原发性头痛疾病：从病理生理学到神经刺激疗法
Primary headache disorders: From pathophysiology to neurostimulation therapies.
作者信息
Wang Ziying, Yang Xiangyu, Zhao Binglei, Li Weidong
机构信息
Bio-X Institutes, Key Laboratory for the Genetics of Development and Neuropsychiatric Disorders (Ministry of Education), Shanghai Key Laboratory of Psychotic Disorders, And Brain Science and Technology Research Center, Shanghai Jiao Tong University, Shanghai, China.
WLA Laboratories, World Laureates Association, Shanghai, China.
出版信息
Heliyon. 2023 Mar 23;9(4):e14786. doi: 10.1016/j.heliyon.2023.e14786. eCollection 2023 Apr.
Primary headache disorders including migraine, cluster headache, and tension-type headache are among the most common disabling diseases worldwide. The unclear pathogenesis of primary headache disorders has led to high rates of misdiagnosis and limited available treatment options. In this review, we have summarized the pathophysiological factors for a better understanding of primary headache disorders. Advances in functional neuroimaging, genetics, neurophysiology have indicated that cortical hyperexcitability, regional brain dysfunction, central sensitization and neuroplasticity changes play vital roles in the development of primary headache disorders. Moreover, we have also discussed a series of neurostimulation approaches with their stimulation mechanism, safety and efficacy for prevention and treatment of primary headache disorders. Noninvasive or implantable neurostimulation techniques show great promise for treating refractory primary headache disorders.
原发性头痛疾病，包括偏头痛、丛集性头痛和紧张型头痛，是全球最常见的致残性疾病之一。原发性头痛疾病的发病机制尚不明确，导致误诊率高且可用的治疗选择有限。在本综述中，我们总结了病理生理因素，以便更好地理解原发性头痛疾病。功能神经影像学、遗传学、神经生理学的进展表明，皮质兴奋性过高、局部脑功能障碍、中枢敏化和神经可塑性变化在原发性头痛疾病的发生发展中起着至关重要的作用。此外，我们还讨论了一系列神经刺激方法及其刺激机制、安全性和预防及治疗原发性头痛疾病的疗效。非侵入性或可植入神经刺激技术在治疗难治性原发性头痛疾病方面显示出巨大的前景。
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