Magis D, Schoenen J
Unité de Recherche sur les Céphalées, Service Universitaire de Neurologie, CHR Citadelle, Liège.
Rev Med Liege. 2012 May-Jun;67(5-6):349-58.
Migraine is a frequent neurological syndrome with a heterogenous clinical presentation. Its pathophysiology remains poorly understood but a genetic aetiology has been suspected for a long time, as well as a significant influence of the environment. Familial hemiplegic migraine belongs to monogenic migraines, which are very rare entities with an autosomal dominant transmission. In that type of migraine, environment has a minor role, even if some attack triggering factors have been identified. The common forms of migraines, with and without aura, episodic or chronic, are polygenic and the results of genetic studies concerning these migraines are rather disappointing. The recent use of genome-wide approaches (linkage analyses and genome wide association studies) opened new perspectives and more convincing results are eagerly awaited in the next years. The environmental contribution (endogenous or exogenous) is much more pronounced in the common forms of migraine, with the identification of numerous predisposing or triggering factors, among which only some can be avoided. Finally, a recent behavioural hypothesis coming from adaptative darwinian theories has proposed a genetic-environment integrative model for common migraine. The latter would result of hereditary physiological adaptative defence mechanisms which would be progressively impaired by repeated brain homeostasis imbalances due to the environment.
偏头痛是一种常见的神经综合征，临床表现具有异质性。其病理生理学仍知之甚少，但长期以来人们怀疑其有遗传病因，同时环境也有重大影响。家族性偏瘫性偏头痛属于单基因偏头痛，是非常罕见的常染色体显性遗传疾病。在这类偏头痛中，环境的作用较小，即便已确定了一些发作触发因素。普通型偏头痛，有先兆或无先兆，发作性或慢性，都是多基因的，有关这些偏头痛的遗传学研究结果相当令人失望。近期全基因组方法（连锁分析和全基因组关联研究）的应用开辟了新的前景，未来几年人们急切期待更有说服力的结果。在普通型偏头痛中，环境因素（内源性或外源性）的作用更为显著，已确定了众多易感或触发因素，其中只有一些是可以避免的。最后，最近源自适应性达尔文理论的一种行为假说提出了一个普通偏头痛的遗传 - 环境综合模型。后者是遗传性生理适应性防御机制的结果，由于环境因素导致反复的脑内稳态失衡，这些机制会逐渐受损。
