The Journal of Headache and Pain

Official Journal of the "European Headache Federation" and of "Lifting The Burden - The Global Campaign against Headache"

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Open Access

CGRP in migraine

The Journal of Headache and Pain200910:139

Received: 2 June 2009

Accepted: 23 June 2009

Published: 19 August 2009


Public HealthMolecular WeightInternal MedicineMigrainePlasma Concentration

Dear Editor,

Concentrations of substances in plasma, in this case CGRP, can be presented in several different to ways, such as pmol/l [17], pg/ml [8, 9] and just recently as ng/ml [10]. These different concentrations can be compared when one uses the molecular weight of 3,790 for CGRP but it takes 5–10 min of arithmetic to do that. When you normally read a paper you do not stop and do the arithmetic needed in order to check the concentrations.

In a recent paper in Journal of Headache and Pain, the plasma concentration of CGRP in cubital blood is given as 1.03 ng/ml in migraine [10]. This looks apparently reliable, but when the concentration in pmol/l, the standard way of presenting CGRP concentrations [17], is calculated the resulting concentration is 272 pmol/l. This was in migraine patients in the cubital vein outside attacks [10] and the CGRP levels are higher than any CGRP levels reported before both in external jugular blood [15], and cubital blood [69]. The authors state that the analyses were done with a commercially available ELISA kit and that the kit had a good sensitivity (range 0–25 ng/ml), but the detection limit for CGRP is not stated.

The best way to avoid such problems is to present CGRP levels in pmol/l. One can then easily skim the literature and compare results in different studies.


Authors’ Affiliations

Department of Neurology, Danish Headache Centre, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark


  1. Goadsby PJ, Edvinsson L, Ekman R (1990) Vasoactive peptide release in the extracerebral circulation of humans during migraine attacks. Ann Neurol 28:183–187, 1699472, 10.1002/ana.410280213, 1:STN:280:DyaK3M%2FisVSktQ%3D%3DView ArticlePubMedGoogle Scholar
  2. Goadsby PJ, Edvinsson L (1993) The trigeminovascular system and migraine: studies characterizing cerebrovascular and neuropeptide changes seen in humans and cats. Ann Neurol 33:48–56, 8388188, 10.1002/ana.410330109, 1:STN:280:DyaK3s3mtlGqsw%3D%3DView ArticlePubMedGoogle Scholar
  3. Tvedskov JF, Lipka K, Ashina M, Iversen HK, Schifter S, Olesen J (2005) No increase of calcitonin gene-related peptide in jugular blood during migraine. Ann Neurol 58:561–563, 16178016, 10.1002/ana.20605, 1:CAS:528:DC%2BD2MXhtFGrsL7OView ArticlePubMedGoogle Scholar
  4. Fanciullacci M, Alessandri M, Figini M, Geppetti P, Michelacci S (1995) Increase in plasma calcitonin gene-related peptide from the extracerebral circulation during nitro-glycerin-induced cluster headache attack. Pain 60:119–123, 7540279, 10.1016/0304-3959(94)00097-X, 1:CAS:528:DyaK2MXkvVSrt7o%3DView ArticlePubMedGoogle Scholar
  5. Fanciullacci M, Alessandri M, Sicuteri R, Marabini S (1997) Responsiveness of the trigeminovascular system to nitroglycerin in cluster headache patients. Brain 120:283–288, 9117375, 10.1093/brain/120.2.283View ArticlePubMedGoogle Scholar
  6. Ashina M, Bendtsen L, Jensen R, Schifter S, Olesen J (2000) Evidence for increased plasma levels of calcitonin gene-related peptide in migraine outside attacks. Pain 86:133–138, 10779670, 10.1016/S0304-3959(00)00232-3, 1:CAS:528:DC%2BD3cXisFGktbg%3DView ArticlePubMedGoogle Scholar
  7. Gallai V, Sarchielli P, Floridi A, Franceshini M, Codini M, Glioti G et al (1995) Vasoactive peptide levels in the plasma of young migraine patients with and without aura assessed both interictally and ictally. Cephalalgia 15:384–390, 8536297, 10.1046/j.1468-2982.1995.1505384.x, 1:STN:280:DyaK287hsVWhug%3D%3DView ArticlePubMedGoogle Scholar
  8. Fan P-C, Kuo P-H, Chang S-H, Lee W-T, Wu R-M, Chiou L-C (2009) Plasma calcitonin gene-related peptide in diagnosing and predicting paediatric migraine. Cephalalgia 29:883–990, 19236383, 10.1111/j.1468-2982.2008.01816.xView ArticlePubMedGoogle Scholar
  9. Fusayasu E, Kowa T, Takeshima T, Nakaso K, Nahashima K (2007) Increased plasma substance P and CGRP levels, and high ACE activity in migraineurs during headache-free periods. Pain 128:209–214, 17123735, 10.1016/j.pain.2006.09.017, 1:CAS:528:DC%2BD2sXis1Oqsbo%3DView ArticlePubMedGoogle Scholar
  10. Gupta R, Ahmed T, Banerjee B, Bhatia M (2009) Plasma calcitonin gene-related peptide concentration is comparable to control group among migraineurs and tension-type headache subjects during inter-ictal period. J Headache Pain 10:161–166, 19277835, 10.1007/s10194-009-0110-x, 1:CAS:528:DC%2BD1MXls1OksLc%3DPubMed CentralView ArticlePubMedGoogle Scholar


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