Sensitization of the trigeminovascular pathway: perspective and implications to migraine pathophysiology.
Sensitization of the trigeminovascular pathway: perspective and implications to migraine pathophysiology.
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DOI：
10.3988/jcn.2012.8.2.89
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发表时间：
2012-06
期刊：
影响因子：
--
通讯作者：
Burstein R
中科院分区：
文献类型：
--
作者：
Bernstein C;Burstein R
偏头痛通常与颅内和颅外机械敏感性过度相关。表现出颅内过敏症状的患者证实，他们的头痛剧烈，而增加颅内压的日常体力活动（例如弯腰或咳嗽）会加剧疼痛。表现出颅外过敏症状的患者证明，在偏头痛期间，他们的面部皮肤会因其他无害的活动而疼痛，例如梳理、剃须、淋浴时让水流过脸部、或戴眼镜或耳环（此处称为头侧皮肤异常性疼痛）。此类患者经常证明，在偏头痛期间，他们的身体皮肤过敏，穿着紧身衣服、手镯、戒指、项链和袜子或使用厚毯子可能会感到不舒服和/或疼痛（称为头外皮肤异常性疼痛）。本综述总结了支持以下观点的证据：三叉血管通路的激活导致偏头痛发作的头痛阶段，偏头痛初始阶段的抽动的发展是由支配脑膜的外周三叉血管神经元的敏化介导的，头部异常性疼痛的发展是由二阶三叉血管神经元的敏化推动的 脊髓三叉神经核中的神经元接收来自脑膜以及来自头皮和面部皮肤的会聚感觉输入，并且头外异常性疼痛的发生是由丘脑后核中的三级三叉血管神经元的敏化介导的，这些神经元接收来自脑膜、面部和身体皮肤的会聚感觉输入。
Migraine headache is commonly associated with signs of exaggerated intracranial and extracranial mechanical sensitivities. Patients exhibiting signs of intracranial hypersensitivity testify that their headache throbs and that mundane physical activities that increase intracranial pressure (such as bending over or coughing) intensify the pain. Patients exhibiting signs of extracranial hypersensitivity testify that during migraine their facial skin hurts in response to otherwise innocuous activities such as combing, shaving, letting water run over their face in the shower, or wearing glasses or earrings (termed here cephalic cutaneous allodynia). Such patients often testify that during migraine their bodily skin is hypersensitive and that wearing tight cloth, bracelets, rings, necklaces and socks or using a heavy blanket can be uncomfortable and/or painful (termed her extracephalic cutaneous allodynia). This review summarizes the evidence that support the view that activation of the trigeminovascular pathway contribute to the headache phase of a migraine attack, that the development of throbbing in the initial phase of migraine is mediated by sensitization of peripheral trigeminovascular neurons that innervate the meninges, that the development of cephalic allodynia is propelled by sensitization of second-order trigeminovascular neurons in the spinal trigeminal nucleus which receive converging sensory input from the meninges as well as from the scalp and facial skin, and that the development of extracephalic allodynia is mediated by sensitization of third-order trigeminovascular neurons in the posterior thalamic nuclei which receive converging sensory input from the meninges, facial and body skin.
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影响因子：
11.2
作者：
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