Piroxicam-beta-cyclodextrin in induced migraine attacks: a SPECT study with Tc-99m HM-PAO split-dose method

To verify the effect of piroxicam-beta-cyclodextrin (P-B-CD), a novel non-steroidal anti-inflammatory compound, on regional cerebral blood flow (rCBF) during migraine attacks, 7 female patients (mean age: 37.4 years), suffering from migraine without aura, were studied. The patients, after induction of a migraine-like attack with sublingual nitroglycerin (NTG), underwent a rCBF evaluation using Single Photon Emission Computerized Tomography (SPECT) and Tc-99m examethyl-propylene-amino-oxyma split-dose method before and after oral administration of P-B-CD (20 mg). In addition, a spontaneous migraine attack and NTG test in 7 control subjects were investigated. All patients observed relief of pain, evaluated by direct and indirect parameters (Pain Intensity; Pain Intensity Difference; Sum of Pain Intensity Difference). SPECT revealed a uniform and symmetrical distribution of the radiocompound in 5 out of 8 patients, while in the remaining 3 symmetrical parietal or parieto-occipital areas of decreased tracer uptake were detected. In these cases, the intake of P-B-CD cancelled out the cerebral perfusion abnormality.