Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", 80138, Naples, Italy.
MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy.
Curr Neurol Neurosci Rep. 2017 Oct 23;17(12):95. doi: 10.1007/s11910-017-0803-5.
This review aims to provide an overview of the most recent and significant functional neuroimaging studies which have clarified the complex mechanisms underlying migraine pathophysiology.
The recent data allow us to overcome the concept of a migraine generator suggesting that functional networks abnormalities may lead to changes in different brain area activities and consequent reduced migraine thresholds susceptibility, likely associated with higher migraine severity and burden. Although functional magnetic resonance imaging studies have allowed recognition of several migraine mechanisms, its pathophysiology is not completely understood and is still a matter of research. Nevertheless, in recent years, functional magnetic resonance imaging studies have allowed us to implement our knowledge of migraine pathophysiology. The pivotal role of both the brainstem and the hippocampus in the first phase of a migraine attack, the involvement of limbic pathway in the constitution of a migrainous pain network, the disrupted functional connectivity in cognitive brain networks, as well as the abnormal function of the visual network in patients with migraine with aura are the main milestones in migraine imaging achieved through functional imaging advances. We believe that further studies based on combined functional and structural techniques and the investigation of the different phases of migraine cycle may represent an efficient methodological approach for comprehensively looking into the migrainous brain secrets.
本文旨在概述最近的重要功能神经影像学研究，这些研究阐明了偏头痛病理生理学的复杂机制。
这些新数据使我们能够克服偏头痛发生器的概念，表明功能网络异常可能导致不同脑区活动的变化，并导致偏头痛阈值敏感性降低，这可能与更高的偏头痛严重程度和负担有关。尽管功能磁共振成像研究已经识别出几种偏头痛机制，但它的病理生理学尚未完全了解，仍然是研究的课题。然而，近年来，功能磁共振成像研究使我们能够深入了解偏头痛的病理生理学。脑干和海马在偏头痛发作的第一阶段的关键作用，边缘通路在偏头痛疼痛网络构成中的作用，认知脑网络中功能连接的中断，以及偏头痛伴先兆患者视觉网络的异常功能，这些都是通过功能成像进展实现的偏头痛成像的主要里程碑。我们相信，基于功能和结构相结合的技术的进一步研究以及偏头痛周期不同阶段的研究可能是全面了解偏头痛大脑秘密的有效方法。
