皮质扩散性抑制激活脑膜伤害感受器:先兆性偏头痛的意义。
Activation of meningeal nociceptors by cortical spreading depression: implications for migraine with aura.
机构信息
Department of Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, and Program in Neuroscience, Harvard Medical School, Boston, Massachusetts 02215, USA.
出版信息
J Neurosci. 2010 Jun 30;30(26):8807-14. doi: 10.1523/JNEUROSCI.0511-10.2010.
Attacks of migraine with aura represent a phenomenon in which abnormal neuronal activity in the cortex produces sensory disturbances (aura) some 20-40 min before the onset of headache. The purpose of this study was to determine whether cortical spreading depression (CSD)--an event believed to underlie visual aura--can give rise to activation of nociceptors that innervate the meninges--an event believed to set off migraine headache. CSD was induced in anesthetized male rats by stimulation of the visual cortex with electrical pulses, pin prick, or KCl; single-unit activity of meningeal nociceptors was monitored in vivo in the rat before and after CSD. Regardless of the method of cortical stimulation, induction of CSD was recorded in 64 trials. In 31 of those trials, CSD induced a twofold increase in meningeal nociceptor firing rate that persisted for 37.0 +/- 4.6 min in trials in which activity returned to baseline, or >68 min in trials in which activity remained heightened at the time recording was interrupted. In two-thirds of the trials, onset of long-lasting neuronal activation began approximately 14 min after the wave of CSD. The findings demonstrates for the first time that induction of CSD by focal stimulation of the rat visual cortex can lead to long-lasting activation of nociceptors that innervate the meninges. We suggest that migraine with aura is initiated by waves of CSD that lead up to delayed activation of the trigeminovascular pathway.
偏头痛先兆发作是一种皮层神经元异常活动产生感觉障碍(先兆)的现象,其在头痛发作前 20-40 分钟出现。本研究的目的是确定皮层扩散性抑制(CSD)——一种被认为是视觉先兆背后的事件——是否会引起支配脑膜的伤害感受器的激活——一种被认为引发偏头痛头痛的事件。通过电脉冲、针刺或 KCl 刺激视觉皮层,在麻醉雄性大鼠中诱导 CSD;在 CSD 前后监测脑膜伤害感受器的体内单细胞活动。无论皮层刺激的方法如何,在 64 次试验中均记录到 CSD 的诱导。在这些试验中的 31 次中,CSD 引起脑膜伤害感受器放电率增加两倍,持续 37.0 +/- 4.6 分钟,在活动恢复到基线的试验中,或在活动在记录中断时仍然升高的试验中持续>68 分钟。在三分之二的试验中,长期神经元激活的起始时间大约在 CSD 波后 14 分钟。这些发现首次表明,通过对大鼠视觉皮层的局灶性刺激诱导 CSD 可导致支配脑膜的伤害感受器的长期激活。我们认为,偏头痛先兆是由 CSD 波引发的,导致三叉血管通路的延迟激活。