Serum calcitonin gene‑related peptide in patients with persistent post‑concussion symptoms, including headache: a cohort study

Peter Preben Eggertsen*, Johan Palmfeldt, Henrik Winther Schytz, Debbie Hay, Rikke Katrine Jentoft Olsen, Jørgen Feldbæk Nielsen

*Corresponding author af dette arbejde

Publikation: Bidrag til tidsskrift/Konferencebidrag i tidsskrift /Bidrag til avisTidsskriftartikelForskningpeer review

Abstract

Background:
Calcitonin gene-related peptide (CGRP) plays an important role in migraine pathophysiology, and post-traumatic headache (PTH) frequently presents with migraine-like features. Despite several clinical similarities, few studies
have explored CGRP in PTH and concussion. This study investigates serum CGRP levels in patients with persistent postconcussion symptoms (PPCS), including PTH.

Methods:
This cohort study was based on serum samples from individuals aged 18–30 years with PPCS who participated in a previously published randomized controlled trial of a non-pharmacological intervention. The primary outcome was serum
CGRP concentrations, determined at baseline before randomization and at follow-up 7 months later, using an enzyme-linked immunosorbent assay (ELISA). CGRP levels at baseline were compared with healthy anonymous blood donors in the same age group.

Results:
Baseline serum samples were collected from 86 participants with PPCS. The participants were most often female (78%) and migraine-like headache was the most frequent headache phenotype (74%). Serum CGRP levels were higher
in participants with PPCS than in 120 healthy individuals (median: 158.5 pg/mL vs. 76.3 pg/mL, p=0.050). A stratifed analysis revealed that females with PPCS had a fvefold higher median than healthy females (166.3 pg/mL vs. 32.1 pg/mL,
p=0.0006), while no diferences were observed in males (p=0.83). At follow-up, CGRP levels decreased with a median change of – 1.3 pg/mL (95% confdence interval: – 17.6–0, p=0.024).

Discussion:
Elevated serum levels of CGRP in patients with PPCS and a decrease over time suggest an involvement of CGRP in PTH/PPCS. If confrmed in other studies, it could pave the way for CGRP-targeted therapies, which could have clinical
signifcance.
OriginalsprogEngelsk
TidsskriftJournal of Neurology
ISSN0340-5354
DOI
StatusUdgivet - 17 jan. 2024

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