Intradural artery dilation during experimentally induced migraine attacks

Pain, vol. 162, pp. 176–183

Abstract

The middle meningeal artery is a proposed surrogate marker for activation of trigeminal nociceptors during migraine. Previous studies focused on the extracranial part of the artery; hence, vasoreactivity in the intradural arteries during migraine is unknown. Thirty-four patients with migraine without aura were given sildenafil on one day and calcitonin gene-related peptide on another in double-blind crossover fashion. Patients were scanned with 3.0 T MR angiography before drug administration and again 6 hours later during induced attacks of migraine. We measured circumference of the intradural segment of the middle meningeal artery before and during induced migraine attacks. The middle cerebral and superficial temporal arteries were also examined. Fourteen patients had attacks during the second scan after both study drugs and 11 had a migraine after either one or the other, resulting in a total of 39 attacks included in the final analysis. Mean circumference of the intradural middle meningeal artery at baseline was 3.18 mm with an increase of 0.11 mm during attacks (P = 0.005), corresponding to a relative dilation of 3.6% [95% CI: 1.4%-5.7%]. Middle cerebral artery dilated by 9.4% [95% CI: 7.1%-11.7%] and superficial temporal artery by 2.3% [95% CI: 0.2%-4.4%]. Our study shows that the intradural middle meningeal artery and the middle cerebral artery are dilated during migraine induced by calcitonin gene-related peptide as well as sildenafil. We propose that intradural vasculature is affected by migraine-driven activation of trigeminal afferents during migraine attacks.

Authors 9

1. Casper Emil Christensen

   University of Copenhagen · Glostrup Hospital · Rigshospitalet

   Affiliation as printed

   Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

2. Samaira Younis

   University of Copenhagen · Glostrup Hospital · Rigshospitalet

   Affiliation as printed

   Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

3. Ulrich Lindberg

   University of Copenhagen · Rigshospitalet

   Affiliation as printed

   Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

4. Patrick J. H. de Koning Aachen Division of Image Processing (LKEB) Department of Radiology, Leiden University Medical Center

   Leiden University Medical Center

   Affiliation as printed

   Division of Image Processing, Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

5. Daniel Tolnai

   Glostrup Hospital · Rigshospitalet

   Affiliation as printed

   Department of Radiology, Rigshospitalet, Glostrup, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

6. Olaf Bjarne Paulson

   University of Copenhagen · Rigshospitalet

   Affiliation as printed

   Neurobiology Research Unit, Department of Neurology, Rigshospitalet Blegdamsvej, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

7. Henrik B. W. Larsson

   University of Copenhagen · Rigshospitalet

   Affiliation as printed

   Functional Imaging Unit, Department of Clinical Physiology, Nuclear Medicine and PET, Rigshospitalet, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

8. Faisal Mohammad Amin

   University of Copenhagen · Glostrup Hospital · Rigshospitalet

   Affiliation as printed

   Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

   Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article

   Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (www.painjournalonline.com)

9. Messoud Ashina corresponding

   University of Copenhagen · Glostrup Hospital · Rigshospitalet

   Affiliation as printed

   Department of Neurology, Danish Headache Center, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark