Goadsby P J, Edvinsson L, Ekman R
Department of Neurology, Prince Henry Prince Hospital, Little Bay, NSW, Australia.
Ann Neurol. 1990 Aug;28(2):183-7. doi: 10.1002/ana.410280213.
The innervation of the cranial vessels by the trigeminal nerve, the trigeminovascular system, has recently been the subject of study in view of its possible role in the mediation of some aspects of migraine. Since stimulation of the trigeminal ganglion in humans leads to facial pain and flushing and associated release of powerful neuropeptide vasodilator substances, their local release into the extracerebral circulation of humans was determined in patients who had either common or classic migraine. Venous blood was sampled from both the external jugular and cubital fossa ipsilateral to the side of headache. Plasma levels of neuropeptide Y, vasoactive intestinal polypeptide, substance P, and calcitonin gene-related peptide were determined using sensitive radioimmunoassays for each peptide, and values for the cubital fossa and external jugular and a control population were compared. A substantial elevation of the calcitonin gene-related peptide level in the external jugular but not the cubital fossa blood was seen in both classic and common migraine. The increase seen in classic migraine was greater than that seen with common migraine. The other peptides measured were unaltered. This finding may have importance in the pathophysiology of migraine.
三叉神经对颅血管的支配，即三叉神经血管系统，鉴于其在偏头痛某些方面的介导作用，最近成为了研究对象。由于刺激人类三叉神经节会导致面部疼痛、潮红以及强力神经肽血管舒张物质的相关释放，因此在患有普通型或典型偏头痛的患者中，测定了这些物质在人体脑外循环中的局部释放情况。从头痛侧同侧的颈外静脉和肘窝采集静脉血。使用针对每种肽的灵敏放射免疫分析法测定神经肽Y、血管活性肠多肽、P物质和降钙素基因相关肽的血浆水平，并比较肘窝、颈外静脉以及对照人群的数值。在典型偏头痛和普通型偏头痛患者中，均观察到颈外静脉血中降钙素基因相关肽水平显著升高，而肘窝血中未出现这种情况。典型偏头痛中观察到的升高幅度大于普通型偏头痛。所检测的其他肽未发生变化。这一发现可能对偏头痛的病理生理学具有重要意义。
