Vasoactive intestinal polypeptide evokes only a minimal headache in healthy volunteers
Vasoactive intestinal polypeptide evokes only a minimal headache in healthy volunteers
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DOI：
10.1111/j.1468-2982.2006.01149.x
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发表时间：
2006-08-01
期刊：
影响因子：
4.9
通讯作者：
Ashina, M.
中科院分区：
文献类型：
--
作者：
Hansen, J. M.;Sitarz, J.;Ashina, M.
副交感神经系统在偏头痛发病机制中的作用是有争议的。副交感神经递质，血管活性肠肽（VIP），其对脑动脉和脑血流动力学的影响还没有系统的研究man. We假设，VIP的输液可能会引起头痛在健康受试者的头痛，并导致脑血流动力学的变化。12名健康青年志愿者采用交叉、双盲设计，静脉滴注VIP（8 pmol/kg·min）或安慰剂（0.9%生理盐水）25 min。头痛评分为0 ~ 10分，局部脑血流量（rCBF）采用单光子发射计算机断层扫描和吸入法测定，大脑中动脉平均血流速度（V-meanMCA）采用经颅多普勒超声测定。头痛非常轻微，最高评分为2分，描述为压迫感或悸动感。五名参与者在VIP期间发生头痛，一名在安慰剂期间发生头痛。在输注过程中，与安慰剂相比，VIP组MCA的V均值显著下降（P < 0.001），但该效应迅速减弱，并且在30 min和120 min之间比较时没有发现差异。此外，在输注过程中，MCA的直径没有发现显著差异。VIP和安慰剂之间的rCBF无显著差异（P = 0.10）。可见颞浅动脉明显扩张VIP后前30分钟（P = 0.04），但30分钟与120分钟之间的时间比较无差异。我们发现VIP和安慰剂日之间的平均动脉血压无差异，但VIP日的心率显着增加与安慰剂日相比（AUC（0-30min），P < 0.001）。VIP日血浆VIP显著高于安慰剂组（AUC（0- 80 min），P < 0.001）。这些结果表明，VIP导致V-meanMCA降低，而不影响rCBF。尽管在颅外血管中有显著的血管扩张作用，血浆VIP增加，但健康受试者仅出现非常轻微的头痛。
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 Xe-133 inhalation and mean flow velocity in the middle cerebral artery (V-meanMCA) 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 V-meanMCA 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 (AUC(0-30min), P < 0.001). Plasma VIP was significantly higher on a VIP day compared with placebo (AUC(0-80min), P < 0.001). These results show that VIP causes a decrease in V-meanMCA 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.