Abstract
Background Intravenous infusion of 10 pmol/kg/min pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) induces migraine-like attacks in migraine patients without aura (MO). Here, we conducted a pilot study and investigated if lower doses of PACAP38 exert similar migraine-inducing abilities. Methods We randomly allocated six MO patients to receive intravenous infusion of 4, 6, and 8 pmol/kg/min of PACAP38 over 20 minutes in a double-blind, three-way cross-over study. Headache and migraine characteristics were recorded during hospital (0-2 hours) and post-hospital (2-13 hours) phases. Results PACAP38 induced migraine-like attacks in one out of six patients with 4 pmol, two out of six patients with 6 pmol and three out of six patients with 8 pmol ( p = 0.368). All patients reported head pain after 8 pmol/kg/min, whereas five of six participants reported head pain after both 4 and 6 pmol/kg/min. We found no difference between the three doses in the AUC for headache intensity over the 12-hour observation period ( p = 0.142). An exploratory analysis showed a significant difference between 4 pmol and 8 pmol ( p = 0.031). Conclusion A trend of a dose-response relationship between dose of PACAP38 and incidence of migraine was observed. We suggest that 10 pmol/kg/min PACAP38 is the most optimal dose to induce migraine-like attacks.
| Original language | English |
|---|---|
| Journal | Cephalalgia : an international journal of headache |
| Volume | 37 |
| Issue number | 4 |
| Pages (from-to) | 391-395 |
| Number of pages | 5 |
| ISSN | 0333-1024 |
| DOIs | |
| Publication status | Published - 1 Apr 2017 |
Keywords
- Adult
- Cross-Over Studies
- Dose-Response Relationship, Drug
- Double-Blind Method
- Female
- Humans
- Infusions, Intravenous
- Male
- Middle Aged
- Migraine without Aura
- Pilot Projects
- Pituitary Adenylate Cyclase-Activating Polypeptide
- Vasodilator Agents
- Young Adult
- Journal Article
- Randomized Controlled Trial