C. Tassorelli et al., The effects on the central nervous system of nitroglycerin - Putative mechanisms and mediators, PROG NEUROB, 57(6), 1999, pp. 607-624
Nitroglycerin is an organic nitrate that has been used as a vasodilator in
the treatment of cardiac diseases for over a century. Only recently it has
been demonstrated that the vasodilator effect of this drug depends upon the
formation of nitric oxide in the blood vessel wall, However, clinical and
research data gathered during the last decades have suggested that nitrogly
cerin possesses, besides its peripheral vasodilator effect, additional, puz
zling biological activities.
This organic nitrate compound provokes reflex cardiovascular activities via
its interaction with the central sympathetic system. Its cerebrovascular e
ffect, on the other hand, is probably mediated by the local release of neur
opeptides, The direct application of nitroglycerin onto brain nuclei causes
a prompt increase in the neuronal discharge rate.
From a neurological point of view, nitroglycerin consistently induces a spe
cific headache attack in patients suffering from migraine. Because of its t
emporal pattern and clinical characteristics, nitroglycerin-induced headach
e cannot be solely ascribed to the a drug-induced vasorelaxation,
The demonstration that systemic nitroglycerin administration activates a wi
despread set of vegetative, nociceptive and neuroendocrine structures in th
e central nervous system seems to further support the occurrence of central
mechanisms in the biological activity of nitroglycerin.
Double labeling immunocytochemical and neuropharmacological studies have pr
ovided information on the putative neurotransmitters and neurochemical mech
anisms involved in nitroglycerin-induced neuronal activation. (C) 1999 Else
vier Science Ltd. All rights reserved.