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The investigators hypothesized that migraine without patients with many genetic loci associated with migraine (high genetic load) would be more sensitive and get provoked more migraine attacks by PACAP compared to patients with few genetic loci associated with migraine (low genetic load).
Migraine is a very prevalent neurological disorder with a strong genetic factor. The common forms of migraine have a multifactorial and polygenic pattern of inheritance and genetics research is crucial for a deeper understanding of migraine mechanisms. Recently, 12 genetic loci have been identified to be associated with migraine with (MA) and without aura (MA) in four large genome-wide association studies (GWAS). The functional consequences of this genetic variant in humans are yet unknown.
PACAP is a neuropeptide which plays a crucial role in the pathophysiology of migraine and is present in migraine relevant structures. PACAP can induce migraine attacks in MO patients via an adenosine monophosphate (cAMP) dependent pathway. Also, a recent study has showed that intracellular accumulation of cAMP is crucial for the induction of migraine attacks.
The phenotype of the migraine inducing effects of PACAP might therefore be linked to some of the 12 genetic susceptibility loci that have been identified.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Migraine patients with high genetic load | Active Comparator | PACAP intravenous infusion 1.5 microgram/min for 20 min |
|
| Migraine patients with low genetic load | Active Comparator | PACAP intravenous infusion 1.5 microgram/min for 20 min |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| PACAP | Drug | Pituitary adenylate cyclase-activating polypeptide (PACAP) |
|
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of migraine attacks induced by PACAP in patients with high and low genetic load. | The difference in incidence of migraine-like attacks after PACAP between patients with and without high genetic load and patients with low genetic load using verbal rating scale (VRS). | Change from baseline in headache intensity at 12 hours after the start of infusion of PACAP |
| Measure | Description | Time Frame |
|---|---|---|
| Incidence of headache induced by PACAP in patients with high and low genetic load. | The difference in area under the curve (AUC) for headache intensity scores (0-12 hours) after infusion of PACAP | Change from baseline in headache intensity at 12 hours after the start of infusion of PACAP |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Danish Headache Center & Department of Neurology | Copenhagen | Glostrup | 2600 | Denmark |
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| ID | Term |
|---|---|
| D020326 | Migraine without Aura |
| ID | Term |
|---|---|
| D008881 | Migraine Disorders |
| D051270 | Headache Disorders, Primary |
| D020773 | Headache Disorders |
| D001927 | Brain Diseases |
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| ID | Term |
|---|---|
| D051219 | Pituitary Adenylate Cyclase-Activating Polypeptide |
| ID | Term |
|---|---|
| D009414 | Nerve Growth Factors |
| D036341 | Intercellular Signaling Peptides and Proteins |
| D010455 | Peptides |
| D000602 | Amino Acids, Peptides, and Proteins |
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|
| D002493 |
| Central Nervous System Diseases |
| D009422 | Nervous System Diseases |
| D009479 | Neuropeptides |
| D011506 | Proteins |
| D009419 | Nerve Tissue Proteins |
| D001685 | Biological Factors |