Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.
Neuroimaging Research Unit, Division of Neuroscience, Institute of Experimental Neurology, Vita-Salute San Raffaele University, Milan, Italy.
Curr Opin Neurol. 2018 Aug;31(4):379-385. doi: 10.1097/WCO.0000000000000573.
Primary headaches, such as migraine and cluster headache, are one of the most common and disabling neurological diseases worldwide. Neuroimaging studies have changed the way we understand these diseases and have enriched our knowledge of the mechanisms of actions of currently available therapies.
The present review highlights the major findings reported in migraine and cluster headache neuroimaging over the last year. Widespread structural and functional abnormalities in cortical and subcortical areas involved in multisensory, including pain, processing have been shown in migraine and cluster headache patients during different phases of the disease. Beyond the involvement of single brain areas, dysfunctional brain networks contribute to their pathophysiology. New central mechanisms of action of headache preventive treatments have also been explored.
A better understanding of migraine and cluster headache biology has paved the way for the development of new improved treatments for both these conditions. Although significant advances have been made over the last year, there are still many unsolved questions to address.
原发性头痛,如偏头痛和丛集性头痛,是全球最常见和致残的神经疾病之一。神经影像学研究改变了我们对这些疾病的理解,丰富了我们对现有治疗方法作用机制的认识。
本综述强调了过去一年中偏头痛和丛集性头痛神经影像学研究的主要发现。在偏头痛和丛集性头痛患者疾病的不同阶段,已显示涉及多感觉(包括疼痛)处理的皮质和皮质下区域的广泛结构和功能异常。除了单个脑区的参与外,功能障碍的脑网络也促成了它们的病理生理学。头痛预防治疗的新的中枢作用机制也得到了探索。
对偏头痛和丛集性头痛生物学的更好理解为这两种疾病的新的改进治疗方法的发展铺平了道路。尽管过去一年取得了重大进展,但仍有许多悬而未决的问题需要解决。