Preventive Treatment with Lomerizine Increases Cerebral Blood Flows during the Interictal Phase of Migraine

J Stroke Cerebrovasc Dis. 2018 Apr;27(4):998-1002. doi: 10.1016/j.jstrokecerebrovasdis.2017.11.004. Epub 2017 Dec 6.


Background: Changes in regional cerebral blood flow (rCBF) were reported in migraineurs. However, little is known how preventive medications of migraine can influence rCBF. Lomerizine, a calcium channel blocker, has been used for migraine prophylaxis in Japan. We examined rCBF after lomerizine treatment.

Subjects and methods: Migraine was diagnosed according to the criteria of the International Classification of Headache Disorders, Third Edition beta. Migraine subtype was classified into migraine with aura (MA) and migraine without aura (MO). Lomerizine (10 mg/day, per oral) was administered for 3 months. Headache Impact Test-6 (HIT-6) and blood pressure (BP) were compared at baseline and end point. Brain single photon emission computed tomography using 99mTc-ethyl cysteinate dimer was performed at the interictal period. Brain SPECT data were analyzed according to revised version of 3-dimensional stereotaxic region of interest template. Clinic-radiological variables were analyzed by paired Student's t test.

Results: Ten migraineurs (4 men and 6 women) participated in the present study. Mean age was 54.1 (standard deviation [SD] 10.1) years. Mean duration of migraine was 25.3 (SD 9.8) years. Migraine subtype showed 4 MA and 6 MO patients. Mean score of HIT-6 was 66.3 (SD 11.7). Lomerizine treatment decreased HIT-6 scores significantly (P < .01). BP did not differ significantly after lomerizine treatment. Lomerizine treatment increased rCBF 20% approximately in the frontal, the parietal, the temporal, and the occipital region.

Conclusions: The present study indicated a significant increase in interictal rCBF after lomerizine treatment in migraineurs. The upregulation of rCBF could contribute to the antimigraine mechanism of lomerizine.

Keywords: Migraine prophylaxis; brain single photon emission tomography; calcium channel blocker; lomerizine; regional cerebral blood flow.

MeSH terms

  • Adult
  • Aged
  • Blood Flow Velocity
  • Calcium Channel Blockers / adverse effects
  • Calcium Channel Blockers / therapeutic use*
  • Cerebrovascular Circulation / drug effects*
  • Cysteine / administration & dosage
  • Cysteine / analogs & derivatives
  • Female
  • Humans
  • Male
  • Middle Aged
  • Migraine with Aura / diagnostic imaging
  • Migraine with Aura / physiopathology
  • Migraine with Aura / prevention & control*
  • Migraine without Aura / diagnostic imaging
  • Migraine without Aura / physiopathology
  • Migraine without Aura / prevention & control*
  • Organotechnetium Compounds / administration & dosage
  • Perfusion Imaging / methods
  • Piperazines / adverse effects
  • Piperazines / therapeutic use*
  • Radiopharmaceuticals / administration & dosage
  • Time Factors
  • Tomography, Emission-Computed, Single-Photon
  • Treatment Outcome


  • Calcium Channel Blockers
  • Organotechnetium Compounds
  • Piperazines
  • Radiopharmaceuticals
  • lomerizine
  • technetium Tc 99m bicisate
  • Cysteine