Transcranial Doppler in migraine attacks before and after treatment with oral zolmitriptan or sumatriptan.
BACKGROUND
Intracranial blood flow velocity (BFV) changes in migraine have been studied fairly extensively. Although a number of investigations have been performed in migraineurs with nitroglycerin-induced attacks, there has been no reported transcranial study involving such attack treated with zolmitriptan or sumatriptan.


METHODS
With ultrasound, we studied the BFV and pulsatility index (PI) changes in the middle cerebral artery in 45 symptom free, otherwise healthy, unmedicated patients with migraine without aura, and in 15 age- and sex-matched controls before nitroglycerin, at the time of maximum head pain induced by nitroglycerin and every 30 minutes for 2 hours after zolmitriptan (15 subjects) or sumatriptan (15 subjects) administration. Headache was rated on a 4-point scale.


RESULTS
During headache attacks, BFV decreased significantly (36.7+/-3.3, 38.4+/-3.4, and 37.4+/-4 cm/sec, respectively, in the zolmitriptan, sumatriptan, and nontreated migraine groups, but not in the controls who were migraine free (P <.01). These abnormalities disappeared 1 hour after zolmitriptan or sumatriptan administration (49.7+/-3.7 and 48.9+/-3.9 cm/sec, respectively). There were no significant changes in PI.


CONCLUSIONS
Our data indicate that nitroglycerin-induced headache in individuals with migraine without aura is associated with BFV changes that are reversed by administration of an oral triptan.
Thomaides
Thomas
T
Neurology Department of Konstandopoulion Complex of Agia Olga General Hospital of Athens, Greece.
Karagounakis
Demetrios
D
Spantideas
Anastasios
A
Katelanis
Stavros
S
D000328:Adult; D001783:Blood Flow Velocity / Q000187:drug effects; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D020326:Migraine without Aura / Q000000981:diagnostic imaging* / Q000188:drug therapy*; D023303:Oxazolidinones / Q000627:therapeutic use*; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use*; D014363:Tryptamines; D017585:Ultrasonography, Doppler, Transcranial
D023303:Oxazolidinones; D017366:Serotonin Receptor Agonists; D014363:Tryptamines; C089750:zolmitriptan