Forskning
Udskriv Udskriv
Switch language
Region Hovedstaden - en del af Københavns Universitetshospital
Udgivet

The effect of propranolol on glyceryltrinitrate-induced headache and arterial response

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Cellular distribution of PACAP-38 and PACAP receptors in the rat brain: Relation to migraine activated regions

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  2. Ictal neck pain investigated in the interictal state - a search for the origin of pain

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Persistent post-traumatic headache attributed to mild traumatic brain injury: Deep phenotyping and treatment patterns

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Letter to the editor regarding proposed new diagnostic criteria for migraine

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  5. Eptinezumab in episodic migraine: A randomized, double-blind, placebo-controlled study (PROMISE-1)

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  1. Letter to the editor regarding proposed new diagnostic criteria for migraine

    Publikation: Bidrag til tidsskriftLetterForskningpeer review

  2. Sumatriptan Does Not Antagonize CGRP-Induced Symptoms in Healthy Volunteers

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  3. Von Frey testing revisited - provision of an online algorithm for improved accuracy of 50% thresholds

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  4. Familial analysis reveals rare risk variants for migraine in regulatory regions

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

  5. Genetic identification of cell types underlying brain complex traits yields insights into the etiology of Parkinson’s disease

    Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Vis graf over relationer
Prophylactic drug trials in migraine are long-lasting and expensive and require long-term toxicology information. A human migraine model would therefore be helpful in testing new drugs. Immediate headache and delayed migraine after glyceryltrinitrate (GTN) has been well characterized. We have recently shown that sodium valproate has prophylactic effect in the GTN model. Here we report our experience with propranolol in this model. Nineteen subjects with migraine without aura and 16 sex- and aged-matched healthy subjects were included in a two-centre randomized double-blind cross-over study. Fourteen migraine subjects and 14 healthy subjects completed the study and results from comparison of the 28 subjects are reported. Randomly propranolol 160 mg or placebo were each given daily for 14 days to both migraine and healthy subjects. A 20-min intravenous infusion of GTN 0.25 microg/kg per min was administered on a study day at the end of both pretreatment periods. Headache was registered for 12 h after GTN infusions. Its intensity was scored on a numerical verbal rating scale from 0 to 10. Fulfilment of International Headache Society (HIS) criteria was recorded for 24 h. Radial and superficial temporal artery diameters and blood velocity of both middle cerebral arteries were measured. All migraine subjects developed headache after GTN. No reduction of overall peak headache was found after propranolol (median 5, range 0-7) compared with placebo (median 5, range 0-10) (P = 0.441). Eight of the 14 completing migraine subject developed IHS 1.1 migraine after GTN, two subjects on both days, three subjects only after placebo, and three subjects only after propranolol. No reduction of GTN-induced migraine was found after propranolol compared with placebo (5 vs. 5, P = 1.000). All healthy subjects developed headache after GTN. No reduction of overall peak headache was found after propranolol (median 2, range 1-5) compared with placebo (median 1, range 1-7) (P = 0.315). Two subjects fulfilled IHS criteria 1.1 for migraine without aura after propranolol but not after placebo. The fulfilment was short lasting and did not require rescue medication. Headache after GTN was more pronounced in migraine subjects than in healthy subjects both with (P = 0.003) and without pretreatment with propranolol (P = 0.017). We found that 2 weeks of propranolol constricted the radial artery in healthy subjects but not in migraine subjects. GTN-induced vasodilatation abolished this difference. Mean maximum blood flow velocity in the middle cerebral artery was higher in healthy subjects than in migraine patients (P = 0.003-0.033) and unaffected by propranolol. We observed no effect of propranolol on GTN-induced headache and migraine. This could indicate that GTN induces migraine at a deeper level of the pathophysiological cascade of migraine than the prophylactic effect of propranolol. Propranolol does not constrict cerebral arteries, which therefore cannot be part of its mechanism of action in migraine.
OriginalsprogEngelsk
TidsskriftCephalalgia
Vol/bind24
Udgave nummer12
Sider (fra-til)1076-87
Antal sider12
ISSN0333-1024
DOI
StatusUdgivet - 1 dec. 2004

ID: 32252555