L A S H Syndrome

http://onlinelibrary.wiley.com/doi/10.1111/j.1526-4610.2012.02248.x/abstract

The central analgesia induced by antimigraine drugs is independent from Gi proteins: superiority of a fixed combination of indomethacin, prochlorperazine and caffeine, compared to sumatriptan, in an in vivo model

The Journal of Headache and Pain
Volume 10, Number 6 / December, 2009
Carla Ghelardini¹, Nicoletta Galeotti¹, Elisa Vivoli¹, Irene Grazioli² and Carla Uslenghi²

(1)	Department of Pharmacology, University of Florence, Viale G. Pieraccini, 6, 50139 Florence, Italy

(2)	Medical Department, Solvay Pharma S.p.A., Via della Libertà, 30, 10095 Grugliasco, Torino, Italy

Abstract  A hypofunctionality of Gi proteins has been found in migraine patients. The fixed combination of indomethacin, prochlorperazine and caffeine (Indoprocaf) is a drug of well-established use in the acute treatment of migraine and tension-type headache. The aim of this study was to investigate if Indoprocaf was able to exert its central antinociceptive action when Gi proteins activity is abolished by pertussis toxin (PTX), compared to its single active ingredients and to sumatriptan. The mice model of abdominal constriction test induced by an i.p. injection of a 0.6% solution of acetic acid was used. The study showed that Indoprocaf (a fixed combination of indomethacin 1 mg/kg, prochlorperazine 1 mg/kg and caffeine 3 mg/kg, s.c.) and sumatriptan (20 mg/kg, s.c.) exert their central antinociceptive action independently from the Gi proteins. In addition, the antinociceptive efficacy of Indoprocaf in this study was statistically superior to that of sumatriptan. This study also showed that the single active ingredients of Indoprocaf, indomethacin (1 mg/kg, s.c.), prochlorperazine (1 mg/kg, s.c.) and caffeine (3 mg/kg, s.c.), were able to exert their central antinociceptive action independently from the Gi proteins. However, Indoprocaf at analgesic doses was able to abolish almost completely the abdominal constrictions, with a statistically higher efficacy compared to the single active ingredients, showing an important synergic effect of Indoprocaf. This synergic effect was evident not only when Gi proteins activity was abolished by PTX, but also under control condition, when Gi proteins were active. This study suggests that the central antinociceptive action induced by antimigraine drugs is independent from Gi proteins.

Cough headache: a study of 83 consecutive patients

Cough headache: a study of 83 consecutive patients

Cephalalgia. Vol 29, Issue 10: Pages 1079 - 1085

Published Online: 17 Mar 2009

P-K Chen ^1,2 , J-L Fuh ^3,4 & S-J Wang ^3,4

¹ Department of Neurology, Lin-Shin Hospital, ² Department of Medical Imaging and Radiological Science, Central Taiwan University of Science and Technology, Taichung, ³ National Yang-Ming University School of Medicine, and ⁴ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan

Correspondence to Dr Shuu-Jiun Wang MD, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. Tel. + 886-2-2876-2522, fax + 886-2-2876-5215, e-mail sjwang@vghtpe.gov.tw

Copyright © 2009 International Headache Society

ABSTRACT

To delineate the differences in clinical characteristics and evaluate the outcome between primary and secondary cough headache, 83 consecutive patients (59M/24F, mean age 61.5 ± 17.7 years) with cough headache (1.2%) out of 7100 patients in a headache clinic were studied. All of them received brain imaging studies. Most did not have relevant brain lesions (n = 74, 89.2%, primary group) except for nine patients (10.8%, the secondary group). Most of the intracranial lesions were located in the posterior fossa (n = 6, 67%), including only two patients with Chiari malformation. The primary group had a higher response rate to indomethacin than the secondary group (72.7% vs. 37.5 %, P = 0.046). Mild to moderate headache intensity and age onset <> 30 min. Clinical features, neurological examinations and drug response could not safely differentiate primary from secondary cough headache. Neuroimaging studies are required in each patient.

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Received 19 October 2008, accepted 22 December 2008

DIGITAL OBJECT IDENTIFIER (DOI)

10.1111/j.1468-2982.2009.01844.x