Abstract text (incl. figure legends and references)

Question

Does adenosine infusion induce migraine attack?

Methods

In a randomized, double-blinded, placebo-controlled, crossover study, 18 participants diagnosed with migraine without aura were allocated to receive 120 µg/kg/min adenosine or placebo over 20 minutes. Headache intensity, migraine associated symptoms, vital signs, the diameter of the superficial temporal artery (STA) and blood flow velocity in the middle cerebral artery (V_MCA) were measured at baseline and every 10 minutes until two hours post-infusion start.

The primary endpoint was the difference in incidence of migraine attacks after adenosine compared to placebo.

Results

Eighteen participants completed the study. We found no difference in incidence of migraine following adenosine (7/18, 39%) compared to placebo (3/18, 17%) (P = 0.29). Fourteen of 18 (78%) participants reported headache after adenosine compared to placebo (6/18, 33%) (P < 0.01). Adenosine increased heart rate (P < 0.001), facial skin blood flow (P < 0.05) and STA diameter (AUC_T0-20min, P = 0.01), and decreased VMCA (AUC_T0-20min, P < 0.001) compared to placebo. While mean arterial blood pressure (P = 0.96) remained unaltered.

Conclusion

Adenosine induced headache accompanied by a short-lasting (< 30 min) dilation of intra- and extracerebral arteries. However, adenosine is a less powerful migraine inducer compared to other migraine inducing substances.