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3D-Neuronavigation In Vivo Through a Patient's Brain During a Spontaneous Migraine Headache
Published on: June 2, 2014
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A nitric oxide donor (nitroglycerin) triggers genuine migraine attacks
L L Thomsen1, C Kruuse, H K Iversen
1Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark.
European Journal of Neurology
|November 29, 2013
Summary
Nitroglycerin, a nitric oxide donor, can trigger typical migraine attacks in susceptible individuals. This study confirms the link between nitric oxide pathway activation and migraine induction, independent of placebo effects.
Area of Science:
- Neurology
- Pharmacology
Background:
- Migraine sufferers exhibit heightened sensitivity to nitric oxide donors like nitroglycerin.
- Recent studies suggest a connection between nitric oxide, arterial dilation, and headache induction.
Purpose of the Study:
- To investigate if nitroglycerin can provoke a typical migraine attack.
- To differentiate nitroglycerin's effects from placebo responses.
- To correlate middle cerebral artery dilation with nitroglycerin-induced migraine.
Main Methods:
- A double-blind, cross-over trial involving 12 migraine patients.
- Infusion of nitroglycerin or placebo.
- Transcranial Doppler to measure middle cerebral artery blood velocity.
- Systematic recording of headache characteristics and symptoms.
Main Results:
- Headache intensity peaked 5.5 hours post-infusion in 8 out of 10 patients, meeting migraine criteria.
- Headaches induced by nitroglycerin were often unilateral, mirroring patients' spontaneous attacks.
- A significant difference in migraine occurrence between nitroglycerin and placebo groups (p < 0.03).
- A strong correlation was observed between headache onset/intensity and middle cerebral artery dilation.
Conclusions:
- Activation of the nitric oxide cyclic guanosine monophosphate (cGMP) pathway can precipitate typical migraine attacks.
- Nitroglycerin serves as a reliable agent for inducing migraine in susceptible individuals.
- The study highlights the role of the nitric oxide pathway in migraine pathophysiology.
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