Suppr超能文献

触发急性偏头痛发作的原因:一种假说。

How triggers trigger acute migraine attacks: a hypothesis.

机构信息

Department of Neurology, Vivekananda Institute of Medical Science, 1E 1202, Avishikta II, Calcutta 700 078, India.

出版信息

Med Hypotheses. 2010 Apr;74(4):750-3. doi: 10.1016/j.mehy.2009.10.027. Epub 2009 Nov 14.

Abstract

A trigger is an integral part of any acute migraine attack. In this article, the author argues that triggers, identifiable or not, must be present in all attacks of migraine headache. It is hypothesized that triggers, internal or external, induce the onset of cortical spreading depression (CSD) in a pre-existing hyper-excitable cortex of a migraine brain, initiating the process of pain generation. The author hypothesizes on a second site of action of triggers at the level of trigeminal nuclear complex (TNC) in brain stem, the cell station of second order neuron pathway for migraine pain transmission to the sensory cortex. The author suggests existence of a hypothetical 'gate' at TNC level where incoming trigeminal migraine pain impulses would 'compete' with descending inhibitory signals from brain stem pain modulatory neurons, to get entry into the central nervous system. The author draws analogy with the 'gate control' mechanism operative at the dorsal horn level for spinally transmitted somatic and visceral pain. It is suggested that the hypothetical 'gate' at TNC level is controlled by activity of 5HT receptors, thus supporting the concept of an additional site of action of triptans in aborting acute migraine pain. The suggested hypothesis on mechanism of action of triggers, offers theoretical basis for efficacy of currently available pharmacologic and non-pharmacologic therapies for abortive and prophylactic treatment of migraine.

摘要

触发因素是任何急性偏头痛发作的一个组成部分。在本文中,作者认为,无论是可识别的还是不可识别的触发因素,都必须存在于偏头痛头痛的所有发作中。作者假设,无论是内部还是外部的触发因素,都会在偏头痛大脑预先存在的超兴奋皮质中引发皮质扩散抑制(CSD),从而启动疼痛产生的过程。作者还假设触发因素在脑干三叉神经核复合体(TNC)水平上有第二个作用部位,三叉神经痛觉神经元通路上的二级神经元的细胞站,用于偏头痛疼痛向感觉皮质的传递。作者提出在 TNC 水平存在一个假设的“门”,传入的三叉神经偏头痛疼痛冲动将与来自脑干疼痛调制神经元的下行抑制信号“竞争”,以进入中枢神经系统。作者借鉴了在脊髓传播的躯体和内脏疼痛的背角水平起作用的“门控”机制。作者建议,TNC 水平的假设“门”由 5HT 受体的活性控制,从而支持曲坦类药物在终止急性偏头痛疼痛方面的另一个作用部位的概念。关于触发因素作用机制的假设,为目前用于偏头痛急性发作和预防性治疗的药物和非药物治疗的疗效提供了理论基础。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍。

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索

文档翻译

学术文献翻译模型,支持多种主流文档格式。

立即体验