Pathophysiology of primary headaches.
The cerebral circulation is innervated by sympathetic, parasympathetic, and sensory nerves, which store a considerable number of neurotransmitters. The role of these has been evaluated in primary headaches. A clear association between head pain and the release of calcitonin gene-related peptide was demonstrated. In cluster headache and in a case of chronic paroxysmal headache there was in addition the release of vasoactive intestinal peptide, which was associated with the facial symptoms (nasal congestion, rhinorrhea). In parallel with sumatriptan treatment, head pain subsided and neuropeptide release normalized. These data show the involvement of sensory and parasympathetic mechanisms in the pathophysiology of primary headaches.
Department of Internal Medicine, Lund University Hospital, Lund S-221 85, Sweden. lars.edvinsson@med.lu.se
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D001808:Blood Vessels / Q000294:innervation / Q000503:physiopathology; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D015220:Calcium Channels / Q000378:metabolism; D002560:Cerebrovascular Circulation; D003027:Cluster Headache / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D006261:Headache / Q000209:etiology* / Q000378:metabolism / Q000503:physiopathology*; D006801:Humans; D008881:Migraine Disorders / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D013564:Sympathetic Nervous System / Q000503:physiopathology; D014277:Trigeminal Neuralgia / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D014653:Vascular Headaches / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology; D014660:Vasoactive Intestinal Peptide / Q000378:metabolism
D015220:Calcium Channels; D014660:Vasoactive Intestinal Peptide; D015740:Calcitonin Gene-Related Peptide