Abstract
BackgroundThe non-invasive biomarkers of migraine can help to develop the personalized medication of this disorder. In testing of the antimigraine drugs the capsaicin-induced skin redness with activated TRPV1 receptors in sensory neurons associated with the release of the migraine mediator CGRP has already been widely used.MethodsFourteen migraine patients (mean age 34.6 ± 10.2 years) and 14 healthy volunteers (mean age 29.9 ± 9.7 years) participated in the experiment. A new arrangement of imaging photoplethysmography recently developed by us was used here to discover novel sensitive parameters of dermal blood flow during capsaicin applications in migraine patients.ResultsBlood pulsation amplitude (BPA) observed as optical-intensity waveform varying synchronously with heartbeat was used for detailed exploration of microcirculatory perfusion induced by capsicum patch application. The BPA signals, once having appeared after certain latent period, were progressively rising until being saturated. Capsaicin-induced high BPA areas were distributed unevenly under the patch, forming “hot spots.” Interestingly the hot spots were much more variable in migraine patients than in the control group. In contrast to BPA, a slow component of waveforms related to the skin redness changed significantly less than BPA highlighting the latter parameter as the potential sensitive biomarker of capsaicin-induced activation of the blood flow. Thus, in migraine patients, there is a non-uniform (both in space and in time) reaction to capsaicin, resulting in highly variable openings of skin capillaries.ConclusionBPA dynamics measured by imaging photoplethysmography could serve as a novel sensitive non-invasive biomarker of migraine-associated changes in microcirculation.
Highlights
The non-invasive biomarkers of migraine can help to develop the personalized medication of this disorder
Capsaicin-induced blood perfusion The baseline of blood perfusion in the capillary bed of the upper arm was at low level for majority of subjects (BPA was less than 0.3%)
According to the protocol of our experiment, the lidocaine patch was applied for one hour and after its removal, the 8%-capsaicin patch was applied to the same area of the upper arm
Summary
The non-invasive biomarkers of migraine can help to develop the personalized medication of this disorder. Kamshilin et al The Journal of Headache and Pain (2018) 19:43 pharmaceutical significance, this DBF method could be attractive to develop personalized approaches for migraine treatments, for instance, to test the sensitivity of the particular individual to capsaicin as a prognostic of CGRP mediated component in his/her vascular reactions. In this regard, it is worth noting that people with TRPV1 rs8065080 polymorphism are differentially sensitive to capsaicin [1] providing a genetic background for the distinct reactivity. In most studies simple measurement of the flare size is commonly used as the index of activation of capsaicin receptors [4, 10] it is clear that this general reaction is determined by many non-specific factors such as the thickness of skin, its native color and, importantly, the level of CGRP released from the skin nerves [2]
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