Serum calcitonin gene related peptide (CGRP) levels in migraine: A study on its clinical correlation and diagnostic efficacy

Migraine is a primary headache disorder marked by recurrent unilateral headache episodes. Calcitonin gene related peptide (CGRP) plays major role in migraine pathophysiology. CGRP is multifunctional, and its vasodilating activity within the central and peripheral blood vessels is one in all its primary functions. The intention is to prove serum calcitonin gene related peptide (CGRP) as an early diagnostic tool for migraine and the novelty is to correlate it with characteristics of migraine so that it helps in early initiation of treatment. Methods. 100 subjects including 90 patients with migraine and 10 with non-headache (NH) age-matched controls were prospectively recruited in our current study. The subjects were aged from 15- 50 years. The clinical assessment was made every month for the three months after the start of therapy. The subjects were compared based on the serum CGRP values. Serum CGRP concentrations were measured by using CGRP ELISA kit. Results. Out of total subjects selected, the maximum (23.3%) subjects were between age 26 and 30 years and least effected age group was 46-50 years (4.44%). Females’ predominance with 82% than males with 18%.Stress was major trigger occurring in 57% of cases. Throbbing pain with elevated CGRP levels 130.44±114.22 and p value (p = 0.01). The average CGRP levels was higher in test group 149.00±93.86 compared to control 61.30±24.37 with p value (p = 0.02). Conclusions. The serum CGRP levels were statistically more in migraine patients correlated with characteristics like throbbing type of pain, stress and inadequate sleep. Hence, the serum CGRP levels estimation can be considered as a diagnostic tool for migraine when the clinical character’s over lap or early in the course of migraine when all criteria for diagnosis are not yet fulfilled.

Download Full-text

Role of Calcitonin Gene Related Peptide (CGRP) in Migraine

Bangladesh Journal of Neuroscience ◽

10.3329/bjn.v33i1.57468 ◽

2017 ◽

Vol 33 (1) ◽

pp. 39-43

Author(s):

Md Ashraf Ali ◽

Habibur Rahaman

Keyword(s):

Family Relationships ◽

Preventive Treatment ◽

Primary Headache ◽

Calcitonin Gene Related Peptide ◽

Childhood And Adolescence ◽

Protein Extravasation ◽

Related Peptide ◽

Plasma Protein Extravasation ◽

Calcitonin Gene ◽

Potent Vasodilator

Migraine is the second most primary headache. The prevalence of Migraine is 12% in the general population, including 18% in women and 6% in men. Migraine can start in childhood and adolescence and continue throughout lifespan. It is most prevalent among people in their 30s and 40s. Migraine is a debilitating hemicranial headache that is pulsating, aggravated by movement, nausea, vomiting and having sensitivity to light and sound, with or without aura. It can affect all aspects of life as work and school, parenting and family relationships and personal and leisure time. There are some theory regarding pathogenesis of migraine which includes cortical spreading depression, cortical spreading oligemia, activation of trigeminocervical complex leading to neuroinflammation & release of vasodialating neuropeptides which include calcitonin gene related peptide (CGRP), substance P, vasoactive intestinal polypeptide (VIP), nitric oxide (NO), and pituitary adenylate cyclase activating peptide (PACAP) & genetic factor. CGRP is a potent vasodilator and causes perivascular plasma protein extravasation and nociceptive pain. Newer medications target CGRP both for acute and preventive treatment of migraine. Bangladesh Journal of Neuroscience 2017; Vol. 33 (1): 39-43

Download Full-text

The role of calcitonin gene-related peptide in the pathogenesis of primary headache

Drugs of the Future ◽

10.1358/dof.2006.031.02.962718 ◽

2006 ◽

Vol 31 (2) ◽

pp. 175

Author(s):

M.J. Fischer

Keyword(s):

Primary Headache ◽

Calcitonin Gene Related Peptide ◽

Related Peptide ◽

Calcitonin Gene

Download Full-text

Serum Calcitonin Gene-Related Peptide and Receptor Protein Levels in Patients With Fibromyalgia Syndrome: A Cross-Sectional Study

Archives of Rheumatology ◽

10.46497/archrheumatol.2020.7783 ◽

2020 ◽

Vol 35 (4) ◽

pp. 463-467

Author(s):

Ragıp Ulvi KORUCU ◽

Ahmet KARADAĞ ◽

Ayça TAŞ ◽

Esma ÖZMEN ◽

Emrullah HAYTA ◽

...

Keyword(s):

Fibromyalgia Syndrome ◽

Cross Sectional Study ◽

Calcitonin Gene Related Peptide ◽

Receptor Protein ◽

Sectional Study ◽

Cross Sectional ◽

Serum Calcitonin ◽

Protein Levels ◽

Related Peptide ◽

Calcitonin Gene

Download Full-text

Comparative evaluation of serum calcitonin gene related peptide level in patients with migraine headache with and without aura

10.21203/rs.3.rs-201874/v1 ◽

2021 ◽

Author(s):

Mostafa Rezaee ◽

Nahid Ashja zadeh ◽

Sadegh Izedi ◽

Farinaz Fakhri

Keyword(s):

Correlation Coefficient ◽

Rank Correlation ◽

Calcitonin Gene Related Peptide ◽

Clinical Findings ◽

Enzyme Linked Immunosorbent Assay ◽

Control Group ◽

Serum Calcitonin ◽

Related Peptide ◽

Spearman’S Rank Correlation ◽

Calcitonin Gene

Abstract Background During a migraine attack, trigeminal activation results in the release of calcitonin gene-related peptide (CGRP), which stimulates the release of inflammatory cytokines playing an important role in migraine. We analyze the serum level of CGRP between two groups of migrainous patients (with aura and without aura) Materials and Methods Thirty six migraine patients (included 18 patients with aura and 18 without aura) additionally 18 healthy volunteers consisted control group were selected from the clinic of Neurology, Shiraz University of Medical Sciences, Shiraz, Iran, between March 2020 and November 2020. The CGRP level were determined from the sera of patients with migraine and control subjects by enzyme-linked immunosorbent assay kits. Spearman's rank correlation coefficient was also determined to calculate the correlation between CGRP and clinical findings. Results The level of CGRP in groups were significantly different between groups (P = 0.00). Also, the level of CGRP in aura group were significantly higher than non-aura group (P = 0.045). The Spearman’s correlation coefficient revealed a positive and significant correlation between the CGRP concentration and age (p = 0.042, r = 0.172), BMI (p = 0.013, r = 0.08), VAS (P = 0.006 ,r = 0.09), frequency of attacks (p = 0.005, r = 0.9), duration of each attack (p = 0.016, r = 0.23), Migraine Disability Assessment Scale.(p = 0.00, r = 0.785), average of number of Medication (p = 0.00, r = 0.694). However, no significant correlation was observed with gender. (P > 0.05 ) Conclusions In our study, we found migraine patients had a higher CGRP level than healthy controls and the level of CGRP was related significantly with the duration, BMI, frequency of headache, age, number of headaches per day. In conclusion, our results confirmed that CGRP may be involved in the pathogenesis of migraine attacks and related with the multiple clinical characteristics.

Download Full-text

Calcitonin Gene-Related Peptide (CGRP) and Cluster Headache

Brain Sciences ◽

10.3390/brainsci10010030 ◽

2020 ◽

Vol 10 (1) ◽

pp. 30 ◽

Cited By ~ 5

Author(s):

Andrea Carmine Belin ◽

Caroline Ran ◽

Lars Edvinsson

Keyword(s):

Cluster Headache ◽

Pain Perception ◽

Primary Headache ◽

Active Phase ◽

Calcitonin Gene Related Peptide ◽

Primary Headaches ◽

Cgrp Receptor ◽

Related Peptide ◽

Calcitonin Gene ◽

Autonomic Reflex

Cluster headache (CH) is a severe primary headache with a prevalence of 1/1000 individuals, and a predominance in men. Calcitonin gene-related peptide (CGRP) is a potent vasodilator, originating in trigeminal neurons and has a central role in CH pathophysiology. CGRP and the CGRP receptor complex have recently taken center stage as therapeutic targets for primary headaches, such as migraine. Multiple CGRP and CGRP receptor monoclonal antibodies, as well as small molecule antagonists (gepants) are on their way constituting a new frontier of migraine and possibly CH medication. During a CH attack, there is an activation of the trigeminal-autonomic reflex with the release of CGRP, and inversely if CGRP is administered to a CH patient in an active disease phase, it triggers an attack. Increased levels of CGRP have been found in ipsilateral jugular vein blood during the active phase of CH. This process is hypothesized to have a key role in the intense pain perception and in the associated distinctive vasodilation. So far, clinical tests of CGRP antibodies have been inconclusive in CH patients. This review summarizes the current state of knowledge on the role of CGRP in CH pathology, and as a target for future treatments.

Download Full-text

CGRP release in an experimental human trigeminal pain model

Cephalalgia ◽

10.1177/03331024211017250 ◽

2021 ◽

pp. 033310242110172

Author(s):

Achim Frese ◽

Oliver Summ ◽

Stefan Evers

Keyword(s):

Healthy Subjects ◽

Primary Headache ◽

Calcitonin Gene Related Peptide ◽

Headache Disorders ◽

Pain Model ◽

Related Peptide ◽

Trigeminal Pain ◽

Calcitonin Gene ◽

Autonomic Activation ◽

Mandibular Region

Background Migraine and trigemino-autonomic cephalalgia attacks are associated with an increase of α-calcitonin-gene related peptide levels in the ipsilateral jugular vein. It is however unknown whether trigeminal pain stimulation in healthy subjects without headache disorders also induces increase of calcitonin-gene related peptide levels. Findings We measured α-calcitonin-gene related peptide levels in eight healthy subjects after subcutaneous injection of capsaicin in the forehead and in the mandibular region and after injection of sodium chloride in the forehead. We observed a significant increase of α-calcitonin-gene related peptide level only after injection of capsaicin in the forehead (i.e. first trigeminal branch). We also observed trigemino-autonomic activation (lacrimation, rhinorrhea etc.) only after injection of capsaicin in the forehead. Conclusion Increase of α-calcitonin-gene related peptide levels do not only occur in primary headache attacks but also after experimental trigeminal pain of the first branch. This finding suggests that α-calcitonin-gene related peptide elevation is, at least an additional, unspecific effect of first trigeminal branch stimulation following pain activation and not a specific mechanism of idiopathic headache disorders.

Download Full-text