Posted by Ted (152.163.197.206) on September 17, 2000 at 11:32:03:
In Reply to: O2 Question posted by Frank Ford on September 16, 2000 at 18:08:33:
Here is an article by Goadsby and Edvinsson about O2 effectiveness and neuropeptides, which was recently also asked about:
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Goadsby, P. || Edvinsson, L
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Brain, Vol 117, Issue 3 427-434, Copyright © 1994 by Oxford University Press
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ARTICLES
Human in vivo evidence for trigeminovascular
activation in cluster headache. Neuropeptide changes
and effects of acute attacks therapies
PJ Goadsby and L Edvinsson
Department of Neurology, Prince Henry Hospital, Sydney, Australia.
Cluster headache is a rare very severe disorder that is clinically well characterized with a
relatively poorly understood pathophysiology. In this study patients with episodic cluster
headache fulfilling the criteria of the International Headache Society were examined
during an acute spontaneous attack of headache to determine the local cranial release of
neuropeptides. Blood was sampled from the external jugular vein ipsilateral to the pain
before and after treatment of the attack. Samples were assayed for calcitonin gene-related
peptide (CGRP), vasoactive intestinal polypeptide (VIP), substance P and neuropeptide
Y. Attacks were treated with either oxygen inhalation, sumatriptan or an opiate. Thirteen
patients were studied of whom 10 were male and three female. All had well-established
typical attacks of cluster headache when blood was sampled. During the attacks external
jugular vein blood levels of CGRP and VIP were raised while there was no change in
neuropeptide Y or substance P. Calcitonin gene-related peptide levels rose to 110 +/- 7
pmol/l (normal: < 40) while VIP levels rose to 20 +/- 3 pmol/l (normal: < 7). Treatment
with both oxygen and subcutaneous sumatriptan reduced the CGRP level to normal,
while opiate administration did not alter the peptide levels. These data demonstrate for
the first time in vivo human evidence for activation of the trigeminovascular system and
the cranial parasympathetic nervous system in an acute attack of cluster headache.
Furthermore, it is shown that both oxygen and sumatriptan abort the attacks and terminate
activity in the trigeminovascular system.
This article has been cited by other articles:
· Durham, P. L., Sharma, R. V., Russo, A. F. (1997). Repression of the Calcitonin
Gene-Related Peptide Promoter by 5-HT1 Receptor Activation. J. Neurosci. 17:
9545-9553 · [Abstract] · [Full Text]
· PASCUAL, J, QUIJANO, J (1998). A case of chronic paroxysmal hemicrania
responding to subcutaneous sumatriptan. J. Neurol. Neurosurg. Psychiatry 65:
407-407 · [Full Text]
· de la Sayette, V., Schaeffer, S., Coskun, O., Leproux, F., Defer, G. (1999).
Cluster headache-like attack as an opening symptom of a unilateral infarction of the
cervical cord: Persistent anaesthesia and dysaesthesia to cold stimuli. J. Neurol.
Neurosurg. Psychiatry 66: 397-400 ·