Montagna Pasquale
Department of Neurological Sciences, University of Bologna Medical School, Via U. Foscolo 7, 40123 Bologna, Italy.
Neurol Sci. 2008 May;29 Suppl 1:S47-51. doi: 10.1007/s10072-008-0886-5.
Migraines carry a substantial genetic liability, and in families affected with the typical migraines (migraine with, MA, and without aura, MO) linkage to some chromosomal loci has been reported. As yet however, no genes are known for MA/MO, while the three genes discovered as responsible for familial hemiplegic migraine (FHM) are not involved in the typical migraines. Accordingly, we propose to consider FHM as a syndromic migraine and not as a variety of MA. Moreover, we suggest that epigenetic mechanisms play a role in the determination of the typical migraines, and that the primary headaches represent behavioural responses (sickness behaviour, fight-or-flight responses), having adaptive advantage and having been evolutionary conserved, in which pain represents a signal of homeostatic imbalance. Epigenetic mechanisms and this proposed genetic behavioural model could be usefully incorporated into headache genetic research.
偏头痛具有显著的遗传易感性，在患有典型偏头痛（伴有先兆偏头痛，MA，和无先兆偏头痛，MO）的家族中，已报道了与某些染色体位点的连锁关系。然而，目前尚未发现与MA/MO相关的基因，而发现的三个导致家族性偏瘫性偏头痛（FHM）的基因并不参与典型偏头痛的发病。因此，我们建议将FHM视为一种综合征性偏头痛，而非MA的一种类型。此外，我们认为表观遗传机制在典型偏头痛的发生中起作用，并且原发性头痛代表行为反应（疾病行为、战斗或逃跑反应），具有适应性优势且在进化过程中得以保留，其中疼痛代表内稳态失衡的信号。表观遗传机制和这种提出的遗传行为模型可有效地纳入头痛遗传学研究。
