Institute and Department of Psychiatry, University of São Paulo, School of Medicine, and Instituto de Ensino e Pesquisa-Hospital Israelita Albert Einstein, São Paulo, Brazil.
Med Hypotheses. 2011 Oct;77(4):534-5. doi: 10.1016/j.mehy.2011.06.024. Epub 2011 Jul 16.
Studies have suggested that the high comorbidity observed between chronic migraine and anxiety disorders can be mediated through a third factor namely increased sensitivity to aversive stimulation. This trait may predispose for both chronic migraines, through medication overuse as an avoidance response, and anxiety disorders. Additional studies have shown that hyper sensitivity to aversive stimulation, migraine chronification and anxiety disorders share other characteristics such as serotonergic mediation and personality traits. Preliminary analysis of empirical data comparing the frequency the impact of traumatic events over chronic [CM] and episodic migraine [EM] patients gives further support to this hypothesis. In spite of CM and EM did not differ in terms of the occurrence of traumatic events, CM patients that had experienced at least one traumatic event during their lives had higher scores in re-experiencing and avoidance (but not in hyperarousal) symptoms than CM patients. These observations suggest that traumatic events have greater impact over CM than over EM patients.
研究表明，慢性偏头痛和焦虑障碍之间观察到的高共病性可以通过第三个因素来介导，即对厌恶刺激的敏感性增加。这种特征可能会使慢性偏头痛和焦虑障碍更容易发生，因为过度使用药物是一种回避反应。此外，研究还表明，对厌恶刺激的敏感性增加、偏头痛慢性化和焦虑障碍还具有其他共同特征，如血清素介导和人格特征。对比较慢性偏头痛[CM]和发作性偏头痛[EM]患者创伤性事件频率和影响的实证数据的初步分析进一步支持了这一假设。尽管 CM 和 EM 在创伤性事件的发生方面没有差异，但在一生中经历过至少一次创伤性事件的 CM 患者，其再体验和回避（但不是过度警觉）症状的评分高于没有经历过创伤性事件的 CM 患者。这些观察结果表明，创伤性事件对 CM 的影响大于对 EM 患者的影响。
