Vasoactive Intestinal Peptide Causes Marked Cephalic Vasodilation, but does not Induce Migraine

• Published in: Cephalalgia Vol. 28; no. 3; pp. 226 - 236
• Main Authors: Rahmann, A, Wienecke, T, Hansen, JM, Fahrenkrug, J, Olesen, J, Ashina, M
• Format: Journal Article
• Language: English
• Published: London, England SAGE Publications 01.03.2008; Blackwell Publishing Ltd
• Subjects: Adult; Cross-Over Studies; Double-Blind Method; Female; Headache; Humans; Male; migraine; Migraine Disorders - blood; Migraine Disorders - chemically induced; Migraine Disorders - etiology; Migraine without Aura; parasympathetic nervous system; vasoactive intestinal peptide; Vasoactive Intestinal Peptide - blood; Vasoactive Intestinal Peptide - toxicity; vasodilation; Vasodilation - drug effects; Vasodilation - physiology; Vasodilator Agents - blood; Vasodilator Agents - toxicity; Headache; vasoactive intestinal peptide; migraine; parasympathetic nervous system; vasodilation
• ISSN: 0333-1024; 1468-2982
• DOI: 10.1111/j.1468-2982.2007.01497.x

We hypothesized that intravenous infusion of the parasympathetic transmitter, vasoactive intestinal peptide (VIP), might induce migraine attacks in migraineurs. Twelve patients with migraine without aura were allocated to receive 8 pmol kg-1 min-1 VIP or placebo in a randomized, double-blind crossover study. Headache was scored on a verbal rating scale (VRS), mean blood flow velocity in the middle cerebral artery (V mean mca) was measured by transcranial Doppler ultrasonography, and diameter of the superficial temporal artery (STA) by high-frequency ultrasound. None of the subjects reported a migraine attack after VIP infusion. VIP induced a mild immediate headache (maximum 2 on VRS) compared with placebo (P = 0.005). Three patients reported delayed headache (3-11 h after infusion) after VIP and two after placebo (P = 0.89). V mean mca decreased (16.3 ± 5.9%) and diameter of STA increased significantly after VIP (45.9 ± 13.9%). VIP mediates a marked dilation of cranial arteries, but does not trigger migraine attacks in migraineurs. These data provide further evidence against a purely vascular origin of migraine.