Leone M, Proietti Cecchini A, Mea E, Curone M, Tullo V, Casucci G, Bonavita V, Bussone G
Headache Centre, Fondazione IRCCS, Istituto Nazionale Neurologico Carlo Besta, Via Celoria 11, I-20133 Milan, Italy.
Neurol Sci. 2007 May;28 Suppl 2:S108-13. doi: 10.1007/s10072-007-0761-9.
In the last ten years pathophysiology of primary headaches has received new insights from neuroimaging studies. Positron emission tomography (PET) showed activation of specific brain structures, brainstem in migraine and hypothalamic grey in trigeminal autonomic cephalalgias. This brain activation suggests it may intervene both in a permissive or triggering manner and as a response to pain driven by the first division of the trigeminal nerve. Voxel-based morphometry has suggested that there is a correlation between the brain area activated specifically in acute cluster headache - the posterior hypothalamic grey matter - and an increase in grey matter in the same region. New insights into mechanisms of head pain have emerged thanks to neuroimaging obtained in experimentally induced headaches, and during peripheral and central neurostimulation.
在过去十年中，原发性头痛的病理生理学从神经影像学研究中获得了新的见解。正电子发射断层扫描（PET）显示特定脑结构的激活，偏头痛时脑干激活，三叉自主神经性头痛时下丘脑灰质激活。这种脑激活表明它可能以允许或触发的方式进行干预，并作为对三叉神经第一分支驱动的疼痛的反应。基于体素的形态测量学表明，在急性丛集性头痛中特异性激活的脑区——下丘脑后部灰质——与同一区域灰质增加之间存在相关性。通过实验性诱发头痛以及外周和中枢神经刺激时获得的神经影像学，对头痛机制有了新的认识。
