Clinical Edge Journal Scan

Adenosine induces headache and short-lasting vasodilation but not migraine attacks


 

Key clinical point: Adenosine vs placebo infusion increased headaches and short-lasting vasodilation without a significant induction of migraine attacks in patients with migraine without aura.

Major finding: The incidence of migraine attacks was not significantly different after adenosine vs placebo infusion (39% vs 17%; P = .29); however, a higher proportion of patients receiving adenosine vs placebo reported headache (78% vs 33%; P < .01). Adenosine vs placebo increased heart rate (area under the curve [AUC]T0-120 min, P < .001), facial skin blood flow (AUCT0-120 min, P < .05), and left superficial temporal artery diameter (AUCT0-20 min, P = .01), but decreased middle cerebral artery blood flow velocity (AUCT0-20 min, P < .001).

Study details: This randomized controlled trial included 18 patients with migraine without aura who received adenosine or placebo infusion over 20 minutes on two study days separated by a 1 week washout period.

Disclosures: This study received support from the Lundbeck Foundation. M Ashina reported receiving consulting fees, honoraria for lectures and presentations, and royalties from various sources, including Lundbeck.

Source: Thuraiaiyah J et al. Adenosine causes short-lasting vasodilation and headache, but not migraine attacks in migraine patients: A randomized clinical trial. Pain. 2022 (Oct 17). Doi: 10.1097/j.pain.0000000000002804

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