Vasoactive intestinal polypeptide evokes only a minimal headache in healthy volunteers
JM Hansen,
J Sitarz,
S Birk, AM Rahmann,
PS Oturai,
J Fahrenkrug,
J Olesen,
M Ashina,
JM Hansen
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorJ Sitarz
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorAM Rahmann
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorPS Oturai
Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, and
Search for more papers by this authorJ Fahrenkrug
Department of Biochemistry, H:S Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorJ Olesen
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorCorresponding Author
M Ashina
Danish Headache Centre and Department of Neurology, and
Messoud Ashina, Danish Headache Centre and Department of Neurology, Glostrup Hospital, University of Copenhagen, DK-2600 Glostrup, Copenhagen, Denmark. Tel. + 45 4323 2713, e-mail [email protected]Search for more papers by this authorJM Hansen,
J Sitarz,
S Birk, AM Rahmann,
PS Oturai,
J Fahrenkrug,
J Olesen,
M Ashina,
JM Hansen
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorJ Sitarz
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorAM Rahmann
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorPS Oturai
Department of Clinical Physiology and Nuclear Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, and
Search for more papers by this authorJ Fahrenkrug
Department of Biochemistry, H:S Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
Search for more papers by this authorJ Olesen
Danish Headache Centre and Department of Neurology, and
Search for more papers by this authorCorresponding Author
M Ashina
Danish Headache Centre and Department of Neurology, and
Messoud Ashina, Danish Headache Centre and Department of Neurology, Glostrup Hospital, University of Copenhagen, DK-2600 Glostrup, Copenhagen, Denmark. Tel. + 45 4323 2713, e-mail [email protected]Search for more papers by this authorAbstract
The role of the parasympathetic nervous system in the pathogenesis of migraine is disputed. The headache-eliciting effect of the parasympathetic neurotransmitter, vasoactive intestinal polypeptide (VIP), and its effect on cerebral arteries and brain haemodynamics has not been systematically studied in man. We hypothesized that infusion of VIP might induce headache in healthy subjects and cause changes in cerebral haemodynamics. VIP (8 pmol/kg per min) or placebo (0.9% saline) was infused for 25 min into 12 healthy young volunteers in a crossover, double-blind design. Headache was scored on a verbal rating scale from 0 to 10, regional cerebral blood flow (rCBF) was measured with single-photon emission computed tomography and 133Xe inhalation and mean flow velocity in the middle cerebral artery (VmeanMCA) was measured with transcranial Doppler ultrasonography. The headache was very mild with a maximum score of 2 and described as a pressing or throbbing sensation. Five participants developed headache during VIP and one during placebo. During the infusion, a significant drop in VmeanMCA was seen for VIP compared with placebo (P < 0.001), but the effect quickly waned and no difference was found when comparing the time between 30 and 120 min. In addition, no significant difference in the diameter of the MCA could be found during the infusion. No significant differences in rCBF (P = 0.10) were found between VIP and placebo. A marked dilation of the superficial temporal artery was seen (P = 0.04) after VIP in the first 30 min but no difference was found when comparing the time between 30 and 120 min. We found no difference in mean arterial blood pressure between VIP and placebo days but the heart rate increased significantly on a VIP day compared with a placebo day (AUC0−30min, P < 0.001). Plasma VIP was significantly higher on a VIP day compared with placebo (AUC0−80min, P < 0.001). These results show that VIP causes a decrease in VmeanMCA without affecting rCBF. In spite of a marked vasodilator effect in the extracranial vessels and increased plasma VIP, healthy subjects developed only a very mild headache.
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