Could leaky blood vessels be a target for treating migraines? Study opens up promising new area of research

August 30, 2018

Migraine headaches are often accompanied by electrical waves that slowly move across the brain,  causing flashes of light and other visual disturbances.  Referred to as “migraine aura”, this phenomenon also affects the brain’s blood vessels, allowing large molecules from the blood to leak into the brain and cause inflammation and damage.

New research led by Dr. Baptiste Lacoste (The Ottawa Hospital, University of Ottawa), Dr. Cenk Ayata (Harvard University, Massachusetts General Hospital) and Dr. Chenghua Gu (Harvard University) reveals for the first time exactly how the blood-brain barrier opens during a migraine attack, and how to stop it.Here, blood vessels are stained in red and the blood itself in green (with surrounding cells in blue). Six hours after the start of a migraine attack, the blood can be found outside the vessel wall, which is prevented by treatment with fasudil. Courtesy of Dr. Baptiste Lacoste.

Using a mouse model, they found that six hours after the start of an aura, there was a 50 percent increase in the movement of tiny fluid-filled vesicles across the brain’s blood vessels. This process, called transcytosis, caused blood plasma to leak into the brain.

They also found that a compound called fasudil, which is already used in humans to treat pulmonary hypertension and cerebral vasospasms, could block this phenomenon and prevent the blood-brain barrier from opening.

Future research could lead to new treatments for migraine and other conditions.

“This kind of blood vessel leakiness is also thought to occur in stroke and other brain conditions, so this opens up a whole new avenue of research,” said Dr. Lacoste, a scientist at The Ottawa Hospital and assistant professor at the University of Ottawa.

This research is published in Annals of Neurology and will be featured on the cover of the September 2018 edition.

Authors: Sadeghian H, Lacoste B, Qin T, Toussay X, Rosa R, Oka F, Chung DY, Takizawa T, Gu C, Ayata C.

Funders: Research at The Ottawa Hospital is possible because of generous donations to The Ottawa Hospital. This study was also supported by the National Institutes of Health, the International Headache Society, the American Headache Society, the Japanese Heart Foundation, the Howard Hughes Medical Institute, Fondation Leducq, Heitman Foundation, Ellison Foundation, the Bayer Yakuhin Research Grant Abroad and Fidelity Biosciences Research.

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