Migraine and the Mu-opioidergic system-Can we directly modulate it? Evidence from neuroimaging studies.
Migraine and the Mu-opioidergic system-Can we directly modulate it? Evidence from neuroimaging studies.
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DOI：
10.1007/s11916-014-0429-0
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发表时间：
2014-07
影响因子：
3.7
通讯作者：
Zubieta, Jon-Kar
中科院分区：
文献类型：
--
作者：
DaSilva, Alexandre F.;Nascimento, Thiago D.;DosSantos, Marcos F.;Zubieta, Jon-Kar
关键词：
偏头痛是一种慢性三叉神经疼痛的条件，影响我们的人口的很大一部分的存在。其使人衰弱的头痛发作，对多种形式的刺激的敏感性增加，迫使许多患者经常依赖非处方镇痛药，并且经常滥用处方药物，特别是阿片类激动剂。在后一种情况下，阿片样物质系统的不加选择的药物驱动的激活可能导致不期望的副作用，例如痛觉过敏和异常性疼痛的增强，以及发作的慢性化。然而，我们仍然缺乏关于偏头痛发作的影响及其对μ-阿片受体（μOR）介导的神经传递（阿片类药物的主要靶点）功能的缓解的信息。这一研究路线特别重要，因为这种神经递质系统可以说是最主要参与疼痛调节的内源性大脑机制，以及阿片类药物的有效性。最近，分子神经影像学和神经调节的新进展提供了重要的信息，可以阐明，在体内，内源性阿片系统在偏头痛的痛苦和救济的作用。
Migraine is a chronic trigeminal pain condition that affects the existence of great part of our population. Its debilitating headache attacks, with increased sensitivity to multiple forms of stimuli, force many of the patients to frequently rely upon over the counter analgesics, and quite frequently resort to abuse of prescribed medications, particularly the opioid agonists. In the latter case, the indiscriminate medication-driven activation of the opioid system can lead to undesired side effects, such as the augmentation of hyperalgesia and allodynia, as well as the chronification of the attacks. However, we still lack information regarding the impact of migraine attacks, and its relief on the function of μ-opioid receptor (μOR) mediated neurotransmission, the primary target of opioid medications. This line of enquiry is of particular importance as this neurotransmitter system is arguably the endogenous brain mechanism most centrally involved in pain regulation, as well as the effectiveness of opioid medications. Recently, new advances in molecular neuroimaging and neuromodulation have provided important information that can elucidate, in vivo, the role of the endogenous opioid system in migraine suffering and relief.
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