1 Nitric oxide (NO) has been proposed to be a key molecule in the pathogene
sis of migraine pain and other headaches that are linked to vascular disord
ers. Several lines of evidence indicate that the meningeal vascularization
is crucially involved in the generation of these headaches. In an experimen
tal model in the rat a dominating role of calcitonin gene-related peptide (
CGRP) in causing neurogenic vasodilatation and increased blood flow has bee
n shown. The aim of the present study was to clarify the role of NO in this
model with regard to the meningeal blood flow.
2 The blood flow in and around the medial meningeal artery (dural arterial
flow) was recorded in the exposed parietal dura mater encephali of barbitur
ate anaesthetized rats using laser Doppler flowmetry. Local electrical stim
ulation of the dura mater (pulses of 0.5 ms delivered at 7.5-17.5 V and 5 o
r 10 Hz for 30 s) caused temporary increases in dural arterial flow for abo
ut 1 min that reached peaks of 1.6-2.6 times the basal flaw. The effects of
NO synthase (NOS) inhibitors on the basal flow and the electrically evoked
increases in flow were examined.
3 Systemic (i.v.) administration of N-omega-nitro-L-arginine methyl ester (
L-NAME) at cumulative doses of 10 and 50 mg kg(-1) lowered the basal flow t
o 87 and 72%, respectively, of the control and reduced the evoked increases
in blood flow to 82 and 44% on an average. Both these effects could partly
be reversed by 300 mg kg(-1) L-arginine. The systemic arterial pressure wa
s increased by L-NAME at both doses. Injection of the stereoisomer D-NAME a
t same doses did not change basal flow and evoked increases in flow.
4 Topical application of L-NAME (10(-4)-10(-2) M) was effective only at the
highest concentration, which caused lowering of the basal blood flow to 78
% of the control; the evoked increases in flow were not changed. Topical ap
plication of 2-amino-5,6-dihydro-6-methyl-4H-1,3-thiazine (AMT), a specific
inhibitor of the inducible NOS, at concentrations of 10(-4)-10(-2) M lower
ed the basal flow to 89, 87.5 and 85%, respectively, but did not significan
tly change the evoked flow increases. Same concentrations of 7-nitroindazol
e monosodium salt (7-NINA), a specific inhibitor of the neuronal NOS, had n
o significant effects on basal flow and evoked increases in flow.
5 It is concluded that NO is involved in the maintenance of the basal level
of dural arterial blood flow as well as in the electrically evoked flow in
creases, which have been shown to be mainly mediated by CGRP released from
dural afferent fibres. The most important source of NO is probably the endo
thelium of dural arterial vessels. The synergistic, effect of NO and CGRP o
n the stimulated blood flow may be in part due to a NO mediated facilitatio
n of the CGRP release.