Journal Article

CGRP-induced migraine-like headache in persistent post-traumatic headache attributed to mild traumatic brain injury

Ashina, Håkan, Larsen, Eigil L, Chaudhry, Basit Ali, Iljazi, Afrim, Eigenbrodt, Anna K, Andersen, Amalie M, Hansen, Kevin J, Schytz, Henrik W, Do, Thien Phu, Al-Khazali, Haidar M, Amin, Faisal Mohammad, Bräuner, Karoline B, Christensen, Casper E

2022

Overview

ObjectiveTo ascertain whether intravenous infusion of calcitonin gene-related peptide (CGRP) can induce migraine-like headache in people with persistent post-traumatic headache attributed to mild traumatic brain injury (TBI) and no pre-existing migraine.MethodsA non-randomized, single-arm, open-label study at a single site in Denmark. Eligible participants were aged 18 to 65 years and had a known history of persistent post-traumatic headache attributed to mild TBI for ≥ 12 months. All participants received continuous intravenous infusion of CGRP (1.5 µg/min) over 20 min. A headache diary was used to collect outcome data until 12 h after the start of CGRP infusion. The primary end point was the incidence of migraine-like headache during 12-hour observational period.ResultsA total of 60 participants completed the study protocol and provided data for the analysis of the primary end point. The median age was 32.5 (IQR, 25.5–43.0) years; 43 participants (72%) were female. Following CGRP infusion, 43 (72%) of 60 participants developed migraine-like headache during the 12-hour observational period. The median time to peak headache intensity was 40 min (IQR, 20–60), and the median peak headache intensity was 6 (IQR, 5–8) on the 11-point numeric rating scale.ConclusionIntravenous infusion of CGRP is a potent inducer of migraine-like headache in people with persistent post-traumatic headache attributed to mild TBI. This observation underscores the importance of CGRP in the genesis of migraine-like headache that is often experienced by individuals who are afflicted by persistent post-traumatic headache. Further research is warranted to ascertain whether other signaling molecules also contribute to the disease mechanisms underlying post-traumatic headache.

• Publisher: Springer Nature B.V
• Subject: Calcitonin / Calcitonin gene-related peptide / Headache / Headaches / Intravenous administration / Migraine / Traumatic brain injury