Migraine pain: reflections against vasodilatation.
The original Wolff's vascular theory of migraine was supported by the discovery of a class of drugs, the triptans, developed as a selective cephalic vasoconstrictor agents. Even in the neurovascular hypothesis of Moskowitz, that is the neurogenic inflammation of meningeal vessels provoked by peptides released from trigeminal sensory neurons, the vasodilatation provoked by calcitonin gene-related peptide (CGRP) is considered today much more important than oedema. The role of cephalic vasodilatation as a cause of migraine pain was recently sustained by studies showing the therapeutic effect of CGRP receptor antagonists. We discuss the evidence against vasodilatation as migraine pain generator and some findings which we suggest in support of a central (brain) origin of pain.
Panconesi
Alessandro
A
Health Authority 11, Empoli (Florence), Italy. a.panconesi@virgilio.it
Bartolozzi
Maria Letizia
ML
Guidi
Leonello
L
D001921:Brain / Q000098:blood supply* / Q000503:physiopathology; D015740:Calcitonin Gene-Related Peptide / Q000378:metabolism; D006801:Humans; D008881:Migraine Disorders / Q000188:drug therapy / Q000503:physiopathology*; D020078:Neurogenic Inflammation / Q000150:complications / Q000503:physiopathology; D010146:Pain / Q000188:drug therapy / Q000503:physiopathology*; D012701:Serotonin / Q000378:metabolism; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014664:Vasodilation / Q000502:physiology*
D014662:Vasoconstrictor Agents; D012701:Serotonin; D015740:Calcitonin Gene-Related Peptide