Naegel Steffen, Obermann Mark
Department of Neurology, Martin Luther University Halle- Wittenberg and University Hospital Halle, Halle (Saale), Germany.
Department of Neurology, Klinikum Weser-Egge, Höxter, Germany.
Neurol India. 2021 Mar-Apr;69(Supplement):S10-S16. doi: 10.4103/0028-3886.315987.
Key structures for the pathophysiology of primary headache disorders such as migraine, cluster headache, and other trigeminal autonomic cephalalgias were identified by imaging in the past years.
Available data on functional imaging in primary headache disorders are summarized in this review.
We performed a MEDLINE search on December 27, 2020 using the search terms "primary headache" AND "imaging" that returned 453 results in English, out of which 137 were labeled reviews. All articles were evaluated for content and relevance for this narrative review.
The structure depicted most consistently using functional imaging in different states of primary headaches (without and with pain) was the posterior hypothalamus. Whole-brain imaging techniques such as resting-state functional resonance imaging showed a wide-ranging association of cortical and subcortical areas with human nociceptive processing in the pathophysiological mechanisms underlying the different TACs. Similarities of distinct groups of primary headache disorders, as well as their differences in brain activation across these disorders, were highlighted.
The importance of neuroimaging research from clinical practice point of view remains the reliable and objective distinction of each individual pain syndrome from one another. This will help to make the correct clinical diagnosis and pave the way for better and effective treatment in the future. More research will be necessary to fulfill this unmet need.
在过去几年中，通过影像学确定了偏头痛、丛集性头痛和其他三叉神经自主性头痛等原发性头痛疾病病理生理学的关键结构。
本综述总结了原发性头痛疾病功能影像学的现有数据。
我们于2020年12月27日在MEDLINE上进行检索，检索词为“原发性头痛”和“影像学”，检索结果中有453篇英文文章，其中137篇为标注综述。对所有文章进行内容评估以及与本叙述性综述的相关性评估。
在原发性头痛的不同状态（无痛和疼痛状态）下，使用功能影像学最一致描绘出的结构是下丘脑后部。全脑成像技术，如静息态功能磁共振成像，在不同三叉神经自主性头痛的病理生理机制中，显示出皮质和皮质下区域与人类伤害性加工的广泛关联。强调了不同组原发性头痛疾病的相似性以及这些疾病在脑激活方面的差异。
从临床实践角度来看，神经影像学研究的重要性仍然在于可靠且客观地区分各个疼痛综合征。这将有助于做出正确的临床诊断，并为未来更好、更有效的治疗铺平道路。需要更多研究来满足这一未满足的需求。
