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Piroxicam-beta-cyclodextrin in induced migraine attacks: a SPECT study with Tc-99m HM-PAO split-dose method
M Trucco1, C Cananzi, P R Salvadori
1Department of Neurology, Santa Corona Hospital, Pietra Ligure, Italy.
Functional Neurology
|September 1, 1994
Summary
Piroxicam-beta-cyclodextrin (P-B-CD) relieved migraine pain and normalized regional cerebral blood flow (rCBF) abnormalities in patients. This non-steroidal anti-inflammatory drug effectively improved brain perfusion during migraine attacks.
Area of Science:
- Neurology
- Pharmacology
- Medical Imaging
Background:
- Migraine attacks are often associated with alterations in regional cerebral blood flow (rCBF).
- Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used for pain relief, but their effects on cerebral hemodynamics during migraine are not fully understood.
Purpose of the Study:
- To investigate the efficacy of piroxicam-beta-cyclodextrin (P-B-CD), a novel NSAID, in alleviating migraine pain.
- To assess the impact of P-B-CD on regional cerebral blood flow (rCBF) during migraine attacks using Single Photon Emission Computerized Tomography (SPECT).
Main Methods:
- A study involving 7 female migraine patients (without aura) who experienced induced migraine-like attacks via sublingual nitroglycerin (NTG).
- rCBF was evaluated using SPECT (Tc-99m examethyl-propylene-amino-oxyma) before and after oral administration of P-B-CD (20 mg).
- Pain intensity was assessed using direct and indirect parameters. Control subjects underwent similar NTG testing.
Main Results:
- All patients reported significant pain relief following P-B-CD administration.
- SPECT imaging showed normalization of previously detected symmetrical parietal or parieto-occipital areas of decreased tracer uptake in 3 patients after P-B-CD intake.
- In 5 out of 8 patients, SPECT revealed a uniform and symmetrical radiocompound distribution, suggesting improved cerebral perfusion.
Conclusions:
- P-B-CD demonstrates effectiveness in relieving migraine pain.
- This novel NSAID can reverse abnormal regional cerebral blood flow patterns observed during migraine attacks, indicating a potential therapeutic benefit beyond pain management.