Skip to main content
SpringerLink
Log in

Neuroeffector functions of sensory fibres: implications for headache mechanisms and drug actions

  • Review Of Migraine And Its Therapy
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Summary

The results of recent investigations designed to elucidate the neuroeffector functions of sensory fibres, the cause of migraine headache and the mechanism of action of antimigraine drugs are reviewed and discussed. Neurogenic inflammation (vasodilatation and neurogenic plasma extravasation) is one explanation for the development of headaches and the blood flow changes which occur during migraine headache. Numerous studies have recently been carried out on rats and guinea-pigs into the effects of antimigraine agents, including ergot alkaloids, sumatriptan and non-steroidal anti-inflammatory drugs (NSAIDs), on neurogenic plasma protein extravasation in the dura mater induced by electrical stimulation of trigeminal ganglia or systemic administration of capsaicin. It is known that the dura mater is able to produce headaches in man. Ergot alkaloids have been shown to block neurogenic inflammation via a C-fibre dependent neuronal mechanism. Sumatriptan appears to act fairly similarly although, whereas the ergot alkaloids are non-selective for either 5-hydroxytryptamine (5-HT; serotonin) receptors or 5-HT1, sumatriptan is selective for 5-HT1 receptors. The antimigraine action of NSAIDs may be via either an effect on blood vessels or an effect on the nerve fibre. The antimigraine effects of ergot alkaloids, sumatriptan and NSAIDs are discussed in the light of the common vasoconstrictor actions of these agents and knowledge that vasodilatation is apparently not responsible for migraine headache pain in most cases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Buzzi MG, Moskowitz MA (1990) The antimigraine drug, sumatriptan (GR43175), selectively blocks neurogenic plasma extravasation from blood vessels in dura mater. Br J Pharmacol 99:202–206

    Google Scholar 

  2. Buzzi MG, Sakas DE, Moskowitz MA (1989) Indomethacin and acetylsalicylic acid block neurogenic plasma protein extravasation in rat dura mater. Eur J Pharmacol 165:252–258

    Google Scholar 

  3. Buzzi MG, Dimitriadou V, Theoharides TC, Moskowitz MA (1990) Morphological effects of electrical trigeminal ganglion stimulation (ETG) on intra- and extracranial vessels. Soc Neurosci Abstr 16:73.2

    Google Scholar 

  4. Buzzi MG, Carter WB, Shimizu T, Heath H, Moskowitz MA Dihydroergotamine and sumatriptan attenuate the increase in plasma CGRP levels within rat superior sagittal sinus during electrical trigeminal ganglion stimulation. (Submitted)

  5. Byer J, Gutterman DL, Plachetka JR, Bhattacharyya H (1989) Dose response study for subcutaneous GR43175 in the treatment of acute migraine. Cephalalgia 9 (suppl 10):349–350

    Google Scholar 

  6. Dahlof C, Winter P, Ludlow S (1989) Oral GR43175, a 5-HT1-like agonist, for treatment of the acute migraine attack: an international study — preliminary results. Cephalalgia 9 (suppl 10):351–352

    Google Scholar 

  7. Doenicke A, Brand J, Perrin VL (1988) Possible benefit of GR43175, a novel 5-HT1-like receptor agonist, for the acute treatment of severe migraine. Lancet I:1309–1311

    Google Scholar 

  8. Drummond PD, Gonski A, Lance JW (1983) Facial flushing after thermocoagulation of the gasserian ganglion. J Neurol Neurosurg Psychiatry 46:611–616

    Google Scholar 

  9. Ekbom K, Hardebo J-E, Waldenlind E (1988) Mechanisms of cluster headache. In: Olesen J, Edvinsson L (eds) Basic mechanisms of headache. Elsevier, Amsterdam, pp 463–476

    Google Scholar 

  10. Feniuk W, Humphrey PPA, Perren MJ (1989) The selective carotid arterial vasoconstrictor action of GR43175 in anaesthetized dogs. Br J Pharmacol 96:83–90

    Google Scholar 

  11. Ferrari M, Bayliss EM, Ludlow S, Pilgrim AJ (1989) Subcutaneous GR43175 in the treatment of acute migraine: an international study. Cephalalgia 9 (suppl 10):348

    Google Scholar 

  12. Goadsby PJ, Edvinsson L, Ekman R (1988) Release of vasoactive peptides in the extracerebral circulation of humans and the cat during activation of the trigeminovascular system. Ann Neurol 23:193–194.

    Google Scholar 

  13. Hua X-Y, Saria A, Gamse R, Theodorsson-Norheim E, Brodin E, Lundberg JM (1986) Capsaicin induced release of multiple tachykinins (substance P, neurokinin A and eledoisin-like material) from guinea-pig spinal cord and ureter. Neuroscience 19:313–319

    Google Scholar 

  14. Jancso N, Jancso-Gabor A, Szolcsanyi J (1967) Direct evidence for neurogenic inflammation and its preservation by denervation and by pretreatment with capsaicin. Br J Pharmacol Chemother 31:138–151

    Google Scholar 

  15. Kenins P, Hurley JV, Bell C (1984) The role of substance P in the axon reflex in the rat. Br J Dermatol 111:551–559

    Google Scholar 

  16. Lembeck F, Holzer P (1979) Substance P as neurogenic mediator of antidromic vasodilatation and neurogenic plasma extravasation. Naunyn Schmiedebergs Arch Pharmacol 310:175–183

    Google Scholar 

  17. Lewis T (1937) The nocifensor system of nerves and its reaction. Br Med J 194:431–435

    Google Scholar 

  18. Lundberg JM, Saria A (1982) Capsaicin-sensitive vagal neurons involved in control of vascular permeability in rat trachea. Acta Physiol Scand 115:521–523

    Google Scholar 

  19. Lundberg JM, Brodin E, Hua X-Y, Saria A (1984) Vascular permeability changes and smooth muscle contraction in relation to capsaicin-sensitive substance P afferents in the guineapig. Acta Physiol Scand 120:217–227

    Google Scholar 

  20. Markowitz S, Saito K, Moskowitz MA (1987) Neurogenically mediated leakage of plasma protein occurs from blood vessels in dura mater but not brain. J Neurosci 7:4129–4136

    Google Scholar 

  21. McCarthy BG, Peroutka SJ (1989) Comparative neuropharmacology of dihydroergotamine and sumatriptan (GR43175). Headache 29:420–422

    Google Scholar 

  22. Moskowitz MA, Sakas D, Wei EP, Kano M, Buzzi MG, Ogilvy C, Kontos HA (1989) Postocclusive hyperemia is markedly attenuated by chronic trigeminal ganglionectomy. Am J Physiol 257:H1736-H1739

    Google Scholar 

  23. Nishimori T, Buzzi MG, Chudler EH, Poletti CE, Moskowitz MA, Uhl GR Preproenkephalin upregulation in nucleus caudalis: high and low intensity stimulation differentially modulate early and late responses. J Comp Neurol (in press)

  24. Peroutka SJ, McCarthy BG (1989) Sumatriptan (GR43175) interacts selectively with 5-HT1B and 5-HT1D binding sites. Eur J Pharmacol 163:133–136

    Google Scholar 

  25. Ray BS, Wolff HG (1940) Experimental studies on headache: pain sensitive structures of the head and their significance in headache. Arch Surg 41:813–856

    Google Scholar 

  26. Saito K, Markowitz S, Moskowitz MA (1988) Ergot alkaloids block neurogenic extravasation in dura mater: proposed mechanism for vascular headache. Ann Neurol 24:732–737

    Google Scholar 

  27. Saria A, Lundberg JM, Skofisch G, Lembeck F (1983) Vascular leakage in various tissues induced by substance P, capsaicin, bradykinin, serotonin, histamine and by antigen challenge. Naunyn Schmiedebergs Arch Pharmacol 324:212–218

    Google Scholar 

  28. Stricker S (1876) Untersuchungen über die Gefäßnerven-Wurzeln des Ischiadicus. Sitz-Ber Kaiserl Akad Wiss (Wien) 3:173–185

    Google Scholar 

  29. Sweet WH, Wepsic JG (1974) Controlled thermocoagulation of trigeminal ganglion and rootlets for differential destruction of pain fibres. Part I: trigeminal neuralgia. J Neurosurg 40:143–156

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Stroke Research Laboratory, Departments of Neurology and Neurosurgery, Massachusetts General Hospital, Harvard Medical School, 02114, Boston, MA, USA

    M. A. Moskowitz & M. G. Buzzi

Authors
  1. M. A. Moskowitz
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M. G. Buzzi
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Moskowitz, M.A., Buzzi, M.G. Neuroeffector functions of sensory fibres: implications for headache mechanisms and drug actions. J Neurol 238 (Suppl 1), S18–S22 (1991). https://doi.org/10.1007/BF01642901

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01642901

Key words

Search

Navigation