Faculty of Medicine, University of Münster, Germany.
Akademie für Manuelle Medizin, Münster, Germany.
Cephalalgia. 2021 Oct;41(11-12):1268-1271. doi: 10.1177/03331024211017250. Epub 2021 Jun 20.
Migraine and trigemino-autonomic cephalalgia attacks are associated with an increase of α-calcitonin-gene related peptide levels in the ipsilateral jugular vein. It is however unknown whether trigeminal pain stimulation in healthy subjects without headache disorders also induces increase of calcitonin-gene related peptide levels.
We measured α-calcitonin-gene related peptide levels in eight healthy subjects after subcutaneous injection of capsaicin in the forehead and in the mandibular region and after injection of sodium chloride in the forehead. We observed a significant increase of α-calcitonin-gene related peptide level only after injection of capsaicin in the forehead (i.e. first trigeminal branch). We also observed trigemino-autonomic activation (lacrimation, rhinorrhea etc.) only after injection of capsaicin in the forehead.
Increase of α-calcitonin-gene related peptide levels do not only occur in primary headache attacks but also after experimental trigeminal pain of the first branch. This finding suggests that α-calcitonin-gene related peptide elevation is, at least an additional, unspecific effect of first trigeminal branch stimulation following pain activation and not a specific mechanism of idiopathic headache disorders.
偏头痛和三叉自主神经性头痛发作与同侧颈内静脉中α-降钙素基因相关肽水平升高有关。然而，目前尚不清楚三叉神经痛刺激是否也会在没有头痛障碍的健康受试者中引起降钙素基因相关肽水平的升高。
我们在 8 名健康受试者的额部和下颌部皮下注射辣椒素以及额部注射氯化钠后，测量了α-降钙素基因相关肽水平。我们仅观察到在额部（即第一三叉神经分支）注射辣椒素后α-降钙素基因相关肽水平显著升高。我们还观察到在额部注射辣椒素后出现了三叉自主神经激活（流泪、流涕等）。
α-降钙素基因相关肽水平的升高不仅发生在原发性头痛发作时，也发生在第一分支的实验性三叉神经痛后。这一发现表明，α-降钙素基因相关肽的升高至少是疼痛激活后第一三叉神经分支刺激的一种非特异性效应，而不是特发性头痛障碍的特定机制。
