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CGRP may play a causative role in migraine.
L H Lassen1, P A Haderslev, V B Jacobsen
1Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark. l.h.lassen@dadlnet.dk
Summary
Calcitonin gene-related peptide (CGRP) infusion induced headaches in migraine patients, suggesting CGRP may cause migraines. This study indicates CGRP plays a role in migraine development.
Area of Science:
- Neuroscience
- Pharmacology
- Clinical Neurology
Background:
- Increased calcitonin gene-related peptide (CGRP) levels are observed during migraine attacks.
- The causative role of CGRP in migraine pathophysiology remains unclear.
Purpose of the Study:
- To investigate whether intravenous administration of human alphaCGRP (hαCGRP) can induce headache and migraine in patients with migraine without aura.
Main Methods:
- A double-blind, placebo-controlled, crossover study involving 12 patients with migraine without aura.
- Intravenous infusion of hαCGRP (2 μg/min) or placebo for 20 minutes.
- Headache intensity was assessed using a 0-10 scale.
Main Results:
- hαCGRP infusion resulted in significantly higher median peak headache scores in the first hour compared to placebo (1.0 vs. 0, P < 0.01).
- Headaches occurred in all patients post-hαCGRP infusion versus one patient post-placebo over 11 hours (P = 0.0004).
- Three patients met the International Headache Society criteria for migraine without aura after hαCGRP infusion, but none after placebo.
Conclusions:
- Intravenous administration of hαCGRP triggers headache and migraine symptoms in individuals with migraine.
- Elevated CGRP levels during spontaneous migraine attacks may be a causative factor in migraine development.