Glyceryl trinitrate triggers premonitory symptoms in migraineurs

被引:158
|
作者
Afridi, SK [1 ]
Kaube, H [1 ]
Goadsby, PJ [1 ]
机构
[1] UCL Natl Hosp Neurol & Neurosurg, Neurol Inst, Headache Grp, London WC1N 3BG, England
基金
英国惠康基金;
关键词
migraine; aura; premonitory; nitric oxide;
D O I
10.1016/j.pain.2004.05.007
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Studying attacks of migraine is considerably hampered by its fundamentally episodic nature. Developing approaches to triggering migraine reliably is important for advancing understanding of the disorder by facilitating its study. Based on the work of the Copenhagen Group we administered an intravenous infusion of 0.5 mug/kg/min glyceryl trinitrate (GTN) to 44 migraineurs, 23 migraine without aura, 21 migraine with aura, and to 12 healthy controls. We sought to characterise the GTN-induced migraine in terms of the clinical features of the attacks and reproducibility of triggering, and included a non-migraine control group for the purpose of comparing any effects to exclude an ordering effect. Of the 44 patients administered GTN, 33 had a migraine attack fulfilling International Headache Society criteria. Thirty-two attacks were of migraine without aura and one of migraine with aura. Twelve patients described typical premonitory symptoms, which have not been previously documented with GTN-induced migraine. A repeat attack was triggered in all subjects but one. In one case a visual aura was also triggered both times. Our study shows that GTN-induced triggering is common in our patients, and remarkably reproducible. The data will facilitate the use of the GTN model in studies requiring extensive planning, such as brain imaging, or where preventive questions are at issue. We also report the first patient with a reproducible GTN-triggered migraine with aura. (C) 2004 International Association for the Study of Pain. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:675 / 680
页数:6
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