectively manage headache symptoms.

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