Bartsch T, Goadsby Peter J
Institute of Neurology, Queen Square, London WC1N 3BG, UK.
Curr Pain Headache Rep. 2003 Oct;7(5):371-6. doi: 10.1007/s11916-003-0036-y.
Neurones in the trigeminocervical complex are the major relay neurones for nociceptive afferent input from the meninges and cervical structures; therefore, they are the neural substrates of head pain. This review highlights the importance of two basic mechanisms in headache physiology: convergence of nociceptive afferents and sensitization of trigeminocervical neurones. These physiologic findings have clinical correlates such as hypersensitivity and spread and referral of pain frequently seen in patients with primary headache, such as migraine. Special reference is made to the influence of structures from the upper cervical spine in generating and contributing to migraine headaches. The pathophysiology and functional relevance of these basic mechanisms to headaches is discussed in the context of recent experimental findings with regard to pain processing.
三叉神经颈复合体中的神经元是来自脑膜和颈部结构的伤害性传入输入的主要中继神经元；因此，它们是头痛的神经基础。本综述强调了头痛生理学中两种基本机制的重要性：伤害性传入的汇聚和三叉神经颈神经元的敏化。这些生理学发现具有临床相关性，例如在偏头痛等原发性头痛患者中常见的疼痛超敏、扩散和牵涉痛。特别提及了上颈椎结构在偏头痛发生和发展中的影响。结合最近关于疼痛处理的实验结果，讨论了这些基本机制与头痛的病理生理学及功能相关性。
