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Phosphodiesterase 3 inhibitor cilostazol induces migraine-like attacks via cyclic AMP increase

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@article{3e4268b6120049faa4b9ed53eea74198,
title = "Phosphodiesterase 3 inhibitor cilostazol induces migraine-like attacks via cyclic AMP increase",
abstract = "The initiating mechanisms of migraine attacks are very complex but may involve the cyclic AMP signalling pathway. It is unknown whether intracellular cyclic AMP accumulation induces migraine attacks. We investigated whether administration of cilostazol, which causes cyclic AMP accumulation, may induce migraine attacks. We included 14 migraine patients without aura in a double-blind, placebo-controlled crossover study. All participants received oral cilostazol or placebo on two separate days. We recorded migraine headache characteristics, associated symptoms and time of rescue medication intake using a questionnaire. Cilostazol induced delayed migraine-like attacks in 12 patients (86%) compared with two (14%) patients after placebo (P = 0.002). The median time to onset for migraine-like attacks was 6 h (range 3-11 h). Patients reported that the attacks mimicked their usual migraine attacks and that cilostazol-induced attacks responded to their usual migraine treatment. Median time of medication intake was 6 h (range 4-11 h). The present study suggests that intracellular cyclic AMP accumulation plays a crucial role in migraine induction. This knowledge is a further step in our understanding of the intracellular pathway of migraine initiation.",
keywords = "Adult, Cross-Over Studies, Cyclic AMP, Double-Blind Method, Female, Humans, Male, Middle Aged, Migraine without Aura, Phosphodiesterase 3 Inhibitors, Placebos, Tetrazoles, Time Factors, Young Adult",
author = "Song Guo and Jes Olesen and Messoud Ashina",
note = "{\textcopyright} The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.",
year = "2014",
month = nov,
doi = "10.1093/brain/awu244",
language = "English",
volume = "137",
pages = "2951--9",
journal = "Brain",
issn = "0006-8950",
publisher = "Oxford University Press",
number = "Pt 11",

}

RIS

TY - JOUR

T1 - Phosphodiesterase 3 inhibitor cilostazol induces migraine-like attacks via cyclic AMP increase

AU - Guo, Song

AU - Olesen, Jes

AU - Ashina, Messoud

N1 - © The Author (2014). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

PY - 2014/11

Y1 - 2014/11

N2 - The initiating mechanisms of migraine attacks are very complex but may involve the cyclic AMP signalling pathway. It is unknown whether intracellular cyclic AMP accumulation induces migraine attacks. We investigated whether administration of cilostazol, which causes cyclic AMP accumulation, may induce migraine attacks. We included 14 migraine patients without aura in a double-blind, placebo-controlled crossover study. All participants received oral cilostazol or placebo on two separate days. We recorded migraine headache characteristics, associated symptoms and time of rescue medication intake using a questionnaire. Cilostazol induced delayed migraine-like attacks in 12 patients (86%) compared with two (14%) patients after placebo (P = 0.002). The median time to onset for migraine-like attacks was 6 h (range 3-11 h). Patients reported that the attacks mimicked their usual migraine attacks and that cilostazol-induced attacks responded to their usual migraine treatment. Median time of medication intake was 6 h (range 4-11 h). The present study suggests that intracellular cyclic AMP accumulation plays a crucial role in migraine induction. This knowledge is a further step in our understanding of the intracellular pathway of migraine initiation.

AB - The initiating mechanisms of migraine attacks are very complex but may involve the cyclic AMP signalling pathway. It is unknown whether intracellular cyclic AMP accumulation induces migraine attacks. We investigated whether administration of cilostazol, which causes cyclic AMP accumulation, may induce migraine attacks. We included 14 migraine patients without aura in a double-blind, placebo-controlled crossover study. All participants received oral cilostazol or placebo on two separate days. We recorded migraine headache characteristics, associated symptoms and time of rescue medication intake using a questionnaire. Cilostazol induced delayed migraine-like attacks in 12 patients (86%) compared with two (14%) patients after placebo (P = 0.002). The median time to onset for migraine-like attacks was 6 h (range 3-11 h). Patients reported that the attacks mimicked their usual migraine attacks and that cilostazol-induced attacks responded to their usual migraine treatment. Median time of medication intake was 6 h (range 4-11 h). The present study suggests that intracellular cyclic AMP accumulation plays a crucial role in migraine induction. This knowledge is a further step in our understanding of the intracellular pathway of migraine initiation.

KW - Adult

KW - Cross-Over Studies

KW - Cyclic AMP

KW - Double-Blind Method

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Migraine without Aura

KW - Phosphodiesterase 3 Inhibitors

KW - Placebos

KW - Tetrazoles

KW - Time Factors

KW - Young Adult

U2 - 10.1093/brain/awu244

DO - 10.1093/brain/awu244

M3 - Journal article

C2 - 25161294

VL - 137

SP - 2951

EP - 2959

JO - Brain

JF - Brain

SN - 0006-8950

IS - Pt 11

ER -

ID: 45038753