Department of Neurology, Danish Headache Center, Copenhagen University Hospital, Glostrup, Denmark.
Cephalalgia. 2022 Nov;42(13):1425-1435. doi: 10.1177/03331024221111529. Epub 2022 Jul 7.
This review aims to model migraine nociception.
Personal experience and litterature.
Genetic and environmental factors in combination decide whether a person suffers from migraine. Endogenous and/or exogenous factors precipitate the individual attacks. Nociception takes place around blood vessels. There is a growing understanding of the molecular pathophysiological mechanisms of migraine from human provocation studies. Rodent models of migraine are necessary to understand the complex interrelation between the many putatively involved molecules and tissues but their relevance for human migraine is uncertain. The crucial element in migraine nociception is a unit consisting of endothelial cells, vascular smooth muscle cells, perivascular nerve fibers (trigeminal, parasympathetic and sympathetic) and mast cells. Attacks may start outside the brain by humoral or neurogenic activity releasing nociceptive substances around blood vessels. They may also (perhaps more often) start by the brain generating efferent activity in autonomic and somatic nerves.
Human and rodent studies can quickly uncover the "mystery of migraine".
本篇综述旨在对偏头痛的痛觉进行建模。
个人经验和文献回顾。
遗传和环境因素共同决定了一个人是否患有偏头痛。内源性和/或外源性因素会引发个体发作。痛觉发生在血管周围。从人类诱发研究中，人们对偏头痛的分子病理生理机制有了更深入的了解。需要使用偏头痛的啮齿动物模型来理解许多可能涉及的分子和组织之间的复杂相互关系，但它们对人类偏头痛的相关性尚不确定。偏头痛痛觉的关键因素是一个由内皮细胞、血管平滑肌细胞、血管周围神经纤维（三叉神经、副交感神经和交感神经）和肥大细胞组成的单位。攻击可能由血管周围释放痛觉物质的体液或神经源性活动在大脑外开始。它们也可能（更常见的是）由大脑产生自主和躯体神经的传出活动开始。
人类和啮齿动物的研究可以迅速揭开“偏头痛之谜”。
