Delayed migraine-like headache in healthy volunteers after a combination of acetazolamide and glyceryl trinitrate

D. Daugaard; L. L. Thomsen; H. K. Iversen; Jes Olesen; L. L. Thomsen

Delayed migraine-like headache in healthy volunteers after a combination of acetazolamide and glyceryl trinitrate

D. Daugaard, L. L. Thomsen, H. K. Iversen, Jes Olesen, L. L. Thomsen

Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › peer review

12 Citationer (Scopus)

Abstract

Udgivelsesdato: 2009

Originalsprog	Engelsk
Tidsskrift	Cephalalgia
Vol/bind	29
Udgave nummer	12
Sider (fra-til)	1294-1300
Antal sider	6
ISSN	0333-1024
Status	Udgivet - 2009

Bibliografisk note

JEnglishArticleOlesen, J, Univ Copenhagen, Dept Neurol, Glostrup Hosp, DK-2600 Glostrup, Copenhagen, [email protected] PUBLISHING, INCMALDENCOMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USACEPHALALGIADECDiscipline: Clinical Neurology; Neurosciences517PP

Citationsformater

@article{e5e4268a06734f25abd34c924b5085e5,

title = "Delayed migraine-like headache in healthy volunteers after a combination of acetazolamide and glyceryl trinitrate",

abstract = "Glyceryl trinitrate (GTN) is a pro-drug dissociating nitric oxide throughout the body. It dilates cephalic arteries without increasing cerebral blood flow (CBF). GTN induces headache in healthy volunteers and migraine attacks in migraineurs. Acetazolamide (Az) increases CBF but does not dilate cerebral arteries. The hypothesis tested here was that Az, by dilating cerebral arterioles but not arteries and thereby decreasing pulsatile stretching of the wall of the large arteries and their perivascular sensory nerves, would reduce or prevent the GTN-induced headache We tested this hypothesis in 14 healthy volunteers. In a randomized, double-blind, cross-over study, they were pretreated with Az or placebo followed on both study days by a GTN infusion of 0.5 mu g kg-1 min-1 for 20 min. Headache was scored on a verbal rating scale and a headache diary was kept for 12 h. Mean blood velocity of the middle cerebral artery was measured (transcranial Doppler). Our hypothesis was disproved, as Az did not decrease GTN-induced headache. Unexpectedly but interestingly, GTN combined with Az induced more delayed headache than GTN alone. Furthermore, a migraine-like headache was observed in three volunteers, who did not develop migraine after GTN alone. The fact that a suitable pharmacological intervention may trigger migraine in individuals with no prior migraine may suggest that the ability to develop migraine without aura is a quantitative genetic trait",

author = "D. Daugaard and Thomsen, {L. L.} and Iversen, {H. K.} and Jes Olesen and Thomsen, {L. L.}",

note = "JEnglishArticleOlesen, J, Univ Copenhagen, Dept Neurol, Glostrup Hosp, DK-2600 Glostrup, Copenhagen, [email protected] PUBLISHING, INCMALDENCOMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USACEPHALALGIADECDiscipline: Clinical Neurology; Neurosciences517PP",

year = "2009",

language = "English",

volume = "29",

pages = "1294--1300",

journal = "Cephalalgia",

issn = "0333-1024",

publisher = "SAGE Publications",

number = "12",

}

TY - JOUR

T1 - Delayed migraine-like headache in healthy volunteers after a combination of acetazolamide and glyceryl trinitrate

AU - Daugaard, D.

AU - Thomsen, L. L.

AU - Iversen, H. K.

AU - Olesen, Jes

AU - Thomsen, L. L.

N1 - JEnglishArticleOlesen, J, Univ Copenhagen, Dept Neurol, Glostrup Hosp, DK-2600 Glostrup, Copenhagen, [email protected] PUBLISHING, INCMALDENCOMMERCE PLACE, 350 MAIN ST, MALDEN 02148, MA USACEPHALALGIADECDiscipline: Clinical Neurology; Neurosciences517PP

PY - 2009

Y1 - 2009

N2 - Glyceryl trinitrate (GTN) is a pro-drug dissociating nitric oxide throughout the body. It dilates cephalic arteries without increasing cerebral blood flow (CBF). GTN induces headache in healthy volunteers and migraine attacks in migraineurs. Acetazolamide (Az) increases CBF but does not dilate cerebral arteries. The hypothesis tested here was that Az, by dilating cerebral arterioles but not arteries and thereby decreasing pulsatile stretching of the wall of the large arteries and their perivascular sensory nerves, would reduce or prevent the GTN-induced headache We tested this hypothesis in 14 healthy volunteers. In a randomized, double-blind, cross-over study, they were pretreated with Az or placebo followed on both study days by a GTN infusion of 0.5 mu g kg-1 min-1 for 20 min. Headache was scored on a verbal rating scale and a headache diary was kept for 12 h. Mean blood velocity of the middle cerebral artery was measured (transcranial Doppler). Our hypothesis was disproved, as Az did not decrease GTN-induced headache. Unexpectedly but interestingly, GTN combined with Az induced more delayed headache than GTN alone. Furthermore, a migraine-like headache was observed in three volunteers, who did not develop migraine after GTN alone. The fact that a suitable pharmacological intervention may trigger migraine in individuals with no prior migraine may suggest that the ability to develop migraine without aura is a quantitative genetic trait

AB - Glyceryl trinitrate (GTN) is a pro-drug dissociating nitric oxide throughout the body. It dilates cephalic arteries without increasing cerebral blood flow (CBF). GTN induces headache in healthy volunteers and migraine attacks in migraineurs. Acetazolamide (Az) increases CBF but does not dilate cerebral arteries. The hypothesis tested here was that Az, by dilating cerebral arterioles but not arteries and thereby decreasing pulsatile stretching of the wall of the large arteries and their perivascular sensory nerves, would reduce or prevent the GTN-induced headache We tested this hypothesis in 14 healthy volunteers. In a randomized, double-blind, cross-over study, they were pretreated with Az or placebo followed on both study days by a GTN infusion of 0.5 mu g kg-1 min-1 for 20 min. Headache was scored on a verbal rating scale and a headache diary was kept for 12 h. Mean blood velocity of the middle cerebral artery was measured (transcranial Doppler). Our hypothesis was disproved, as Az did not decrease GTN-induced headache. Unexpectedly but interestingly, GTN combined with Az induced more delayed headache than GTN alone. Furthermore, a migraine-like headache was observed in three volunteers, who did not develop migraine after GTN alone. The fact that a suitable pharmacological intervention may trigger migraine in individuals with no prior migraine may suggest that the ability to develop migraine without aura is a quantitative genetic trait

M3 - Journal article

SN - 0333-1024

VL - 29

SP - 1294

EP - 1300

JO - Cephalalgia

JF - Cephalalgia

IS - 12

ER -