Duan Jinfeng, Yang Rongmei, Lu Wenwen, Zhao Lingfei, Hu Shaohua, Hu Chenxia
Key Laboratory of Mental Disorder's Management of Zhejiang Province, Department of Psychiatry, School of Medicine, First Affiliated Hospital, Zhejiang University, Hangzhou, China.
Department of Psychogeriatrics, Hangzhou Seventh People's Hospital, Hangzhou, China.
Front Psychiatry. 2021 Jan 11;11:560138. doi: 10.3389/fpsyt.2020.560138. eCollection 2020.
Bipolar disorder (BD) is a severe psychiatric disorder characterized by recurrent episodes of manic/hypomanic or depressive symptoms and euthymic periods, with some patients suffering a gradual deterioration of illness and consequent cognitive deficits during the late stage. Migraine is a disease generally without abnormal medical examinations, neurological examinations or laboratory studies, and the diagnosis is made based on the retrospective demonstration of headache features and groupings of disease-associated symptoms. The epidemiology of comorbid BD and migraine is high and it is obligatory to find effective treatments to improve the prognosis. Recent investigations demonstrated that the close relationship between BD and migraine significantly increased the rapid cycling rates of both BD and migraine in patients. Although the detailed mechanism is complex and largely unclear in comorbid BD and migrain, genetic factors, neurotransmitters, altered signaling pathways, disturbances of inflammatory cytokines, and mitochondrial dysfunction are risk factors of BD and migraine. Particularly these two diseases share some overlapping mechanisms according to previous studies. To this end, we call for further investigations of the potential mechanisms, and more efforts are underway to improve the treatment of people with comorbid BD and migraine. In this review, we provide an overview of the potential mechanisms in patients with BD or migraine and we further discuss the treatment strategies for comorbid BD and migraine and it is obligatory to find effective treatments to improve the prognosis. This work will provide insights for us to know more about the mechanisms of comorbid BD and migraine, provides new therapeutic targets for the treatment and give clinicians some guidance for more appropriate and beneficial treatment.
双相情感障碍（BD）是一种严重的精神疾病，其特征为躁狂/轻躁狂或抑郁症状反复发作以及症状缓解期，部分患者在疾病后期会逐渐病情恶化并出现认知缺陷。偏头痛是一种通常在体格检查、神经学检查或实验室检查中无异常表现的疾病，其诊断基于对头痛特征及相关症状群的回顾性判定。BD与偏头痛共病的流行病学情况较为常见，因此必须找到有效的治疗方法以改善预后。近期研究表明，BD与偏头痛之间的密切关系显著增加了患者中BD和偏头痛的快速循环发作率。尽管在BD与偏头痛共病中详细机制复杂且很大程度上尚不清楚，但遗传因素、神经递质、信号通路改变、炎性细胞因子紊乱以及线粒体功能障碍都是BD和偏头痛的危险因素。根据以往研究，这两种疾病尤其存在一些重叠机制。为此，我们呼吁进一步研究潜在机制，并且正在做出更多努力来改善BD与偏头痛共病患者的治疗。在本综述中，我们概述了BD或偏头痛患者的潜在机制，并进一步讨论了BD与偏头痛共病的治疗策略，而且必须找到有效的治疗方法以改善预后。这项工作将为我们深入了解BD与偏头痛共病的机制提供见解，为治疗提供新的靶点，并为临床医生提供一些指导，以进行更合适且有益的治疗。
