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Understanding the Pathophysiology of Migraine Pain

April 24, 2019


This clinical trial examines the physiology of abnormal states for migraines. Specifically, it focuses on monitoring the changes in patients with migraines. Investigators will use medical imaging to view these changes within the brain.


Study Information

Before monitoring the changes within migraine patients’ brains with medical imaging, the patients are injected with nitroglycerin as a form of treatment. There is an estimated 20 participants. The study began in January 2017.


Inclusion Criteria


  • Subjects with a documented diagnosis of migraine by a neurologist
  • Subjects resistant to treatment of standard migraine therapy with persistent, severe, and debilitating symptoms
  • Subjects without changes to their neurological exam within the 6 months before study participation
  • Migraines at least twice a month
  • Migraines unique and distinguishable from other non-migraine headache pain
  • Subjects must sign a consent form for both medical imaging (angiography) and for participation in this study, and must be willing to undergo angiography for the evaluation of their symptoms


Exclusion Criteria


  • Subjects taking vasoactive drugs including epinephrine, norepinephrine, dopamine, dobutamine, isoprenaline, dopexamine, milrinone, amrinon, levosimendan, glucagon, phenylephrine, metaraminol, ephedrine, vasopressin, digoxin, and levothyroxine
  • Subjects with underlying cardiac disease including, but not limited to, coronary artery disease, heart attacks, or severe buildup of fats and cholesterol in artery walls (atherosclerosis)
  • Subjects with severe pulmonary disease requiring supplemental oxygen therapy
  • Subjects taking medications similar to nitroglycerin such as phosphodiesterase inhibitors
  • Subjects with advised to avoid nitroglycerin or calcium channel blockers
  • Subjects who have had coffee, tea, or alcohol in the 12 hours before the start of the angiogram
  • Subjects having other headache conditions or pain syndromes
  • Subjects with prior therapies within the cranium or craniotomies for management of any lesions within the cranium
  • Subjects with an angiography that demonstrates severely twisted vessels or stenosis, vasospasm not responsive to medical therapy, or abnormal communication between intracranial and extracranial vessels, in the past or during the study
  • Subjects who are not able to reliably report symptoms
  • Subjects who do not consent to participate
  • Subjects who are pregnant
  • Children



You may participate in this clinical trial at Montefiore Medical Center in Bronx, New York 10467. If you have any questions or concerns, please contact David Altschul, MD at 718-920-7400 or at You may also contact Andrew J Kobets, MD at



This study is sponsored by Montefiore Medical Center.

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