A Paradoxical Vasodilatory Nutraceutical Intervention for Prevention and Attenuation of Migraine-A Hypothetical Review.
MetadataShow full item record
© 2020 The Authors. Published by MDPI Publishing.
Studies suggest that migraine pain has a vascular component. The prevailing dogma is that peripheral vasoconstriction activates baroreceptors in central, large arteries. Dilatation of central vessels stimulates nociceptors and induces cortical spreading depression. Studies investigating nitric oxide (NO) donors support the indicated hypothesis that pain is amplified when acutely administered. In this review, we provide an alternate hypothesis which, if substantiated, may provide therapeutic opportunities for attenuating migraine frequency and severity. We suggest that in migraines, heightened sympathetic tone results in progressive central microvascular constriction. Suboptimal parenchymal blood flow, we suggest, activates nociceptors and triggers headache pain onset. Administration of NO donors could paradoxically promote constriction of the microvasculature as a consequence of larger upstream central artery vasodilatation. Inhibitors of NO production are reported to alleviate migraine pain. We describe how constriction of larger upstream arteries, induced by NO synthesis inhibitors, may result in a compensatory dilatory response of the microvasculature. The restoration of central capillary blood flow may be the primary mechanism for pain relief. Attenuating the propensity for central capillary constriction and promoting a more dilatory phenotype may reduce frequency and severity of migraines. Here, we propose consideration of two dietary nutraceuticals for reducing migraine risk: L-arginine and aged garlic extracts.
Showing items related by title, author, creator and subject.
L-arginine and aged garlic extract for the prevention of migraine: a study protocol for a randomised, double-blind, placebo-controlled, phase-II trial (LARGE trial).Chaliha, Devahuti; Vaccarezza, Mauro ; Corti, Emily; Takechi, Ryusuke; Dhaliwal, Satvinder; Drummond, Peter; Visser, Eric; Chen, Fred; Charng, Jason; Lam, Virginie; Mamo, John (2023)Background Migraine is a common and distressing neurological condition characterised by recurrent throbbing headaches, nausea and heightened sensitivity to light and sound. Accumulating evidence suggests that cerebral ...
Marciszewski, K.K.; Meylakh, N.; Harrington, Flavia ; Mills, E.P.; Macefield, V.G.; Macey, P.M.; Henderson, L.A. (2018)© 2018 the authors. The neural mechanism responsible for migraine remains unclear. While an external trigger has been proposed to initiate a migraine, it has also been proposed that changes in brainstem function are ...
The clinical utility and validity of the cervical flexion-rotation test in the diagnosis and management of cervicogenic headacheHall, Toby M (2010)Headache is a common complaint with increasing prevalence in the third decade. Because it is so common, headache gives rise to substantial financial costs to society. In addition headache burdens both the health care ...