Center for Pain and the Brain, McLean, Massachusetts General, and Children's Hospitals, Harvard Medical School, Boston, MA 02115, USA.
Neuron. 2012 Jan 26;73(2):219-34. doi: 10.1016/j.neuron.2012.01.001.
The brain and body respond to potential and actual stressful events by activating hormonal and neural mediators and modifying behaviors to adapt. Such responses help maintain physiological stability ("allostasis"). When behavioral or physiological stressors are frequent and/or severe, allostatic responses can become dysregulated and maladaptive ("allostatic load"). Allostatic load may alter brain networks both functionally and structurally. As a result, the brain's responses to continued/subsequent stressors are abnormal, and behavior and systemic physiology are altered in ways that can, in a vicious cycle, lead to further allostatic load. Migraine patients are continually exposed to such stressors, resulting in changes to central and peripheral physiology and function. Here we review how changes in brain states that occur as a result of repeated migraines may be explained by a maladaptive feedforward allostatic cascade model and how understanding migraine within the context of allostatic load model suggests alternative treatments for this often-debilitating disease.
大脑和身体通过激活激素和神经介质，并改变行为以适应潜在的和实际的压力事件做出反应。这些反应有助于维持生理稳定性（“适应”）。当行为或生理压力源频繁且/或严重时，适应反应可能会失调和适应不良（“适应负荷”）。适应负荷可能会改变大脑网络的功能和结构。结果，大脑对持续/随后的压力源的反应异常，行为和全身生理学以一种可以恶性循环的方式发生改变，导致进一步的适应负荷。偏头痛患者不断受到这种压力源的影响，导致中枢和外周生理学和功能发生变化。在这里，我们回顾了由于反复偏头痛而导致的大脑状态变化如何可以用适应性前馈适应级联模型来解释，以及在适应负荷模型的背景下理解偏头痛如何为这种常常使人衰弱的疾病提供替代治疗方法。
