Cortelli Pietro, Montagna Pasquale
Clinica Neurologica, Dipartimento di Scienze Neurologiche, Center for the Study of Headaches, Alma Mater Studiorum-Università di Bologna, Via Ugo Foscolo, 7, 40123, Bologna, Italy.
Neurol Sci. 2009 May;30 Suppl 1:S19-22. doi: 10.1007/s10072-009-0054-6.
Migraine is a reversible brain dysfunction characterized by pain and passive coping strategies consistent with sickness behaviour. The brain contains no pain fibres and the only way it may signal pain is through the trigemino-vascular system. Here, it is postulated that migraine is an example of genetically determined behavioural responses and that sickness behaviour, a pan-mammalian adaptive response to internal and external stressors, characterizes the migraine attacks. Sickness behaviour is manifested in withdrawal and motor quiescence, sympatho-inhibition and lethargy, in which visceral pain signals a homeostatic imbalance of the brain. The sickness behavioural response is associated to pain felt as inescapable visceral pain, and depends upon brain networks involving different brainstem, hypothalamus and forebrain regions, that encode evolutionarily conserved adaptive genetic responses. This hypothesis, still speculative, may offer a more coherent view of migraine as an adaptive biobehavioural response triggered by a threatened brain.
偏头痛是一种可逆性脑功能障碍，其特征为疼痛以及与疾病行为相符的被动应对策略。大脑中没有痛觉纤维，它传递疼痛信号的唯一途径是通过三叉神经血管系统。在此，有人提出偏头痛是基因决定的行为反应的一个例子，而疾病行为作为一种对内部和外部应激源的全哺乳动物适应性反应，是偏头痛发作的特征。疾病行为表现为退缩和运动静止、交感神经抑制和嗜睡，其中内脏疼痛表明大脑的内环境失衡。疾病行为反应与被感知为无法逃避的内脏疼痛的疼痛相关，并且取决于涉及不同脑干、下丘脑和前脑区域的脑网络，这些脑网络编码进化上保守的适应性基因反应。这一假说仍属推测，但可能为偏头痛提供一个更连贯的观点，即偏头痛是由受到威胁的大脑触发的一种适应性生物行为反应。
