New insights into pathophysiology of vestibular migraine.
New insights into pathophysiology of vestibular migraine.
复制标题
DOI：
10.3389/fneur.2015.00012
复制
发表时间：
2015
影响因子：
3.4
通讯作者：
Lopez-Escamez JA
中科院分区：
文献类型：
--
作者：
Espinosa-Sanchez JM;Lopez-Escamez JA
前庭性偏头痛是一种常见的疾病，遗传、表观遗传和环境因素可能导致其发生。VM的病理生理学尚不清楚;然而，在过去的几年中，一些研究有助于了解VM中涉及的神经生理学通路。目前的假说大多是基于偏头痛本身的知识。三叉神经支配的迷路血管和血管活性神经肽的本地化这些三叉神经纤维的血管周围传入末梢的证据支持三叉神经血管系统的参与。由三叉神经前庭耳蜗反射激活触发的神经源性炎症，伴随随后的内耳血浆蛋白外渗和炎症介质的释放，可以有助于三叉神经初级传入神经元的持续激活和致敏，从而解释VM症状。脑干前庭核与调节三叉神经伤害性输入的结构（延髓头端腹内侧区、中脑导水管周围灰质腹外侧区、蓝斑和中缝大核）之间的相互联系对于理解VM的病理生理至关重要。虽然皮层扩散性抑制可以影响参与处理前庭信息的皮层区域，但功能性神经影像学技术表明，前庭和伤害性信息的多模态感觉整合和处理中存在失调，这是由前庭-丘脑-皮层功能障碍引起的，是VM的致病机制。VM的患病率升高表明，多种功能变体可能赋予遗传易感性，导致参与感觉信息、前庭输入和疼痛处理的脑结构中兴奋-抑制平衡失调。多种功能和结构神经网络之间的相互作用可以解释VM的发病机制。
Vestibular migraine (VM) is a common disorder in which genetic, epigenetic, and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal gray, locus coeruleus, and nucleus raphe magnus) are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory–inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs, and pain. The interactions among several functional and structural neural networks could explain the pathogenic mechanisms of VM.
登录
查看更多内容
DOI：
10.3988/jcn.2012.8.2.89
发表时间：
2012-06
期刊：
Journal of clinical neurology (Seoul, Korea)
影响因子：
--
作者：
Bernstein C;Burstein R
通讯作者：
Burstein R
影响因子：
1.4
作者：
Bahmad, Fayez, Jr.;DePalma, Steven R.;Seidman, Jonathan G.
通讯作者：
Seidman, Jonathan G.
影响因子：
4.9
作者：
Chu, Chia-Huei;Liu, Chia-Jen;Wang, Shuu-Jiun
通讯作者：
Wang, Shuu-Jiun
DOI：
10.3233/ves-2009-0343
发表时间：
2009-01-01
影响因子：
2.3
作者：
Bisdorff, Alexandre;Von Brevern, Michael;Newman-Toker, David E.
通讯作者：
Newman-Toker, David E.
影响因子：
30.8
作者：
Anttila, Verneri;Winsvold, Bendik S.;Gormley, Padhraig;Kurth, Tobias;Bettella, Francesco;McMahon, George;Kallela, Mikko;Malik, Rainer;de Vries, Boukje;Terwindt, Gisela;Medland, Sarah E.;Todt, Unda;McArdle, Wendy L.;Quaye, Lydia;Koiranen, Markku;Ikram, M. Arfan;Lehtimaki, Terho;Stam, Anine H.;Ligthart, Lannie;Wedenoja, Juho;Dunham, Ian;Neale, Benjamin M.;Palta, Priit;Hamalainen, Eija;Schuerks, Markus;Rose, Lynda M.;Buring, Julie E.;Ridker, Paul M.;Steinberg, Stacy;Stefansson, Hreinn;Jakobsson, Finnbogi;Lawlor, Debbie A.;Evans, David M.;Ring, Susan M.;Farkkila, Markus;Artto, Ville;Kaunisto, Mari A.;Freilinger, Tobias;Schoenen, Jean;Frants, Rune R.;Pelzer, Nadine;Weller, Claudia M.;Zielman, Ronald;Heath, Andrew C.;Madden, Pamela A. F.;Montgomery, Grant W.;Martin, Nicholas G.;Borck, Guntram;Goebel, Hartmut;Heinze, Axel;Heinze-Kuhn, Katja;Williams, Frances M. K.;Hartikainen, Anna-Liisa;Pouta, Anneli;van den Ende, Joyce;Uitterlinden, Andre G.;Hofman, Albert;Amin, Najaf;Hottenga, Jouke-Jan;Vink, Jacqueline M.;Heikkila, Kauko;Alexander, Michael;Muller-Myhsok, Bertram;Schreiber, Stefan;Meitinger, Thomas;Wichmann, Heinz Erich;Aromaa, Arpo;Eriksson, Johan G.;Traynor, Bryan J.;Trabzuni, Daniah;Rossin, Elizabeth;Lage, Kasper;Jacobs, Suzanne B. R.;Gibbs, J. Raphael;Birney, Ewan;Kaprio, Jaakko;Penninx, Brenda W.;Boomsma, Dorret I.;van Duijn, Cornelia;Raitakari, Olli;Jarvelin, Marjo-Riitta;Zwart, John-Anker;Cherkas, Lynn;Strachan, David P.;Kubisch, Christian;Ferrari, Michel D.;van den Maagdenberg, Arn M. J. M.;Dichgans, Martin;Wessman, Maija;Smith, George Davey;Stefansson, Kari;Daly, Mark J.;Nyholt, Dale R.;Chasman, Daniel I.;Palotie, Aarno
通讯作者：
Palotie, Aarno