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Neuropeptides in migraine and cluster headache
1Department of Internal Medicine, University Hospital, Lund, Sweden.
Cephalalgia : an International Journal of Headache
|October 1, 1994
Summary
Neuropeptide Y (NPY) and noradrenaline constrict cerebral blood vessels, while vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) dilate them. These peptides are implicated in migraine and cluster headache.
Area of Science:
- Neuroscience
- Vascular Biology
- Pharmacology
Background:
- Cerebral circulation is innervated by sympathetic nerve fibers.
- Neuropeptide Y (NPY) and noradrenaline cause vasoconstriction.
- Vasoactive intestinal peptide (VIP), substance P (SP), and calcitonin gene-related peptide (CGRP) are vasodilators.
Purpose of the Study:
- To investigate the role of specific neuropeptides in cerebral circulation.
- To explore the involvement of SP, CGRP, and VIP in headache disorders.
- To examine the effect of sumatriptan on peptide release during headaches.
Main Methods:
- Analysis of neuropeptide and neurotransmitter distribution in cerebral vasculature.
- Stimulation of the trigeminal ganglion in animal models and humans.
- Measurement of peptide levels during spontaneous headache attacks.
- Assessment of sumatriptan's effect on headache and peptide release.
Main Results:
- Sympathetic innervation is rich in NPY and noradrenaline, but sparse in VIP, SP, and CGRP.
- Trigeminal ganglion stimulation releases SP and CGRP.
- CGRP is released during migraine headaches, and CGRP and VIP during cluster headache bouts.
- Sumatriptan treatment reduces headache and associated peptide release.
Conclusions:
- The balance between vasoconstrictive and vasodilative neuropeptides influences cerebral blood flow.
- SP, CGRP, and VIP play a significant role in the pathophysiology of migraine and cluster headaches.
- Sumatriptan effectively manages headaches by modulating the release of these vasoactive peptides.