Studies from University of Copenhagen provide new data on headache and migraine

   "Therefore, we tested the hypothesis that ATP1A2 mutations in patients with FHM-2 are associated with hypersensitivity to NO-cGMP pathway. Eight FHM-2 patients with R202Q, R763C, V138A and L764P mutations and nine healthy controls received intravenous infusions of 0.5 mu g kg(-1) min(-1) glyceryl trinitrate (GTN) over 20 min. We recorded the following variables: headache intensity on a verbal rating scale; mean flow velocity in the middle cerebral artery (V-meanMCA) by transcranial Doppler; diameter of the superficial temporal artery (STA) by ultrasound. The primary end-points were differences in incidence of migraine headache and area under the curve (AUC) for headache score during an immediate phase (0-120 min) and a delayed phase (2-14 h) after start of infusion. We found no difference in the incidence of reported migraine between FHM-2 patients, 25% (two out of eight), and controls, 0% (0 out of nine) (95% confidence interval -0.06, 0.56) (P = 0.21). The AUC(headache) in the immediate (P = 0.37) and delayed (P = 0.09) phase was not different between patients and controls. The GTN infusion resulted in a biphasic response in patients. During the immediate phase, the median peak headache occurred at 30 min and tended to be higher in patients, 1 (0, 3.8), than in controls, 0 (0, 1) (P = 0.056). During the delayed phase, the median peak headache occurred 4 h after the start of the infusion and was significantly higher in patients, 2.5 (0, 3), than in controls, 0 (0, 0) (P = 0.046). We found no difference in the AUC(VmeanMCA) (P = 0.77) or AUC(STA) (P = 0.53) between FHM-2 patients and controls. GTN infusion failed to induce more migraine in FHM-2 patients than in controls," wrote J.M. Hansen and colleagues, University of Copenhagen.

   The researchers concluded: "The pathophysiological pathways underlying migraine headache in FHM-2 may be different from the common types of migraine."

   Hansen and colleagues published their study in Cephalalgia (Familial hemiplegic migraine type 2 does not share hypersensitivity to nitric oxide with common types of migraine. Cephalalgia, 2008;28(4):367-375).

   Additional information can be obtained by contacting J.M. Hansen, University of Copenhagen, Glostrup Hospital, Faculty Health Science, Danish Headache Center, Dept. of Neurology, Nordre Ringvej 57, DK-2600 Glostrup, Denmark.

   The publisher of the journal Cephalalgia can be contacted at: Blackwell Publishing, 9600 Garsington Rd., Oxford OX4 2ZG, Oxon, England.

   Keywords: Denmark, Glostrup, Headache and Migraine, Angiology, Drugs, Headache, Hypersensitivity, Middle Cerebral Artery, Migraine, Migraine Disorder, Neurology, Nitric Oxide, Pharmaceuticals, Physiology, Superficial Temporal Artery, Therapy, Treatment, University of Copenhagen.

   This article was prepared by Pain & Central Nervous System Week editors from staff and other reports. Copyright 2008, Pain & Central Nervous System Week via NewsRx.com.

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