Castellano A E, Micieli G, Bellantonio P, Buzzi M G, Marcheselli S, Pompeo F, Rossi F, Nappi G
Headache Centers, Mediterranean Institute of Neuroscience, IMN, Pozzilli, Italy.
Cephalalgia. 1998 Nov;18(9):622-30. doi: 10.1046/j.1468-2982.1998.1809622.x.
Intracerebral vascular reactivity induced by the nitric oxide (NO) donor isosorbide dinitrate (IDN, 5 mg sublingually) is more major and longer-lasting in migraine patients who develop delayed headache in response to the drug. The headache is purportedly due to neuronally-mediated vascular mechanisms. Indomethacin inhibits prostaglandin synthesis, which is involved in NO generation. Indomethacin also decreases cerebral blood flow by constricting precapillary resistance vessels. In the present study, the hemodynamic effects of indomethacin were evaluated in migraine patients and healthy controls by means of transcranial Doppler monitoring. Indomethacin caused a significant decrease in mean flow velocity in the middle cerebral artery. This was an additional effect to the mean velocity decrease induced by IDN. The interactions between the two drugs suggest that their effects on cerebral hemodynamics (and pain) may be of relevance both in understanding the role of NO in migraine pathogenesis and in evaluating symptomatic treatments for migraine attacks.
一氧化氮（NO）供体二硝酸异山梨酯（IDN，舌下含服5毫克）诱导的脑血管反应性在因该药出现延迟性头痛的偏头痛患者中更为显著且持续时间更长。据称，这种头痛是由神经元介导的血管机制引起的。吲哚美辛抑制参与NO生成的前列腺素合成。吲哚美辛还通过收缩毛细血管前阻力血管来减少脑血流量。在本研究中，通过经颅多普勒监测评估了吲哚美辛在偏头痛患者和健康对照者中的血流动力学效应。吲哚美辛导致大脑中动脉平均流速显著降低。这是对IDN诱导的平均流速降低的额外影响。两种药物之间的相互作用表明，它们对脑血流动力学（和疼痛）的影响可能在理解NO在偏头痛发病机制中的作用以及评估偏头痛发作的对症治疗方面都具有相关性。
