Department of Iranian Traditional Medicine, Faculty of Medicine, Shahed University, Tehran, Iran.
Department of Iranian Traditional Medicine, Faculty of Medicine, Shahed University, Tehran, Iran.
Med Hypotheses. 2019 Apr;125:90-93. doi: 10.1016/j.mehy.2019.02.041. Epub 2019 Feb 19.
Migraine is a highly prevalent, disabling, and costly disorder worldwide. From a long time ago, headaches have been known to be associated with gastrointestinal (GI) disorders. Headaches originating from gastric complaints were appreciated by Persian Medicine (PM) scholars. Today, functional GI disorders are shown to have high comorbidity with migraines; however, a causal relationship is not accepted today and pathophysiological explanations for this comorbidity are scarce. Therefore, based on the PM philosophy and the existing evidence, we aimed to propose an explanation for the co-morbidity of migraine and GI disorders.
Noxious stimuli from the GI tract are relayed to the nucleus tractus solitarius (NTS) in the brain stem, which is located close to the trigeminal nucleus caudalis (TNC). TNC has shown projections to (NTS) through which frequent GI stimuli may antidromically reach the TNC and finally result in neurogenic inflammation. In addition, immune products, particularly histamine, are released in the submucosa of the GI tract and absorbed into the systemic circulation, which renders migraineurs more prone to attacks.
偏头痛是一种在全球范围内高发、致残且代价高昂的疾病。很久以前，人们就知道头痛与胃肠道（GI）疾病有关。源自胃部不适的头痛受到了波斯医学（PM）学者的关注。如今，功能性胃肠道疾病与偏头痛的高共病率已得到证实；然而，目前尚未接受这种因果关系，并且这种共病的病理生理学解释也很少。因此，基于 PM 哲学和现有证据，我们旨在为偏头痛和胃肠道疾病的共病提供一种解释。
来自胃肠道的有害刺激通过脑干中的孤束核（NTS）传递，该核靠近尾状三叉神经核（TNC）。TNC 通过投射与（NTS）相连，通过该投射，频繁的胃肠道刺激可能逆行到达 TNC，最终导致神经源性炎症。此外，免疫产物，特别是组胺，在胃肠道的黏膜下层释放并被吸收到全身循环中，这使得偏头痛患者更容易发作。
