Calcitonin gene-related peptide causes migraine aura

Background Although the involvement of calcitonin gene-related peptide (CGRP) in migraines is well-established, its specific role in investigating the aura phase, which often precedes the headache, remains largely unexplored. This study aims to instigate CGRP’s potential in triggering aura, thus est...

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Published inJournal of headache and pain Vol. 24; no. 1; p. 124
Main Authors Al-Khazali, Haidar M., Ashina, Håkan, Wiggers, Astrid, Rose, Kathrine, Iljazi, Afrim, Christensen, Rune Häckert, Schytz, Henrik Winther, Amin, Faisal Mohammad, Ashina, Messoud
Format Journal Article
LanguageEnglish
Published Milan Springer Milan 07.09.2023
Springer Nature B.V
BMC
Subjects
Calcitonin
Calcitonin gene-related peptide
Cortical spreading depolarization
Headache
Headache disorders
Headaches
Internal Medicine
Medicine
Medicine & Public Health
Migraine
Neurology
Pain Medicine
Pathophysiology
Peptides
Therapeutic applications
Trigeminovascular System
Headache disorders
Trigeminovascular System
Cortical spreading depolarization
Pathophysiology
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Summary:Background Although the involvement of calcitonin gene-related peptide (CGRP) in migraines is well-established, its specific role in investigating the aura phase, which often precedes the headache, remains largely unexplored. This study aims to instigate CGRP’s potential in triggering aura, thus establishing its role in the early stages of migraine. Methods In this open-label, non-randomized, single-arm trial, 34 participants with migraine with aura received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min on a single experimental day. Participants were required to be free of headache and report no use of acute medications 24 h before infusion start. The primary endpoint was the incidence of migraine aura during the 12-hour observational period after the start of infusion. Results Thirteen (38%) of 34 participants developed migraine aura after CGRP infusion. In addition, 24 (71%) of 34 participants developed migraine headache following CGRP infusion. Conclusions Our findings suggest that CGRP could play an important role in the early phases of a migraine attack, including during the aura phase. These insights offer a new perspective on the pathogenesis of migraines with aura. They underscore the need for additional research to further explore the role of CGRP in these initial stages of a migraine attack, and potentially inform future development of therapeutic interventions. Trial registration ClinicalTrials.gov Identifier: NCT04592952. Graphical Abstract
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ISSN:1129-2377
1129-2369
1129-2377
DOI:10.1186/s10194-023-01656-4