Interaction between symptoms of brainstem disturbance, sensory disturbances and pain in migraine

大约18%的女性和6%的男性在一生中都受到偏头痛的影响，通常在生命中最多产的年份达到高峰。虽然偏头痛对神经系统的严重影响是罕见的，但一些患者在偏头痛相关中风发作后会留下永久性的身体残疾。更常见的是药物使人衰弱的副作用，以及偏头痛反复发作造成的心理和社会破坏。除了偏头痛期间的疼痛和痛苦之外，复发性头痛还造成了相当大的医疗费用和生产力损失。因此，有重要的经济和社会原因开发新的治疗方法，特别是减少易感性复发的治疗方法。本项目旨在探讨偏头痛症状（头痛、恶心和面部血流变化）之间的相互作用，以便系统地研究症状发展的顺序。我们将诱发晕动病（引起恶心和偏头痛的许多其他症状），然后研究头痛和强烈感官刺激的影响。我们预计，与很少头痛的人相比，偏头痛患者会报告更强烈的症状，并对这些刺激表现出更大的生理变化，无论是单独的还是联合的。最常见的偏头痛诱因之一是心理压力。该项目第二部分的目的是确定在压力下释放的一种物质（去甲肾上腺素）是否会加剧头皮血管的炎症，从而增加偏头痛的可能性。我们希望这种方法将有助于确定增加偏头痛易感性的异常的基础，从而可以有针对性地进行治疗。

Migraine affects about 18% of women and 6% of men across their lifespan and usually peaks during the most productive years of life. Although serious neurological effects of migraine are rare, some sufferers are left with permanent physical disability after attacks of migraine-related stroke. More common are debilitating side effects of medication, and the psychological and social disruption of experiencing recurrent attacks of migraine. Apart from the pain and distress experienced during migraine, recurrent headaches are responsible for considerable health care costs and lost productivity. Thus, there are important economic and social reasons for developing new treatments, particularly treatments that reduce susceptibility to recurrent attacks. This project aims to investigate interactions among symptoms of migraine (head pain, nausea, and changes in facial blood flow), so that the sequence of symptom development can be studied systematically. We will induce motion sickness (which provokes nausea and many other symptoms of migraine), and then study the effects of head pain and strong sensory stimulation. We expect that migraine sufferers will report stronger symptoms and show greater physiological changes to these stimuli, either alone or in combination, than people who rarely suffer from headache. One of the most commonly recognized triggers of migraine is psychological stress. The aim of the second part of this project is to determine whether a substance released during stress (noradrenaline) heightens inflammation in scalp blood vessels, thus increasing the likelihood of migraine. We hope that this approach will help to identify the basis of the abnormality which increases susceptibility to migraine, so that it can be targeted for treatment.