Danish Headache Center, Departments of Neurology, Glostrup Hospital, Faculty of Health Sciences, University of Copenhagen, Glostrup, Copenhagen, Denmark.
Headache. 2011 Apr;51(4):544-53. doi: 10.1111/j.1526-4610.2011.01861.x.
Calcitonin gene-related peptide (CGRP) is a key molecule in migraine pathogenesis. Intravenous CGRP triggers migraine-like attacks in patients with migraine with aura and without aura. In contrast, patients with familial hemiplegic migraine (FHM) with known mutations did not report more migraine-like attacks compared to controls. Whether CGRP triggers migraine-like attacks in FHM patients without known mutations is unknown.
In the present study we therefore examined the migraine-inducing effect of CGRP in FHM patients without known mutations and healthy controls.
Eleven patients suffering from FHM without known mutations and 11 controls received an intravenous infusion of 1.5 µg/minute CGRP over 20 minutes. The study design was a balanced and controlled provocation study. Headache and other migraine symptoms were scored for 1 hour and self-recorded hourly thereafter until 13-hour postinfusion.
We found no difference in the incidence of migraine-like attacks between the 2 groups, with 9% (1 of 11) of patients and 0% (0 of 10) of controls reporting migraine-like headache (P = 1.00). CGRP infusion did not induce aura symptoms in any of the participants. There was no difference in the incidence of CGRP-induced delayed headaches between the groups (P = .18).
In contrast to patients suffering from migraine with aura and without aura, CGRP infusion did not induce more migraine-like attacks in FHM patients without known mutations compared to controls. It seems that the majority of FHM patients with and without known mutation display no sensitivity to CGRP signaling compared to common types of migraine.
降钙素基因相关肽（CGRP）是偏头痛发病机制中的关键分子。静脉内 CGRP 可引发有先兆和无先兆偏头痛患者的偏头痛样发作。相比之下，已知突变的家族性偏瘫性偏头痛（FHM）患者与对照组相比，并未报告更多的偏头痛样发作。是否 CGRP 会引发无已知突变的 FHM 患者的偏头痛样发作尚不清楚。
本研究旨在检查无已知突变的 FHM 患者中 CGRP 引发偏头痛样发作的情况。
11 名患有无已知突变的 FHM 患者和 11 名对照者接受了 1.5µg/min 的 CGRP 静脉输注，持续 20 分钟。该研究设计为平衡对照激发研究。在输注后 1 小时内对头痛和其他偏头痛症状进行评分，之后每小时记录一次，直到输注后 13 小时。
我们发现两组之间偏头痛样发作的发生率没有差异，有 9%（11 名患者中的 1 名）的患者和 0%（10 名对照者中的 0 名）报告偏头痛样头痛（P=1.00）。在任何参与者中，CGRP 输注均未引起先兆症状。两组之间 CGRP 诱导的迟发性头痛的发生率无差异（P=0.18）。
与有先兆和无先兆偏头痛患者不同，与对照者相比，无已知突变的 FHM 患者中 CGRP 输注并未引起更多的偏头痛样发作。似乎大多数有和无已知突变的 FHM 患者与常见类型的偏头痛相比，对 CGRP 信号没有敏感性。
