Cavestro Cinzia, Ferrero Marcella
Headache Centre, Department of Neurology, "S.Lazzaro", ASL CN2, Alba, Italy.
Forensic and Conservation Genetics, University of Central Lancashire, Preston, United Kingdom.
Endocr Metab Immune Disord Drug Targets. 2018 Feb 13;18(2):124-134. doi: 10.2174/1871530317666171124124340.
Migraine and systemic autoimmune diseases are 2-3-fold more common in women and various studies have reported an association between the two pathologies.
This review takes into account epidemiological studies involving migraine and systemic lupus erythematosus, antiphospholipid syndrome, Sjogren's syndrome, and other diffuse connective tissue diseases. This scientific literature analysis consists of the main articles found in Medline with a search up to April 2017.
Many epidemiological studies were carried out on patients suffering from systemic lupus erythematosus. Results showed that headache and migraine are more prevalent in systemic lupus erythematosus patients compared to controls, especially migraine with aura. Patients with Lupus and migraine show a higher lupus activity and association with Raynaud and/or antiphospholipids in these populations are contradictory. There are not enough data to establish an association between antiphospholipid syndrome and migraine. However, data are more consistent between antiphospholipid carrier condition and migraine. Systemic sclerosis is a rare disease, for this reason the amount of available data on this disorder are scanty. However, some studies reported an association between headache, migraine and systemic sclerosis, especially where gliotic brain lesions and Raynaud are coexisting. Finally, large propensity cohort population based studies suggested that systemic autoimmune diseases are more frequent in patients suffering from migraine.
An attempt at explaining the possible link between these disorders and migraine is discussed at the end of the review. Several autoimmune alterations are shared by most autoimmune diseases and headache types. Endothelial dysfunction is the only alteration that is common among all these disorders.
偏头痛和系统性自身免疫性疾病在女性中更为常见,其发病率是男性的2至3倍,并且多项研究报告了这两种病症之间存在关联。
本综述纳入了涉及偏头痛与系统性红斑狼疮、抗磷脂综合征、干燥综合征及其他弥漫性结缔组织病的流行病学研究。该科学文献分析涵盖了截至2017年4月在Medline数据库中检索到的主要文章。
针对系统性红斑狼疮患者开展了多项流行病学研究。结果显示,与对照组相比,系统性红斑狼疮患者中头痛和偏头痛更为普遍,尤其是伴有先兆的偏头痛。狼疮合并偏头痛的患者狼疮活动度更高,且在这些人群中雷诺现象和/或抗磷脂的关联性存在矛盾。尚无足够数据证实抗磷脂综合征与偏头痛之间存在关联。然而,抗磷脂携带者状态与偏头痛之间的数据更为一致。系统性硬化症是一种罕见疾病,因此关于该疾病的现有数据较少。不过,一些研究报告了头痛、偏头痛与系统性硬化症之间存在关联,尤其是在存在脑胶质增生性病变和雷诺现象的情况下。最后,基于大规模倾向队列人群的研究表明,偏头痛患者中系统性自身免疫性疾病更为常见。
综述结尾处讨论了对这些病症与偏头痛之间可能联系的解释尝试。大多数自身免疫性疾病和头痛类型都存在一些共同的自身免疫改变。内皮功能障碍是所有这些病症共有的唯一改变。