The Role of Calcitonin Gene‐Related Peptide in High‐Altitude Headache: A Prospective Field Study

Schniepp, Roman; Karrasch, Ludwig; Breitenstein, Helena; Straube, Andreas; Kamm, Katharina (2026): The Role of Calcitonin Gene‐Related Peptide in High‐Altitude Headache: A Prospective Field Study. Annals of Clinical and Translational Neurology, 16 (10). pp. 2046-2056. ISSN 2328-9503

Abstract

Objective:
High-altitude headache (HAH) is a common neurological condition associated with rapid ascent to high altitude. The pathophysiological mechanisms underlying HAH remain incompletely understood. Calcitonin gene-related peptide (CGRP), a neuropeptide implicated in migraine pathophysiology, may play a key role in the pathophysiology of the disorder due to the shared clinical presentation of migraine and HAH. This study investigated tear fluid CGRP concentrations in response to high-altitude exposure and headache in healthy volunteers.

Methods:
A prospective field study was conducted during a high-altitude trekking expedition in the Alps. Headache and accompanying symptoms were raised using a structured questionnaire, and tear fluid samples were collected at study Day 1 (baseline, 450 m), at study Day 3 (3647 m), and at study Day 4 (4554 m). Tear fluid CGRP concentrations were quantified using a commercial ELISA kit.

Results:
Thirteen participants were included in the analysis. At 4554 m, 61.5% of participants reported a HAH. In participants with HAH, increase of tear fluid CGRP was significantly higher compared to participants without HAH (HAH: +1.49 ± 1.74 ng/mL, no HAH: −0.42 ± 0.64 ng/mL; p = 0.011). Increase of tear fluid CGRP levels was significantly higher in participants with a moderate-to-severe headache (+1.86 ± 1.86 ng/mL) compared to participants with mild headache (−0.19 ± 0.75 ng/mL; p = 0.008).

Interpretation:
The results support a potential role for CGRP in the pathophysiology of HAH. Further studies with a larger number of participants are needed to determine the mechanisms of the disorder.

• Dokumententyp: Artikel (Klinikum der LMU)
• Organisationseinheit (Fakultäten): 07 Medizin > Klinikum der LMU München > Neurochirurgische Klinik und Poliklinik
• DFG-Fachsystematik der Wissenschaftsbereiche: Lebenswissenschaften
• DFG: Gefördert durch die Deutsche Forschungsgemeinschaft (DFG) - 491502892