Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, CSD, sensitization and modulation of pain.
Migraine pathophysiology: anatomy of the trigeminovascular pathway and associated neurological symptoms, CSD, sensitization and modulation of pain.
复制标题
DOI：
10.1016/j.pain.2013.07.021
复制
发表时间：
2013-12
期刊：
影响因子：
7.4
通讯作者：
Burstein R
中科院分区：
文献类型：
--
作者：
Noseda R;Burstein R
科学证据支持偏头痛病理生理学涉及大脑兴奋性的遗传改变、颅内动脉扩张、三叉神经血管通路的反复激活和致敏以及遗传易感个体的相应结构和功能变化。大脑兴奋性改变的证据出现在临床和临床前调查的感觉先兆，发作和发作间期的视觉，听觉和嗅觉刺激的超敏反应，并减少下行抑制性疼痛通路的激活。支持三叉神经血管系统激活和致敏的数据包括偏头痛发作期间头部和全身皮肤异常性疼痛的进行性发展。此外，结构和功能改变包括存在皮质下白色物质病变、参与处理感觉信息的皮质区增厚以及由皮质扩散性抑制诱导的皮质神经可塑性改变。在这里，我们回顾了最近的解剖学数据三叉神经血管通路及其激活皮层扩散性抑制，一种新的理解偏头痛型神经恐惧症的神经基板，和调制的三叉神经血管通路的脑干，下丘脑和皮层。
Scientific evidence support the notion that migraine pathophysiology involves inherited alteration of brain excitability, intracranial arterial dilatation, recurrent activation and sensitization of the trigeminovascular pathway, and consequential structural and functional changes in genetically susceptible individuals. Evidence of altered brain excitability emerged from clinical and preclinical investigation of sensory auras, ictal and interictal hypersensitivity to visual, auditory and olfactory stimulation, and reduced activation of descending inhibitory pain pathways. Data supporting the activation and sensitization of the trigeminovascular system include the progressive development of cephalic and whole-body cutaneous allodynia during a migraine attack. Also, structural and functional alterations include the presence of subcortical white mater lesions, thickening of cortical areas involved in processing sensory information, and cortical neuroplastic changes induced by cortical spreading depression. Here, we review recent anatomical data on the trigeminovascular pathway and its activation by cortical spreading depression, a novel understanding of the neural substrate of migraine-type photophobia, and modulation of the trigeminovascular pathway by the brainstem, hypothalamus and cortex.
登录
查看更多内容
影响因子：
30.8
作者：
De Fusco, M;Marconi, R;Casari, G
通讯作者：
Casari, G
影响因子：
5
作者：
Aurora, SK;Cao, Y;Welch, KMA
通讯作者：
Welch, KMA
影响因子：
64.5
作者：
Basbaum AI;Bautista DM;Scherrer G;Julius D
通讯作者：
Julius D
影响因子：
11.2
作者：
Bowyer, SM;Aurora, SK;Welch, KMA
通讯作者：
Welch, KMA
影响因子：
--
作者：
Afridi, SK;Giffin, NJ;Goadsby, PJ
通讯作者：
Goadsby, PJ