Knight Yolande E, Classey John D, Lasalandra Michele P, Akerman Simon, Kowacs Fernando, Hoskin Karen L, Goadsby Peter J
Headache Group, Institute of Neurology, Queen Square, London WC1N 3BG, UK.
Brain Res. 2005 May 31;1045(1-2):1-11. doi: 10.1016/j.brainres.2005.01.091.
Functional imaging studies and clinical evidence suggest that structures in the brainstem contribute to migraine pathophysiology with a strong association between the brainstem areas, such as periaqueductal gray (PAG), and the headache phase of migraine. Stimulation of the superior sagittal sinus (SSS) in humans evokes head pain. Second-order neurons in the trigeminal nucleus that are activated by SSS stimulation can be inhibited by PAG stimulation. The present study was undertaken to identify pontine and medullary structures that respond to noxious stimulation of the superior sagittal sinus or to ventrolateral PAG stimulation. The distribution of neurons expressing the protein product (fos) of the c-fos immediate early gene were examined in the rostral medulla and caudal pons of the cat after (i) sham, (ii) stimulation of the superior sagittal sinus, (iii) stimulation of the superior sagittal sinus with PAG stimulation, or (iv) stimulation of the PAG alone. The structures examined for fos were the trigeminal nucleus, infratrigeminal nucleus, reticular nuclei, nucleus raphe magnus, pontine blink premotor area, and superior salivatory nucleus. Compared with all other interventions, fos expression was significantly greater in the trigeminal nucleus and superior salivatory nucleus after SSS stimulation. After PAG with SSS stimulation, on the side ipsilateral to the site of PAG stimulation, fos was significantly greater in the nucleus raphe magnus. These structures are likely to be involved in the neurobiology of migraine.
功能成像研究和临床证据表明，脑干中的结构与偏头痛的病理生理学有关，脑干区域（如导水管周围灰质，PAG）与偏头痛的头痛阶段之间存在密切关联。刺激人类上矢状窦（SSS）会引发头痛。SSS刺激激活的三叉神经核中的二级神经元可被PAG刺激抑制。本研究旨在确定对SSS有害刺激或腹外侧PAG刺激有反应的脑桥和延髓结构。在猫的延髓头端和脑桥尾端，检查了在（i）假手术、（ii）刺激上矢状窦、（iii）刺激上矢状窦并同时刺激PAG或（iv）单独刺激PAG后，表达c-fos立即早期基因蛋白产物（fos）的神经元分布。检查fos的结构包括三叉神经核、三叉神经下核、网状核、中缝大核、脑桥眨眼运动前区和上泌涎核。与所有其他干预措施相比，SSS刺激后三叉神经核和上泌涎核中的fos表达明显更高。在PAG与SSS联合刺激后，在PAG刺激部位同侧，中缝大核中的fos明显更高。这些结构可能参与偏头痛的神经生物学过程。
