Department of Neurology, University Medical Center Ljubljana, Zaloška Cesta 2, 1000 Ljubljana, Slovenia.
Biomed Res Int. 2021 Apr 24;2021:5540254. doi: 10.1155/2021/5540254. eCollection 2021.
Calcitonin gene-related peptide (CGRP) is regarded as an important molecule in trigeminovascular sensitization (TVS). CGRP-induced headaches (CGRP-IH) are evoked by intravascular administration of CGRP in nonmigraine and migraine subjects. CGRP might be associated with vasodilatation of the middle cerebral artery (MCA). It is unclear whether CGRP-induced hemodynamic changes relate to CGRP-IH in nonmigraine subjects.
Twenty healthy subjects participated in our study. Polymodal recording of mean arterial velocity in MCA (vm MCA), end-tidal carbon dioxide partial pressure (Et-CO), mean arterial pressure (MAP), and heart rate (HR) was employed using transcranial Doppler (TCD) sonography. During the experiment, we administered intravenous infusion of CGRP at a rate of 1.5 mcg/min. The vm MCA, Et-CO, HR, and MAP were determined at time points , , , and . We calculated the responses at different time points and combined them into a single response vm MCA, Et-CO, HR, and MAP.
We found significant differences along the time points in vm MCA ( = <0.001), Et-CO ( = 0.003), MAP ( < 0.001), and HR ( < 0.001). The relationship between vm MCA and Et-CO was significant and positive ( = 0.005). The -test showed significant differences between CGRP-IH and non-CGRP-IH subjects in vm MCA ( = 0.021) but not in Et-CO ( = 0.838), MAP ( = 0.839), and HR ( = 0.198). Only vm MCA showed a significant relationship with CGRP-IH ( = 0.028).
Our study provides evidence for vasodilatation of MCA in relation to CGRP-IH due to intravascular CGRP detected by multimodal TCD. In the context of TVS induced by CGRP, MCA vasodilatation seems to represent an epiphenomenon of the underlying TVS.
降钙素基因相关肽（CGRP）被认为是三叉血管敏化（TVS）的重要分子。在非偏头痛和偏头痛患者中，通过血管内给予 CGRP 可引发 CGRP 诱导的头痛（CGRP-IH）。CGRP 可能与大脑中动脉（MCA）的血管扩张有关。目前尚不清楚 CGRP 诱导的血流动力学变化是否与非偏头痛患者的 CGRP-IH 有关。
20 名健康受试者参加了我们的研究。使用经颅多普勒（TCD）超声对大脑中动脉平均动脉速度（vm MCA）、呼气末二氧化碳分压（Et-CO）、平均动脉压（MAP）和心率（HR）进行多模态记录。在实验过程中，我们以 1.5mcg/min 的速度静脉输注 CGRP。在时间点 、 、 、 时分别测定 vm MCA、Et-CO、HR 和 MAP。我们计算了不同时间点的反应，并将它们组合成一个单一的反应 vm MCA、Et-CO、HR 和 MAP。
我们发现 vm MCA（ = <0.001）、Et-CO（ = 0.003）、MAP（ < 0.001）和 HR（ < 0.001）在时间点上有显著差异。vm MCA 与 Et-CO 之间存在显著正相关（ = 0.005）。t 检验显示，CGRP-IH 组和非 CGRP-IH 组在 vm MCA 方面存在显著差异（ = 0.021），但在 Et-CO（ = 0.838）、MAP（ = 0.839）和 HR（ = 0.198）方面无显著差异。只有 vm MCA 与 CGRP-IH 呈显著相关（ = 0.028）。
我们的研究提供了证据表明，由于血管内 CGRP 引起的多模态 TCD 检测到的 MCA 血管扩张与 CGRP-IH 有关。在 CGRP 诱导的 TVS 背景下，MCA 血管扩张似乎代表了潜在的 TVS 的一种伴随现象。
