Calcitonin gene-related peptide and size of the atrial septal defect in new-onset migraine after transcatheter closure: results of a preliminary study
Headache: The Journal of Head and Face Pain, 04/20/2012Wei SH et al.
Bigger atrial septal defect (ASD) size and lower plasma calcitonin gene–related peptide (CGRP) levels before closure can be a potential predictor of new–onset MHAs. Furthermore, a significant increase of CGRP levels during migraine attack implies that the occurrences of new–onset MHAs after ASD closure correlate with the release of CGRP. This suggests CGRP sensitization from a lower baseline may be involved in the occurrence of new–onset MHAs after ASD closure.
Authors prospectively collected patients before and after closure and measured plasma CGRP levels using enzyme–linked immunosorbent assay.
Forty atrial septal defect (ASD) patients who had no migraine previously were enrolled.
Four (23.5%) of the 17 consecutive patients whose CGRP levels were checked before ASD closure had new–onset MHAs.
The patients with MHAs had bigger ASD size (20 ± 0.9 vs 16 ± 1 mm, P = .009) and lower CGRP levels before closure (21.1 ± 3.9 vs 90.1 ± 27.1 pg/mL, P = .042) than those without.
Among the 5 patients with blood samplings both during and between attacks, a paired comparison revealed a significantly increased level during attack (257.2 ± 45.5 vs 45.6 ± 25.5 pg/mL, P = .03).
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