Headache Center, Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Naples, Italy.
MRI Research Center SUN-FISM, University of Campania "Luigi Vanvitelli", Naples, Italy.
Headache. 2019 Apr;59(4):637-649. doi: 10.1111/head.13512. Epub 2019 Apr 6.
INTRODUCTION: Migraine is a complex neurological disorder characterized by severe headaches associated with a plethora of sensory hypersensitivity and neurovegetative symptoms. In about one-third of the cases, a set of fully reversible focal neurological symptoms, the aura, accompanies the headache. In the last decades, advanced neuroimaging investigations allowed identification of structural, microstructural, and functional abnormalities characterizing the brain of patients with migraine with aura (MwA). However, mechanisms underlying the aura phenomena are still a matter of debate. AIMS: This article reviews the most significant findings from advanced neuroimaging studies in patients with MwA both to provide a unifying physiopathological model of the aura phenomena and to clarify the potential impact of advanced neuroimaging investigation in the clinical field. METHODS: A comprehensive review of PubMed citations was conducted by entering the key words "magnetic resonance imaging" combined with "migraine" AND "aura." Other key words included "grey matter" OR "white matter," "structural" OR "functional." The only restriction was to English-language publications. The abstracts of all articles published between 1997 and 2018 meeting these criteria were reviewed, and the full texts were examined for relevance to the topic. CONCLUSION: Although several advanced neuroimaging studies have been conducted to investigate the neural correlates of aura phenomena, they have failed in identifying underlying pathophysiological mechanisms in their entirety. Nevertheless, functional and structural neuroimaging findings concerning the extrastriate visual cortex are characterized by a high level of reproducibility, so much so that they could be applied, in a not so far future, as diagnostic, prognostic, or therapeutic biomarkers for MwA.
简介:偏头痛是一种复杂的神经系统疾病,其特征是严重头痛,并伴有多种感觉过敏和自主神经症状。大约三分之一的病例中,头痛伴随着一组完全可逆的局灶性神经症状,即先兆。在过去的几十年中,先进的神经影像学研究可以识别出偏头痛伴先兆(MwA)患者大脑的结构、微观结构和功能异常。然而,先兆现象的机制仍存在争议。
目的:本文综述了 MwA 患者先进神经影像学研究的最显著发现,旨在提供一个统一的先兆现象生理病理模型,并阐明先进神经影像学研究在临床领域的潜在影响。
方法:通过输入关键字“磁共振成像”结合“偏头痛”和“先兆”,在 PubMed 上进行了全面的文献检索。其他关键字包括“灰质”或“白质”、“结构”或“功能”。唯一的限制是英文出版物。综述了所有在 1997 年至 2018 年间符合这些标准的文章的摘要,并对全文进行了审查,以确定与主题的相关性。
结论:尽管已经进行了几项先进的神经影像学研究来研究先兆现象的神经相关性,但它们未能完全确定潜在的病理生理机制。然而,关于后外侧视觉皮层的功能和结构神经影像学研究结果具有高度的可重复性,以至于它们可以在不久的将来作为 MwA 的诊断、预后或治疗生物标志物。
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