During cluster headache attacks, plasma levels of calcitonin gene-related peptide (CGRP) increase, and trigeminal nerve activation leads to pain. A new study shows that CGRP infusion can induce cluster headache attacks in some patients, with important implications for the investigation of CGRP-targeted therapies in cluster headache.
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Hoffmann, J. & May, A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol. 17, 75–83 (2018).
Vollesen, A. L. et al. Effect of infusion of calcitonin gene-related peptide on cluster headache attacks: a randomized clinical trial. JAMA Neurol. https://doi.org/10.1001/jamaneurol.2018.1675 (2018).
Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38, 1–211 (2018).
Martelletti, P. & Curto, M. Headache: cluster headache treatment — RCTs versus real-world evidence. Nat. Rev. Neurol. 10, 557–558 (2016).
Goadsby, P. J. & Edvinsson, L. Human in vivo evidence for trigeminovascular activation in cluster headache. Neuropeptide changes and effects of acute attacks therapies. Brain 117, 427–434 (1994).
May, A. et al. PET and MRA findings in cluster headache and MRA in experimental pain. Neurology 55, 1328–1335 (2000).
Goadsby, P. J., Edvinsson, L. & Ekman, R. Vasoactive peptide release in the extracerebral circulation of humans during migraine headache. Ann. Neurol. 28, 183–187 (1990).
Lassen, L. H. et al. CGRP may play a causative role in migraine. Cephalalgia 22, 54–61 (2002).
Ong, J. J., Wei, D. Y. & Goadsby, P. J. Recent advances in pharmacotherapy for migraine prevention: from pathophysiology to new drugs. Drugs 78, 411–437 (2018).
The author has received fees from Eli Lilly and TEVA for serving on their advisory boards.
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Leone, M. Evidence mounts for anti-CGRP treatment in cluster headache. Nat Rev Neurol 14, 636–637 (2018). https://doi.org/10.1038/s41582-018-0063-2
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