Effects of PDE-3 inhibition in persistent post-traumatic headache: evidence of cAMP-dependent signaling.
J Headache Pain
; 25(1): 56, 2024 Apr 17.
Article
in En
| MEDLINE
| ID: mdl-38627631
ABSTRACT
BACKGROUND:
Phosphodiesterase 3 (PDE-3) inhibition have been implicated in the neurobiologic underpinnings of migraine. Considering the clinical similarities between migraine and persistent post-traumatic headache (PPTH), we aimed to ascertain whether PDE-3 inhibition can elicit migraine-like headache in persons with PPTH.METHODS:
We tested cilostazol, which inhibits PDE-3, in a randomized, double-blind, placebo-controlled, two-way crossover study involving persons with PPTH attributed to mild traumatic brain injury. The randomized participants were allocated to receive oral administration of either 200-mg cilostazol or placebo (calcium tablet) on two separate experiment days. The primary end point was the incidence of migraine-like headache during a 12-hour observation window post-ingestion. The secondary endpoint was the area under the curve (AUC) for reported headache intensity scores during the same observation window.RESULTS:
Twenty-one persons underwent randomization and completed both experiment days. The mean participants' age was 41.4 years, and most (n = 17) were females. During the 12-hour observation window, 14 (67%) of 21 participants developed migraine-like headache post-cilostazol, in contrast to three (14%) participants after placebo (P =.003). The headache intensity scores were higher post-cilostazol than after placebo (P <.001).CONCLUSIONS:
Our results provide novel evidence showing that PDE-3 inhibition can elicit migraine-like headache in persons with PPTH. Given that PDE-3 inhibition increases intracellular cAMP levels, our findings allude to the potential therapeutic value of targeting cAMP-dependent signaling pathways in the management of PPTH. Further investigations are imperative to substantiate these insights and delineate the importance of cAMP-dependent signaling pathways in the neurobiologic mechanisms underlying PPTH. GOV IDENTIFIER NCT05595993.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Tension-Type Headache
/
Post-Traumatic Headache
/
Migraine Disorders
Limits:
Adult
/
Female
/
Humans
/
Male
Language:
En
Journal:
J Headache Pain
Journal subject:
MEDICINA INTERNA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Year:
2024
Document type:
Article
Affiliation country:
Country of publication: