Lindblad Marianne, Hougaard Anders, Amin Faisal Mohammad, Ashina Messoud
Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark.
Cephalalgia. 2017 Jan;37(1):74-88. doi: 10.1177/0333102416636097. Epub 2016 Sep 29.
Background The nature of the migraine aura and its role in migraine pathophysiology is incompletely understood. In particular, the mechanisms underlying aura initiation and the causal relation between aura and headache are unknown. The scientific investigation of aura in patients is only possible if aura can be triggered. This paper reviews potential methods for the experimental provocation of migraine aura. Methods We systematically searched PubMed for studies of experimental migraine provocation, including case reports of patients with aura and reports of the occurrence of aura following exposure to any kind of suspected trigger. Results We identified 21 provocation studies, using 13 different prospective provocation methods, and 34 case reports. In the prospective studies, aura were reported following the administration of intravenous and sublingual glyceryl trinitrate, visual stimulation, physical activity, calcitonin gene-related peptide infusion, chocolate ingestion, and the intravenous injection of insulin. In addition, carotid artery puncture has consistently been reported as a trigger of aura. Conclusions No safe and efficient method for aura provocation exists at present, but several approaches could prove useful for this purpose.
背景 偏头痛先兆的本质及其在偏头痛病理生理学中的作用尚未完全明确。特别是，先兆起始的机制以及先兆与头痛之间的因果关系尚不清楚。只有当先兆能够被诱发时，才有可能对患者的先兆进行科学研究。本文综述了诱发偏头痛先兆的潜在方法。方法 我们系统检索了PubMed上有关实验性偏头痛诱发的研究，包括有先兆患者的病例报告以及接触任何可疑触发因素后出现先兆的报告。结果 我们确定了21项诱发研究，采用了13种不同的前瞻性诱发方法，以及34例病例报告。在前瞻性研究中，静脉注射和舌下含服硝酸甘油、视觉刺激、体育活动、降钙素基因相关肽输注、摄入巧克力以及静脉注射胰岛素后均有先兆报告。此外，颈动脉穿刺一直被报告为先兆的触发因素。结论 目前不存在安全有效的先兆诱发方法，但有几种方法可能对此有用。
