Lomerizine Increases Cerebral Blood Flow and Reduces Migraine

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Lomerizine is a calcium channel blocker used for migraine prophylaxis.
Lomerizine is a calcium channel blocker used for migraine prophylaxis.

Treatment with lomerizine increases interictal regional cerebral blood flow (rCBF) and may reduce migraine in chronic migraineurs, according to study findings published in the Journal of Stroke & Cerebrovascular Disease.

In this study, researchers included 10 patients who were diagnosed with migraine based on the International Classification of Headache Disorders, Third Edition beta. Participants were categorized as having migraine with aura (n=4) or migraine without aura (n=6) and were given lomerizine 10 mg/d for a total of 3 months.

To determine the effect of lomerizine administration in these patients, investigators compared baseline and end point headache Impact Test-6 (HIT-6) and blood pressure (BP) levels. In addition, single photon emission computed tomography (SPECT) of the brain was conducted at the interictal period.

The average migraine duration across this cohort was 25.3 years (standard deviation [SD] 9.8), and the mean baseline HIT-6 was 66.3 (SD 11.7). Compared with baseline, participants experienced a significant decrease in HIT-6 scores following lomerizine treatment at 3-month follow-up (66.3±11.7 vs 28.1±15.0, respectively; P <.01).

Despite the reduction in HIT-6 in 80% of lomerizine responders, there were no significant differences between baseline and follow-up with regard to systolic and diastolic BP changes (mean systolic BP 110.6 mm Hg [SD 12.2] and mean diastolic BP 72.7 mm Hg [SD 10.0] vs mean systolic BP 109.6 mm Hg [SD 9.9] and mean diastolic BP 70.1 mm Hg [SD 8.9]). The investigators observed an approximately 20% increase in rCBF in the frontal, parietal, temporal, and occipital regions after lomerizine use.

The small number of participants in this study represents a significant study limitation. In addition, the use of brain SPECT at the interictal phase potentially limits the ability to determine the effect of lomerizine treatment during other periods.

Due to the 20% increase in rCBF in this small case series, the researchers suggest a “close relationship between clinical improvement and rCBF potentiation after lomerizine administration.”

Reference

Ikeda K, Aoyagi J, Hanashiro S, et al. Preventive treatment with lomerizine increases cerebral blood flows during the interictal phase of migraine [published online December 5, 2017].  J Stroke Cerebrovasc Dis. doi:10.1016/j.jstrokecerebrovasdis.2017.11.004

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