TY - JOUR
T1 - Calcitonin gene-related peptide causes migraine aura
AU - Al-Khazali, Haidar M
AU - Ashina, Håkan
AU - Wiggers, Astrid
AU - Rose, Kathrine
AU - Iljazi, Afrim
AU - Christensen, Rune Häckert
AU - Schytz, Henrik Winther
AU - Amin, Faisal Mohammad
AU - Ashina, Messoud
N1 - © 2023. Springer-Verlag Italia S.r.l., part of Springer Nature.
PY - 2023/12
Y1 - 2023/12
N2 - BACKGROUND: Although the involvement of calcitonin gene-related peptide (CGRP) in migraines is well-established, its specific role in investigating the aura phase, which often precedes the headache, remains largely unexplored. This study aims to instigate CGRP's potential in triggering aura, thus establishing its role in the early stages of migraine.METHODS: In this open-label, non-randomized, single-arm trial, 34 participants with migraine with aura received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min on a single experimental day. Participants were required to be free of headache and report no use of acute medications 24 h before infusion start. The primary endpoint was the incidence of migraine aura during the 12-hour observational period after the start of infusion.RESULTS: Thirteen (38%) of 34 participants developed migraine aura after CGRP infusion. In addition, 24 (71%) of 34 participants developed migraine headache following CGRP infusion.CONCLUSIONS: Our findings suggest that CGRP could play an important role in the early phases of a migraine attack, including during the aura phase. These insights offer a new perspective on the pathogenesis of migraines with aura. They underscore the need for additional research to further explore the role of CGRP in these initial stages of a migraine attack, and potentially inform future development of therapeutic interventions.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04592952.
AB - BACKGROUND: Although the involvement of calcitonin gene-related peptide (CGRP) in migraines is well-established, its specific role in investigating the aura phase, which often precedes the headache, remains largely unexplored. This study aims to instigate CGRP's potential in triggering aura, thus establishing its role in the early stages of migraine.METHODS: In this open-label, non-randomized, single-arm trial, 34 participants with migraine with aura received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min on a single experimental day. Participants were required to be free of headache and report no use of acute medications 24 h before infusion start. The primary endpoint was the incidence of migraine aura during the 12-hour observational period after the start of infusion.RESULTS: Thirteen (38%) of 34 participants developed migraine aura after CGRP infusion. In addition, 24 (71%) of 34 participants developed migraine headache following CGRP infusion.CONCLUSIONS: Our findings suggest that CGRP could play an important role in the early phases of a migraine attack, including during the aura phase. These insights offer a new perspective on the pathogenesis of migraines with aura. They underscore the need for additional research to further explore the role of CGRP in these initial stages of a migraine attack, and potentially inform future development of therapeutic interventions.TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT04592952.
KW - Cortical spreading depolarization
KW - Headache disorders
KW - Pathophysiology
KW - Trigeminovascular System
UR - http://www.scopus.com/inward/record.url?scp=85170161353&partnerID=8YFLogxK
U2 - 10.1186/s10194-023-01656-4
DO - 10.1186/s10194-023-01656-4
M3 - Journal article
C2 - 37679723
SN - 1129-2369
VL - 24
JO - Journal of Headache and Pain
JF - Journal of Headache and Pain
IS - 1
M1 - 124
ER -