Department of Oral Physiology, BioCure Laboratory, School of Dentistry, Kyungpook National University, 2177 Dalgubeol Blvd., Jung-gu, Daegu 41940, Republic of Korea.
Med Hypotheses. 2018 Jan;110:27-30. doi: 10.1016/j.mehy.2017.10.026. Epub 2017 Oct 26.
Most previous studies suggest that the subnucleus caudalis (Vc) of spinal trigeminal nucleus (Vsp) plays a key role in the generation and maintenance of migraine, a type of primary headache, by participating in the trigeminovascular system. Furthermore, the excitability of the Vc with the stimulation of the peripheral nociceptive fibers innervating the intracranial vessels or dura matter is regarded as a main cellular substrate for migraine. Here, a revised hypothesis is introduced, reinforcing the previous hypothesis and complementing it. This hypothesis suggests that, besides the Vc, much broader areas of the trigeminal sensory nuclei (Vsn), i.e., the principal sensory nucleus (Vp), the oralis nucleus (Vo), and the interpolaris nucleus (Vi), contribute to process and integrate pain signals generated in the head. In addition, the plasticity of synaptic transmission between nuclei or subnuclei in the Vsn, in particular, the Vsp, can be a cellular model for migraine, in the same way as the hippocampal synaptic plasticity is a model for learning and memory. This hypothesis will contribute to the discovery of new therapeutic tools for patients with migraine.
大多数先前的研究表明，三叉神经脊束核尾侧亚核（Vc）通过参与三叉血管系统，在偏头痛（一种原发性头痛）的产生和维持中起着关键作用。此外，刺激支配颅内血管或硬脑膜的外周伤害性纤维会引起 Vc 的兴奋性增加，被认为是偏头痛的主要细胞基础。在这里，引入了一个修正后的假说，该假说不仅强化了之前的假说，还对其进行了补充。该假说表明，除了 Vc，三叉神经感觉核（Vsn）的更广泛区域，即主感觉核（Vp）、口腔核（Vo）和中间核（Vi），也有助于处理和整合头部产生的疼痛信号。此外，Vsn 中核或亚核之间的突触传递可塑性，特别是 Vsp 的可塑性，可以作为偏头痛的细胞模型，就像海马突触可塑性是学习和记忆的模型一样。该假说将有助于为偏头痛患者发现新的治疗工具。
