• Faisal Mohammad Amin, Mohammad Sohail Asghar, Song Guo, Anders Hougaard, Adam Espe Hansen, Henrik Winther Schytz, Rob J van der Geest, Patrick Jh de Koning, Henrik Bw Larsson, Jes Olesen, and Messoud Ashina.
• University of Copenhagen, Denmark.
• Cephalalgia. 2012 Jan 1;32(2):140-9.

AimTo explore a possible relationship between vasodilatation and delayed headache we examined the effect of pituitary adenylate cyclase-activating polypeptide-38 (PACAP38) on the middle meningeal artery (MMA) and middle cerebral artery (MCA) using high resolution magnetic resonance angiography (MRA).MethodsIn a double-blind, randomized, placebo-controlled study 14 healthy volunteers were scanned repeatedly after infusion (20 min) of 10 pmol/kg/min PACAP38 or placebo. In addition, four participants were scanned following subcutaneous sumatriptan (6 mg).ResultsWe found significant dilatation of the MMA (p = 0.00001), but not of the MCA (p = 0.50) after PACAP38. There was no change after placebo (p > 0.40). Vasodilatation (range 16-23%) lasted more than 5 h. Sumatriptan selectively contracted the MMA by 12.3% (p = 0.043).ConclusionPACAP38-induced headache is associated with prolonged dilatation of the MMA but not of the MCA. Sumatriptan relieves headache in parallel with contraction of the MMA but not of the MCA.

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