Endothelial function in migraine: a cross-sectional study.
BACKGROUND
Migraine has been associated with cardiovascular disorders. Endothelial dysfunction may be a mechanism underlying this association. The present study tested the hypothesis that endothelium-dependent vasodilation, basal endothelial nitric oxide release and endothelial fibrinolytic capacity are impaired in migraine patients.


METHODS
Graded doses of sodium nitroprusside (SNP, 0.2 to 0.8 μg x min(-1) x dL(-1) forearm), substance P (0.2 to 0.8 pmol x min(-1) x dL(-1) forearm) and N(G)-monomethyl-L-arginine (L-NMMA, 0.1 to 0.4 μmol x min(-1) x dL(-1) forearm) were infused into the brachial artery of 16 migraine patients with or without aura during a headache-free interval and 16 age- and sex-matched subjects without a history of migraine. Forearm blood flow (FBF) was measured by strain-gauge venous occlusion plethysmography. Local forearm release of tissue plasminogen activator (t-PA) in response to substance P infusion was assessed using the arteriovenous plasma concentration gradient. Responses to infused drugs were compared between patients and matched controls by analysis of variance.


RESULTS
In both migraine patients and control subjects, SNP and substance P caused a dose-dependent increase, and L-NMMA a dose-dependent decrease in FBF (P < 0.001 for all responses). In both groups, substance P caused an increase in t-PA release (P < 0.001). FBF responses and t-PA release were comparable between migraine patients and control subjects.


CONCLUSIONS
The absence of differences in endothelium-dependent vasodilation, basal endothelial nitric oxide production and stimulated t-PA release between migraine patients and healthy control subjects argues against the presence of endothelial dysfunction in forearm resistance vessels of migraine patients.
Department of Internal Medicine, Maastricht University Medical Center, P, Debyelaan 25, 6202 AZ Maastricht, The Netherlands. floris.vanmolkot@mumc.nl
Floris H
FH
Vanmolkot
Jan N
JN
de Hoon
D000328:Adult; D000704:Analysis of Variance; D003430:Cross-Sectional Studies; D004305:Dose-Response Relationship, Drug; D004730:Endothelium, Vascular / Q000187:drug effects / Q000503:physiopathology*; D005260:Female; D005542:Forearm / Q000098:blood supply*; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology*; D009599:Nitroprusside / Q000494:pharmacology; D012039:Regional Blood Flow / Q000187:drug effects / Q000502:physiology*; D013373:Substance P / Q000494:pharmacology; D010959:Tissue Plasminogen Activator / Q000378:metabolism; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*; D019323:omega-N-Methylarginine / Q000494:pharmacology
D009599:Nitroprusside; D019323:omega-N-Methylarginine; D013373:Substance P; D010959:Tissue Plasminogen Activator