Rossi Heather L, Recober Ana
Department of Neurology, Perelman School of Medicine, University of Pennsylvania & Children's Hospital of Pennsylvania, Philadelphia, PA, USA.
Headache. 2015 Apr;55(4):600-4. doi: 10.1111/head.12532. Epub 2015 Mar 19.
Photophobia is a debilitating feature of many headache disorders.
Clinical and preclinical research has identified several potential pathways involved in enhanced light sensitivity. Some of these structures include trigeminal afferents in the eye, second-order neurons in the trigeminal nucleus caudalis, third-order neurons in the posterior thalamus, modulatory neurons in the hypothalamus, and fourth-order neurons in the visual and somatosensory cortices. It is unclear to what degree each site plays a role in establishing the different temporal patterns of photophobia across different disorders. Peptides such as calcitonin gene-related peptide and pituitary adenylate cyclase-activating polypeptide may play a role in photophobia at multiple levels of the visual and trigeminal pathways.
While our understanding of photophobia has greatly improved in the last decade, there are still unanswered questions. These answers will help us develop new therapies to provide relief to patients with primary headache disorders.
畏光是许多头痛疾病的一个使人衰弱的特征。
临床和临床前研究已经确定了几种与光敏感度增强有关的潜在途径。其中一些结构包括眼部的三叉神经传入纤维、三叉神经尾侧核中的二级神经元、丘脑后部的三级神经元、下丘脑的调节神经元以及视觉和体感皮层中的四级神经元。目前尚不清楚每个部位在不同疾病中建立畏光的不同时间模式方面发挥多大作用。降钙素基因相关肽和垂体腺苷酸环化酶激活多肽等肽可能在视觉和三叉神经通路的多个水平上参与畏光过程。
虽然在过去十年中我们对畏光的理解有了很大提高，但仍有一些问题未得到解答。这些答案将帮助我们开发新的疗法，为原发性头痛疾病患者提供缓解。
