Lance J W
Prince Henry Hospital, Little Bay NSW, Australia.
Pathol Biol (Paris). 1992 Apr;40(4):355-60.
It is proposed that the migraine attack is explicable by an interaction between the brain and the cranial circulation in subjects with unstable vascular and pain-control mechanisms. While peptides are undoubtedly involved in vasodilatation, there is strong evidence that 5-HT plays an important part in the genesis of migraine. Whether the place of 5-HT lies in central pain-control pathways, in the serotonergic project to the cerebral cortex, in a direct action on the cranial blood vessels or in its action at all three sites remains uncertain. It seems probable that the primary action of sumatriptan or ergotamine in terminating migraine headache is exerted on the cerebral and extracranial circulation whereas medications employed in prophylaxis may act centrally.
有人提出，偏头痛发作可通过血管和疼痛控制机制不稳定的受试者大脑与颅循环之间的相互作用来解释。虽然肽类无疑参与血管舒张，但有强有力的证据表明5-羟色胺在偏头痛的发生中起重要作用。5-羟色胺是位于中枢性疼痛控制通路、向大脑皮层的5-羟色胺能投射、对颅血管的直接作用还是在所有这三个部位都起作用仍不确定。舒马曲坦或麦角胺终止偏头痛头痛的主要作用似乎是作用于脑和颅外循环，而预防性使用的药物可能作用于中枢。
