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Open Access 01-12-2023 | Aura | Research

Calcitonin gene-related peptide causes migraine aura

Authors: Haidar M. Al-Khazali, Håkan Ashina, Astrid Wiggers, Kathrine Rose, Afrim Iljazi, Rune Häckert Christensen, Henrik Winther Schytz, Faisal Mohammad Amin, Messoud Ashina

Published in: The Journal of Headache and Pain | Issue 1/2023

Abstract

Background

Although the involvement of calcitonin gene-related peptide (CGRP) in migraines is well-established, its specific role in investigating the aura phase, which often precedes the headache, remains largely unexplored. This study aims to instigate CGRP’s potential in triggering aura, thus establishing its role in the early stages of migraine.

Methods

In this open-label, non-randomized, single-arm trial, 34 participants with migraine with aura received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min on a single experimental day. Participants were required to be free of headache and report no use of acute medications 24 h before infusion start. The primary endpoint was the incidence of migraine aura during the 12-hour observational period after the start of infusion.

Results

Thirteen (38%) of 34 participants developed migraine aura after CGRP infusion. In addition, 24 (71%) of 34 participants developed migraine headache following CGRP infusion.

Conclusions

Our findings suggest that CGRP could play an important role in the early phases of a migraine attack, including during the aura phase. These insights offer a new perspective on the pathogenesis of migraines with aura. They underscore the need for additional research to further explore the role of CGRP in these initial stages of a migraine attack, and potentially inform future development of therapeutic interventions.

Trial registration

ClinicalTrials.gov Identifier: NCT04592952.

Graphical Abstract

Available only for authorised users

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Title: Calcitonin gene-related peptide causes migraine aura
Authors: Haidar M. Al-Khazali
Håkan Ashina
Astrid Wiggers
Kathrine Rose
Afrim Iljazi
Rune Häckert Christensen
Henrik Winther Schytz
Faisal Mohammad Amin
Messoud Ashina
Publication date: 01-12-2023
Publisher: Springer Milan
Keywords: Aura
Migraine
Headache
Published in: The Journal of Headache and Pain / Issue 1/2023
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-023-01656-4

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Calcitonin gene-related peptide causes migraine aura

Abstract

Background

Methods

Results

Conclusions

Trial registration

Graphical Abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

Graphical Abstract

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