Abstract
In normal subjects or migraine patients, nitrates induce a non-specific early headache caused by vasodilation of intracranial arteries. In migraineurs a delayed headache response to nitrates may have a typical clinical profile of a spontaneous migraine attack. The cerebral vasomotor changes of this delayed response require further study. Isosorbide dinitrate (IDN), an exogenous nitric oxide (NO) donor, was given at a dose of 5 mg sublingually and a bilateral transcranial Doppler device was used to monitor bilateral mean velocity (Vm) changes at the middle cerebral artery (MCA) after IDN administration and until delayed headache occurred. Spontaneous migraine-like headache occurred only in migraine patients during the delayed phase after IDN and was accompanied by a prolonged arterial vasodilation compared to normal subjects. This vasomotor response was more evident on the customary side of the head pain of a spontaneous migraine attack. Our findings suggest a particular vasomotor response to nitrates in migraine patients. This response is associated with the nitrate-induced headache and it is not evident in healthy pain-free controls during the delayed phase after administration of an NO donor. Owing to the short half-life of NO, the neurotransmitter released by IDN, and because of the late onset of headache, we believe the mechanism is unlikely to be vascular in origin, but may have a neurogenic component.
| Original language | English |
|---|---|
| Pages (from-to) | 183-187 |
| Number of pages | 5 |
| Journal | Cephalalgia |
| Volume | 17 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 1997 |
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Keywords
- migraine
- nitrates
- nitric oxide
- transcranial Doppler
ASJC Scopus subject areas
- Clinical Neurology
Cite this
Haemodynamic correlates of early and delayed responses to sublingual administration of isosorbide dinitrate in migraine patients : A transcranial Doppler study. / Bellantonio, P.; Micieli, G.; Buzzi, M. G.; Marcheselli, S.; Castellano, A. E.; Rossi, F.; Nappi, G.
In: Cephalalgia, Vol. 17, No. 3, 1997, p. 183-187.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Haemodynamic correlates of early and delayed responses to sublingual administration of isosorbide dinitrate in migraine patients
T2 - A transcranial Doppler study
AU - Bellantonio, P.
AU - Micieli, G.
AU - Buzzi, M. G.
AU - Marcheselli, S.
AU - Castellano, A. E.
AU - Rossi, F.
AU - Nappi, G.
PY - 1997
Y1 - 1997
N2 - In normal subjects or migraine patients, nitrates induce a non-specific early headache caused by vasodilation of intracranial arteries. In migraineurs a delayed headache response to nitrates may have a typical clinical profile of a spontaneous migraine attack. The cerebral vasomotor changes of this delayed response require further study. Isosorbide dinitrate (IDN), an exogenous nitric oxide (NO) donor, was given at a dose of 5 mg sublingually and a bilateral transcranial Doppler device was used to monitor bilateral mean velocity (Vm) changes at the middle cerebral artery (MCA) after IDN administration and until delayed headache occurred. Spontaneous migraine-like headache occurred only in migraine patients during the delayed phase after IDN and was accompanied by a prolonged arterial vasodilation compared to normal subjects. This vasomotor response was more evident on the customary side of the head pain of a spontaneous migraine attack. Our findings suggest a particular vasomotor response to nitrates in migraine patients. This response is associated with the nitrate-induced headache and it is not evident in healthy pain-free controls during the delayed phase after administration of an NO donor. Owing to the short half-life of NO, the neurotransmitter released by IDN, and because of the late onset of headache, we believe the mechanism is unlikely to be vascular in origin, but may have a neurogenic component.
AB - In normal subjects or migraine patients, nitrates induce a non-specific early headache caused by vasodilation of intracranial arteries. In migraineurs a delayed headache response to nitrates may have a typical clinical profile of a spontaneous migraine attack. The cerebral vasomotor changes of this delayed response require further study. Isosorbide dinitrate (IDN), an exogenous nitric oxide (NO) donor, was given at a dose of 5 mg sublingually and a bilateral transcranial Doppler device was used to monitor bilateral mean velocity (Vm) changes at the middle cerebral artery (MCA) after IDN administration and until delayed headache occurred. Spontaneous migraine-like headache occurred only in migraine patients during the delayed phase after IDN and was accompanied by a prolonged arterial vasodilation compared to normal subjects. This vasomotor response was more evident on the customary side of the head pain of a spontaneous migraine attack. Our findings suggest a particular vasomotor response to nitrates in migraine patients. This response is associated with the nitrate-induced headache and it is not evident in healthy pain-free controls during the delayed phase after administration of an NO donor. Owing to the short half-life of NO, the neurotransmitter released by IDN, and because of the late onset of headache, we believe the mechanism is unlikely to be vascular in origin, but may have a neurogenic component.
KW - migraine
KW - nitrates
KW - nitric oxide
KW - transcranial Doppler
UR - http://www.scopus.com/inward/record.url?scp=0031007510&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0031007510&partnerID=8YFLogxK
U2 - 10.1046/j.1468-2982.1997.1703183.x
DO - 10.1046/j.1468-2982.1997.1703183.x
M3 - Article
C2 - 9170341
AN - SCOPUS:0031007510
VL - 17
SP - 183
EP - 187
JO - Cephalalgia
JF - Cephalalgia
SN - 0333-1024
IS - 3
ER -