Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients
Case reports suggest a link between anticoagulant use and improved migraine symptoms, and a role for platelet-induced cerebral vasoconstriction in migraine pathobiology. Hence, we investigated the mechanism by which warfarin may affect migraine symptoms and whether there is a change in migraine symp...
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Georg Thieme Verlag KG
2019-04-01
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Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1692989 |
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doaj-2b00b87b6b9e4e78ab98875a9cb29ef12020-11-25T03:24:18ZengGeorg Thieme Verlag KGTH Open2512-94652512-94652019-04-010302e180e18910.1055/s-0039-1692989Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of PatientsBenjamin Nilsson0Valentina Back1Ran Wei2Frances Plane3Paul Jurasz4Tammy J. Bungard5Alberta Health Services, Edmonton, Alberta, CanadaFaculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, CanadaCardiovascular Research Centre, University of Alberta, Edmonton, Alberta, CanadaCardiovascular Research Centre, University of Alberta, Edmonton, Alberta, CanadaFaculty of Pharmacy and Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, CanadaDepartment of Cardiology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, CanadaCase reports suggest a link between anticoagulant use and improved migraine symptoms, and a role for platelet-induced cerebral vasoconstriction in migraine pathobiology. Hence, we investigated the mechanism by which warfarin may affect migraine symptoms and whether there is a change in migraine symptomology in patients initiating oral anticoagulants, most commonly warfarin. The effects of warfarin on human platelet aggregation and secretion as well as platelet-induced rat cerebral artery vasoconstriction were studied. A survey of migraine and symptom change after starting or stopping oral anticoagulants was also conducted. Warfarin inhibited platelet aggregation and 5-hydroxytryptamine (5-HT) secretion in a concentration-dependent manner. Warfarin-inhibited platelet secretion products constricted middle cerebral arteries from male but not from female rats. For the survey, patient demographic information, migraine and medical history, and Migraine Disability Assessment Score (MIDAS) changes were collected. Out of 175 consenting, 40 respondents met the criteria for migraine and completed the survey. A total of 11 patients reported migraine symptom change, all coinciding with starting warfarin. Of those having symptom and MIDAS improvement, most were female with migraines with aura, whereas those worsening were male with fewer having migraine with aura. Of those reporting migraine symptom change with warfarin, female sex may be associated with improved MIDAS, and those experiencing an aura component are more likely to report a symptom change. Warfarin-mediated symptom improvement in females may occur due to inhibition of platelet 5-HT secretion and a lower sensitivity of female cerebral blood vessels to platelet-derived 5-HT-induced vasoconstriction.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1692989warfarinmigraineplateletsserotoninblood vessels |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Benjamin Nilsson Valentina Back Ran Wei Frances Plane Paul Jurasz Tammy J. Bungard |
spellingShingle |
Benjamin Nilsson Valentina Back Ran Wei Frances Plane Paul Jurasz Tammy J. Bungard Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients TH Open warfarin migraine platelets serotonin blood vessels |
author_facet |
Benjamin Nilsson Valentina Back Ran Wei Frances Plane Paul Jurasz Tammy J. Bungard |
author_sort |
Benjamin Nilsson |
title |
Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients |
title_short |
Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients |
title_full |
Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients |
title_fullStr |
Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients |
title_full_unstemmed |
Potential Antimigraine Effects of Warfarin: An Exploration of Biological Mechanism with Survey of Patients |
title_sort |
potential antimigraine effects of warfarin: an exploration of biological mechanism with survey of patients |
publisher |
Georg Thieme Verlag KG |
series |
TH Open |
issn |
2512-9465 2512-9465 |
publishDate |
2019-04-01 |
description |
Case reports suggest a link between anticoagulant use and improved migraine symptoms, and a role for platelet-induced cerebral vasoconstriction in migraine pathobiology. Hence, we investigated the mechanism by which warfarin may affect migraine symptoms and whether there is a change in migraine symptomology in patients initiating oral anticoagulants, most commonly warfarin. The effects of warfarin on human platelet aggregation and secretion as well as platelet-induced rat cerebral artery vasoconstriction were studied. A survey of migraine and symptom change after starting or stopping oral anticoagulants was also conducted. Warfarin inhibited platelet aggregation and 5-hydroxytryptamine (5-HT) secretion in a concentration-dependent manner. Warfarin-inhibited platelet secretion products constricted middle cerebral arteries from male but not from female rats. For the survey, patient demographic information, migraine and medical history, and Migraine Disability Assessment Score (MIDAS) changes were collected. Out of 175 consenting, 40 respondents met the criteria for migraine and completed the survey. A total of 11 patients reported migraine symptom change, all coinciding with starting warfarin. Of those having symptom and MIDAS improvement, most were female with migraines with aura, whereas those worsening were male with fewer having migraine with aura. Of those reporting migraine symptom change with warfarin, female sex may be associated with improved MIDAS, and those experiencing an aura component are more likely to report a symptom change. Warfarin-mediated symptom improvement in females may occur due to inhibition of platelet 5-HT secretion and a lower sensitivity of female cerebral blood vessels to platelet-derived 5-HT-induced vasoconstriction. |
topic |
warfarin migraine platelets serotonin blood vessels |
url |
http://www.thieme-connect.de/DOI/DOI?10.1055/s-0039-1692989 |
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