Facchinetti F, Sgarbi L, Piccinini F
Department of Gynaecology, Obstetrics and Paediatric Sciences, University of Modena and Reggio Emilia, Modena, Italy.
Funct Neurol. 2000;15 Suppl 3:137-42.
It is well known that migraine is far more represented in females than in males. However, this gender-related difference is present only during reproductive life since in prepubertal children, migraine prevalence figures are independent of sex. Thus, transition to puberty accounts for changes which render females more susceptible to migraine attacks. In females, the main driver of the hormonal events allowing sexual maturation is the pulsatile secretion of hypothalamic LHRH modulated by opioid activity. Clinical reports suggest that migraine attacks could be prevented by the abolition of this neurohormonal secretion. On the other hand, several clinical and experimental observations have focused on neuroendocrine systems (opiatergic, serotonergic, adrenergic) as participating in the constitution of the so-called "migraine trait", the biological predisposition in patients that would explain their sensitivity to migraine triggers. Such neuroendocrine secretions are mainly dependent upon hypothalamic activity where a sexual dimorphic nucleus has been discovered in the preoptic area. We suggest that the sexual dimorphism of migraine should be sought in hypothalamic networks related to LHRH secretion.
众所周知，偏头痛在女性中的发病率远高于男性。然而，这种与性别相关的差异仅出现在生殖期，因为在青春期前儿童中，偏头痛患病率与性别无关。因此，进入青春期会导致一些变化，使女性更容易受到偏头痛发作的影响。在女性中，促使性成熟的激素事件的主要驱动因素是由阿片类活性调节的下丘脑促黄体生成素释放激素（LHRH）的脉冲式分泌。临床报告表明，取消这种神经激素分泌可以预防偏头痛发作。另一方面，一些临床和实验观察集中在神经内分泌系统（阿片能、5-羟色胺能、肾上腺素能）参与构成所谓的“偏头痛特质”，即患者的生物学易感性，这可以解释他们对偏头痛触发因素的敏感性。这种神经内分泌分泌主要依赖于下丘脑活动，在视前区已发现一个性二态核。我们建议，偏头痛的性二态性应在与LHRH分泌相关的下丘脑网络中寻找。
