Ashina Sait, Bentivegna Enrico, Martelletti Paolo, Eikermann-Haerter Katharina
Department of Neurology and Department of Anesthesia, Critical Care and Pain Medicine, BIDMC Comprehensive Headache Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
Pain Ther. 2021 Jun;10(1):211-223. doi: 10.1007/s40122-021-00240-5. Epub 2021 Feb 16.
Migraine is a prevalent primary headache disorder and is usually considered as benign. However, structural and functional changes in the brain of individuals with migraine have been reported. High frequency of white matter abnormalities, silent infarct-like lesions, and volumetric changes in both gray and white matter in individuals with migraine compared to controls have been demonstrated. Functional magnetic resonance imaging (MRI) studies found altered connectivity in both the interictal and ictal phase of migraine. MR spectroscopy and positron emission tomography studies suggest abnormal energy metabolism and mitochondrial dysfunction, as well as other metabolic changes in individuals with migraine. In this review, we provide a brief overview of neuroimaging studies that have helped us to characterize some of these changes and discuss their limitations, including small sample sizes and poorly defined control groups. A better understanding of alterations in the brains of patients with migraine could help not only in the diagnosis but may potentially lead to the optimization of a targeted anti-migraine therapy.
偏头痛是一种常见的原发性头痛疾病，通常被认为是良性的。然而，已有报道称偏头痛患者大脑存在结构和功能变化。与对照组相比，偏头痛患者白质异常、无症状梗死样病变以及灰质和白质体积变化的发生率较高。功能磁共振成像（MRI）研究发现，偏头痛发作间期和发作期的脑连接均有改变。磁共振波谱和正电子发射断层扫描研究表明，偏头痛患者存在能量代谢异常、线粒体功能障碍以及其他代谢变化。在本综述中，我们简要概述了神经影像学研究，这些研究有助于我们描述其中一些变化，并讨论其局限性，包括样本量小和对照组定义不明确。更好地了解偏头痛患者大脑的改变不仅有助于诊断，还可能优化针对性的抗偏头痛治疗。
