Prostacyclin (epoprostenol) induces headache in healthy subjects.

Abstract:

:The role of prostanoids in nociception is well established. The headache eliciting effects of prostacyclin (prostaglandin I(2), (PGI(2))) and its possible mechanisms had previously not been systematically studied in man. We hypothesized that infusion of PGI(2) might induce headache and vasodilatation of cranial vessels. A stable analog of PGI(2) epoprostenol (10 ng/kg/min) was infused for 25 min into 12 healthy subjects in a cross-over, double-blind study. Headache intensity was scored on a verbal rating scale from 0 to 10. In addition, we recorded mean flow in the middle cerebral artery (V(mean MCA)) by the transcranial doppler and diameter of the superficial temporal artery (STA) by a high-resolution ultrasonography unit. During the immediate phase (0-30 min) and the post-infusion phase (30-90 min), 11 subjects reported headache on the PGI(2) day and no subjects reported headache on the placebo day (p=0.002). During epoprostenol (0-30 min) and in the post-infusion phase (30-90 min), the area under the curve (AUC) for headache score was significantly larger than during and after placebo (p=0.005). PGI(2) caused headache associated with the dilatation of STA (AUC, p<0.001), but no significant dilatation of the MCA (AUC, p=0.508). These data indicate that PGI(2) induced headache might be due to activation and sensitization of sensory afferents around extracranial arteries.

journal_name

Pain

journal_title

Pain

authors

Wienecke T,Olesen J,Oturai PS,Ashina M

doi

10.1016/j.pain.2008.03.018

subject

Has Abstract

pub_date

2008-09-30 00:00:00

pages

106-116

issue

1

eissn

0304-3959

issn

1872-6623

pii

00006396-200809300-00012

journal_volume

139

pub_type

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