Headache Group, Department of Basic and Clinical Neuroscience, King's College London, London, UK.
NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK.
J Neurol. 2017 Sep;264(9):2031-2039. doi: 10.1007/s00415-017-8434-y. Epub 2017 Mar 20.
Migraine is a common brain disorder with high disability rates which involves a series of abnormal neuronal networks, interacting at different levels of the central and peripheral nervous system. An increase in the interest around migraine pathophysiology has allowed researchers to unravel certain neurophysiological mechanisms and neurotransmitter involvement culminating in the recent development of novel therapies, which might substantially change the clinical approach to migraine patients. The present review will highlight the current aspects of migraine pathophysiology, covering an understanding of the complex workings of the migraine state and the brain regions responsible for them. We will further discuss the therapeutic agents which have appeared in the most recent years for migraine care, from calcitonin gene-related peptide (CGRP) receptor antagonists, gepants; through serotonin 5-HT receptor agonists, ditans, and CGRP or CGRP receptor monoclonal antibodies to invasive and non-invasive neuromodulation techniques.
偏头痛是一种常见的脑部疾病,其致残率较高,涉及一系列异常的神经元网络,在中枢和外周神经系统的不同水平相互作用。对偏头痛病理生理学的兴趣增加,使研究人员能够揭示某些神经生理机制和神经递质的参与,最终导致新疗法的发展,这可能会极大地改变偏头痛患者的临床治疗方法。本综述将重点介绍偏头痛病理生理学的当前方面,涵盖对偏头痛状态和负责偏头痛状态的大脑区域的复杂运作的理解。我们将进一步讨论近年来在偏头痛治疗中出现的治疗药物,包括降钙素基因相关肽(CGRP)受体拮抗剂、 gepants;5-羟色胺 5-HT 受体激动剂、ditans 和 CGRP 或 CGRP 受体单克隆抗体,以及侵袭性和非侵袭性神经调节技术。
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