The Effect of Circulating Adenosine on Cerebral Haemodynamics and Headache Generation in Healthy Subjects

Cephalalgia ◽  
2005 ◽  
Vol 25 (5) ◽  
pp. 369-377 ◽  
Author(s):  
S Birk ◽  
KA Petersen ◽  
C Kruuse ◽  
R Guieu ◽  
O Jonassen ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Cerebral Artery ◽  
Single Photon ◽  
Cerebral Arteries ◽  
Superficial Temporal Artery ◽  
Photon Emission ◽  
Temporal Artery ◽  
Emission Computed Tomography ◽  
Double Blind

Adenosine is an endogenous neurotransmitter that is released from the brain during hypoxia and relaxes isolated human cerebral arteries. Many cerebral artery dilators cause migraine attacks. However, the effect of intravenous adenosine on headache and cerebral artery diameter has not previously been investigated in man and reports regarding the effect of intravenous adenosine on cerebral blood flow are conflicting. Twelve healthy participants received adenosine 80, 120 μg kg-1 min-1 and placebo intravenously for 20 min, in a double-blind, three-way, crossover, randomized design. Headache was rated on a verbal scale (0-10). Regional cerebral blood flow (rCBF) with 133Xe inhalation and single-photon emission computed tomography (SPECT) and MCA flow velocity (VMCA) with transcranial Doppler, were measured in direct sequence. Six participants developed headache during 80 μg kg-1 min-1 and six during 120 μg kg-1 min-1 compared with none on placebo ( P = 0.006). The headache was very mild and predominantly described as a pressing sensation. When correcting data for adenosine-induced hyperventilation, no significant changes in rCBF ( P = 0.22) or VMCA ( P = 0.16) were found between treatments. A significant dilation of the superficial temporal artery (STA) was seen ( P < 0.001). These results show that circulating adenosine has no effect on rCBF or VMCA, while it dilates the STA and causes very mild headache.

Is Precise Targeting of the Recipient Artery in a Superficial Temporal Artery–Middle Cerebral Artery Anastomosis Crucial?

2019 ◽  
Vol 80 (06) ◽  
pp. 441-453
Author(s):  
Hiroyuki Katano ◽  
Hiroshi Yamada ◽  
Yusuke Nishikawa ◽  
Kazuo Yamada ◽  
Shigenori Miyachi ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Single Photon ◽  
Superficial Temporal Artery ◽  
Photon Emission ◽  
Temporal Artery ◽  
Visual Assessment ◽  
Emission Computed Tomography ◽  
Recipient Artery ◽  
Visual Group

Abstract Objective To investigate the difference in treatment outcomes according to the method used to select the recipient artery in superficial temporal artery–middle cerebral artery (STA-MCA) anastomoses. Methods We retrospectively analyzed the cases of 35 patients who underwent an STA-MCA anastomosis for internal carotid artery/MCA occlusion or stenosis. Patients were divided into two groups based on whether the recipient artery was precisely targeted by single-photon emission computed tomography (SPECT group) or less precisely targeted by visual assessment (Visual group). Then the bypass results in both groups were evaluated postoperatively based on changes in the regional cerebral blood flow (rCBF) and clinical outcomes. Results The delineated recipient artery in magnetic resonance angiography (MRA) matched the intraoperatively selected artery in 87.6% of the SPECT group cases and 83.3% of the Visual group cases. The SPECT group's digital subtraction angiography (DSA) findings coincided with the intraoperative selection in 76.9% of cases, and the MRA findings corresponded with the DSA findings in 92.3%. The postoperative areas with increased rCBF matched the perfused areas of intraoperatively selected arteries in 80.0% of the SPECT group cases and 77.8% of the Visual group cases. Postoperatively increased rCBF areas matching totally or partially with preoperative low-perfusion areas were observed in all cases. Conclusions The present results revealed no significant differences in the change in rCBF in the low-perfusion area between the patients whose recipient arteries were selected by SPECT or visual assessment.

scholarly journals Dipyridamole Dilates Large Cerebral Arteries Concomitant to Headache Induction in Healthy Subjects

2000 ◽  
Vol 20 (9) ◽  
pp. 1372-1379 ◽  
Author(s):  
Christina Kruuse ◽  
Torsten B. Jacobsen ◽  
Lisbeth H. Lassen ◽  
Lars L. Thomsen ◽  
Steen G. Hasselbalch ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Middle Cerebral Artery ◽  
Cerebral Artery ◽  
Healthy Subjects ◽  
Single Photon ◽  
Photon Emission ◽  
Controlled Study ◽  
Emission Computed Tomography ◽  
Large Artery

Dipyridamole is used for secondary prophylaxis in ischemic stroke and as a vasodilator agent in myocardial scintigraphy. An important side effect to administering dipyridamole is headache. The aim of the current study was to investigate the effects of dipyridamole on cerebral blood flow, large artery diameter, and headache induction. Twelve healthy subjects were included in this single-blind placebo-controlled study in which placebo (0.9% NaCl) and dipyridamole 0.142 mg/kg·min were administered intravenously over 4 minutes 1 hour apart. Blood flow velocity in the middle cerebral artery (Vmca) was recorded by transcranial Doppler and regional cerebral blood flow in the middle cerebral artery (rCBFmca) was measured using single photon emission computed tomography and 133Xenon-inhalation. Blood pressure, heart rate, and pCO2 were measured repeatedly. Headache response was scored every 10 minutes on a verbal scale from 0 to 10 (10 = worst). Dipyridamole caused a decrease in pCO2 ( P < 0.001). pCO2 corrected rCBFmca was 41.7 ± 6.9 mL/100 g ·min after placebo versus 41.2 ± 6.9 after dipyridamole ( P ≥ 0.05). pCO2 corrected Vmca decreased 8.4% ± 11.7 ( P < 0.001) after dipyridamole, indicating a mean 5.6% ± 6.7 ( P = 0.005) relative increase of the arterial diameter. After dipyridamole the median peak headache score was 2 (range 0 to 7) compared with 0 (range 0 to 3) after placebo ( P = 0.02). Dilatation of the middle cerebral artery outlasted the headache response. In conclusion, dipyridamole causes a modest pCO2 independent dilatation of the MCA, which is time-linked to the onset, but not to the cessation, of headache.

Effect of Adrenomedullin on the Cerebral Circulation: Relevance to Primary Headache Disorders

Cephalalgia ◽  
2009 ◽  
Vol 29 (1) ◽  
pp. 23-30 ◽  
Author(s):  
KA Petersen ◽  
S Birk ◽  
K Kitamura ◽  
J Olesen
Keyword(s):  
Blood Flow ◽  
Cerebral Circulation ◽  
Single Photon ◽  
Superficial Temporal Artery ◽  
Photon Emission ◽  
Emission Computed Tomography ◽  
Double Blind Study ◽  
Causative Role ◽  
Double Blind ◽  
Primary Headache Disorders

Adrenomedullin (ADM) is closely related to calcitonin gene-related peptide, which has a known causative role in migraine. Animal studies have strongly suggested that ADM has a vasodilatory effect within the cerebral circulation. For these reasons, ADM is also likely to be involved in migraine. However, the hypothetical migraine-inducing property and effect on human cerebral circulation of ADM have not previously been investigated. Human ADM (0.08 µg kg−1 min−1) or placebo (saline 0.9%) was administered as a 20-min intravenous infusion to 12 patients suffering from migraine without aura in a crossover double-blind study. The occurrence of headache and associated symptoms were registered regularly 24 h post infusion. Cerebral blood flow (CBF) was measured by 133Xenon single-photon emission computed tomography, mean blood flow velocity in the middle cerebral artery (VMCA) by transcranial Doppler and the diameter of peripheral arteries by transdermal ultrasound (C-scan). ADM did not induce significantly more headache or migraine compared with placebo ( P = 0.58). CBF was unaffected by ADM infusion (global CBF, P = 0.32 and rCBFMCA, P = 0.38) and the same applied for the VMCA ( P = 0.18). The superficial temporal artery dilated compared with placebo ( P < 0.001), and facial flushing was seen after ADM administration ( P = 0.001). In conclusion, intravenous ADM is not a mediator of migraine headache and does not dilate intracranial arteries.

scholarly journals Brain Correlates of Memory Processes in Patients with Dementia of Alzheimer's Type: A Spect Activation Study

1998 ◽  
Vol 18 (4) ◽  
pp. 457-462 ◽  
Author(s):  
Dominique Cardebat ◽  
Jean-François Démonet ◽  
Michèle Puel ◽  
Alain Agniel ◽  
Gerard Viallard ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Regional Cerebral Blood Flow ◽  
Single Photon ◽  
Photon Emission ◽  
Memory Task ◽  
Frontal Region ◽  
Emission Computed Tomography ◽  
Regional Cerebral Blood ◽  
Actual Performance

Task-induced changes in regional cerebral blood flow (rCBF) during verbal episodic memory activation were compared in 17 right-handed patients with dementia of the Alzheimer's type (DAT) and 20 healthy volunteers. Regional cerebral blood flow was assessed using single photon emission computed tomography (SPECT) and an injection of 133Xe (xenon, isotope of mass 133) in 21 regions of interest (ROI) during rest, passive listening to 36 words, and memorizing of a 12-word list repeated three times. In healthy subjects, memory—listening comparison showed activation of a distributed system involving several left-sided ROI, especially the posterior inferior frontal region. In patients with DAT, the same pattern of activation was found for listening—rest comparison, and no significant changes were found in memory—listening comparison. During listening compared with rest, significant activation was observed in left-sided hypoperfused regions. A significant correlation between memory performance and rCBF recorded in patients with DAT during the memory task was found only in the right lateral frontal region, a region that was not hypoperfused significantly in patients. The involvement of this region might relate to either retrieval effort or actual performance of patients with DAT on the memory task.

Focal hyperperfusion after superficial temporal artery—middle cerebral artery anastomosis in a patient with moyamoya disease

2004 ◽  
Vol 100 (1) ◽  
pp. 128-132 ◽  
Author(s):  
Kazuhide Furuya ◽  
Nobutaka Kawahara ◽  
Akio Morita ◽  
Toshimitsu Momose ◽  
Shigeki Aoki ◽  
...  
Keyword(s):  
Middle Cerebral Artery ◽  
Moyamoya Disease ◽  
Cerebral Artery ◽  
Single Photon ◽  
Superficial Temporal Artery ◽  
Photon Emission ◽  
Temporal Artery ◽  
Neurological Deterioration ◽  
Perfusion Reserve ◽  
Frontal Operculum

✓ Superficial temporal artery—middle cerebral artery (STA—MCA) anastomosis is a standard surgical therapeutic option in patients with moyamoya disease. Most patients experience improvement in their clinical symptoms immediately after surgery. The authors report on the case of a 39-year-old man with moyamoya disease who suffered from temporary and frequent neurological deterioration after undergoing a left STA—MCA anastomosis. Hemodilution and hypervolemia therapies did not improve his course. Technetium-99m hexamethylpropyleneamine oxime single-photon emission tomography scans demonstrated focal intense accumulation of the tracer in the frontal operculum on the side of the surgery. Although diffusion-weighted magnetic resonance (MR) imaging demonstrated no abnormalities except for the postoperative change, perfusion-weighted MR images and MR digital subtraction angiography revealed focal hyperperfusion in the left frontal operculum where the cerebral perfusion reserve was severely disturbed preoperatively. This evidence strongly supports the notion that focal hyperperfusion observed after STA—MCA anastomosis could occur in the poor perfusion reserve area preoperatively and could cause temporary neurological deterioration.

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