Carbon monoxide inhalation induces headache in a human headache model

Nanna Arngrim, Henrik Winther Schytz, Josefine Britze, Mark Bitsch Vestergaard, Mikael Sander, Karsten Skovgaard Olsen, Jes Olesen, Messoud Ashina

6 Citations (Scopus)

Abstract

Introduction Carbon monoxide (CO) is an endogenously produced signalling molecule that has a role in nociceptive processing and cerebral vasodilatation. We hypothesized that inhalation of CO would induce headache and vasodilation of cephalic and extracephalic arteries. Methods In a randomized, double-blind, placebo-controlled crossover design, 12 healthy volunteers were allocated to inhalation of CO (carboxyhemoglobin 22%) or placebo on two separate days. Headache was scored on a verbal rating scale from 0-10. We recorded mean blood velocity in the middle cerebral artery (VMCA) by transcranial Doppler, diameter of the superficial temporal artery (STA) and radial artery (RA) by high-resolution ultrasonography and facial skin blood flow by laser speckle contrast imaging. Results Ten volunteers developed headache after CO compared to six after placebo. The area under the curve for headache (0-12 hours) was increased after CO compared with placebo ( p = 0.021). CO increased VMCA ( p = 0.002) and facial skin blood flow ( p = 0.012), but did not change the diameter of the STA ( p = 0.060) and RA ( p = 0.433). Conclusion In conclusion, the study demonstrated that CO caused mild prolonged headache but no arterial dilatation in healthy volunteers. We suggest this may be caused by a combination of hypoxic and direct cellular effects of CO.

Original languageEnglish
JournalCephalalgia : an international journal of headache
Volume38
Issue number4
Pages (from-to)697-706
Number of pages10
ISSN0333-1024
DOIs
Publication statusPublished - 1 Apr 2018

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