Kaube H, Goadsby P J
Department of Neurology, Prince Henry Hospital, Sydney, NSW, Australia.
Eur Neurol. 1994;34(1):30-5. doi: 10.1159/000117004.
Leao's cortical spreading depression (SD) is often cited as the pathophysiological substrate for the neurological symptoms of migraine with aura. If this is the case it might be expected that drugs useful as anti-migraine agents, particularly those useful in prophylaxis, may alter or prevent SD. Indeep it has been suggested that the anti-migraine compound dihydroergotamine (DHE) blocks or reduces the speed of propagation of SD in the rabbit. In this study we attempted to further investigate the effects of DHE and other anti-migraine drugs on SD by measuring cortical blood flow with laser Doppler flowmetry (CBFLDF) and cortical single unit activity in the alpha-chloralose-anaesthetised cat. The following substances were tested: DHE, acetylsalicylic acid, lignocaine, metoprolol, clonazepam and valproate. The NMDA-receptor blocker MK-801 and halothane (1.5%) were used as reference substances that reliably block SD. The outcome measures were speed of propagation of the wave of SD across the cortex and the CBFLDF increase during the hyperaemic phase of SD. Data were taken from three control episodes (60 min apart) and after drug administration. The rate of propagation was significantly reduced from the first control period (3.0 +/- 0.3 mm/min) to the subsequent 2 control observations (2.3 +/- 0.1 mm/min) even without any drug treatment. Following the control observations the test drug was administered and a further SD elicited. This fourth SD was reliably blocked by MK-801 and halothane. None of the other test drugs inhibited SD, reduced the rate of propagation or changed the amplitude of the CBFLDF increase.(ABSTRACT TRUNCATED AT 250 WORDS)
莱奥的皮层扩散性抑制(SD)常被认为是偏头痛伴先兆神经症状的病理生理基础。如果真是如此,那么有望作为抗偏头痛药物,尤其是对预防有效的药物,可能会改变或预防SD。实际上,有人提出抗偏头痛化合物双氢麦角胺(DHE)可阻断或降低家兔中SD的传播速度。在本研究中,我们试图通过用激光多普勒血流仪测量皮层血流(CBFLDF)以及在α-氯醛糖麻醉的猫中测量皮层单单位活动,进一步研究DHE和其他抗偏头痛药物对SD的影响。测试了以下物质:DHE、乙酰水杨酸、利多卡因、美托洛尔、氯硝西泮和丙戊酸盐。NMDA受体阻滞剂MK-801和氟烷(1.5%)用作可靠阻断SD的参考物质。观察指标为SD波在皮层上的传播速度以及SD充血期CBFLDF的增加。数据取自三个对照时段(间隔60分钟)以及给药后。即使未进行任何药物治疗,传播速度也从第一个对照期(3.0±0.3毫米/分钟)显著降低至随后两个对照观察期(2.3±0.1毫米/分钟)。对照观察后给予测试药物并引发另一次SD。第四次SD被MK-801和氟烷可靠地阻断。其他测试药物均未抑制SD、降低传播速度或改变CBFLDF增加的幅度。(摘要截短于250字)