Department of Developmental Neurology and Epileptology, Polish Mother's Memorial Hospital Research Institute, 93-338 Lodz, Poland.
Department of Pediatric Dentistry, Medical University of Lodz, 92-216 Lodz, Poland.
Aging Dis. 2023 Dec 1;14(6):2028-2050. doi: 10.14336/AD.2023.0313.
Migraine is a common neurological disease displaying an unusual dependence on age. For most patients, the peak intensity of migraine headaches occurs in 20s and lasts until 40s, but then headache attacks become less intense, occur less frequently and the disease is more responsive to therapy. This relationship is valid in both females and males, although the prevalence of migraine in the former is 2-4 times greater than the latter. Recent concepts present migraine not only as a pathological event, but rather as a part of evolutionary adaptive response to protect organism against consequences of stress-induced brain energy deficit. However, these concepts do not fully explain that unusual dependence of migraine prevalence on age. Many aspects of aging, both molecular/cellular and social/cognitive, are interwound in migraine pathogenesis, but they neither explain why only some persons are affected by migraine, nor suggest any causal relationship. In this narrative/hypothesis review we present information on associations of migraine with chronological aging, brain aging, cellular senescence, stem cell exhaustion as well as social, cognitive, epigenetic, and metabolic aging. We also underline the role of oxidative stress in these associations. We hypothesize that migraine affects only individuals who have inborn, genetic/epigenetic, or acquired (traumas, shocks or complexes) migraine predispositions. These predispositions weakly depend on age and affected individuals are more prone to migraine triggers than others. Although the triggers can be related to many aspects of aging, social aging may play a particularly important role as the prevalence of its associated stress has a similar age-dependence as the prevalence of migraine. Moreover, social aging was shown to be associated with oxidative stress, important in many aspects of aging. In perspective, molecular mechanisms underlying social aging should be further explored and related to migraine with a closer association with migraine predisposition and difference in prevalence by sex.
偏头痛是一种常见的神经系统疾病，其表现出一种异常的年龄依赖性。对于大多数患者来说，偏头痛头痛的峰值强度出现在 20 多岁，持续到 40 多岁，但随后头痛发作的强度降低，发作频率降低，疾病对治疗的反应性增强。这种关系在男性和女性中都是有效的，尽管前者偏头痛的患病率是后者的 2-4 倍。最近的概念不仅将偏头痛视为一种病理事件，而是将其视为一种进化适应反应的一部分，以保护机体免受应激诱导的脑能量不足的后果。然而，这些概念并不能完全解释偏头痛患病率异常依赖于年龄的现象。衰老的许多方面，包括分子/细胞和社会/认知方面，都交织在偏头痛的发病机制中，但它们既不能解释为什么只有某些人受到偏头痛的影响，也不能暗示任何因果关系。在这篇叙述/假说综述中，我们介绍了偏头痛与年龄相关的衰老、大脑衰老、细胞衰老、干细胞衰竭以及社会、认知、表观遗传和代谢衰老之间的关联信息。我们还强调了氧化应激在这些关联中的作用。我们假设偏头痛仅影响那些具有先天的、遗传/表观遗传的或后天的（创伤、冲击或情结）偏头痛易感性的人。这些易感性与年龄的相关性较弱，受影响的个体比其他人更容易受到偏头痛触发因素的影响。虽然触发因素可能与衰老的许多方面有关，但社会衰老可能起着特别重要的作用，因为其相关应激的患病率与偏头痛的患病率具有相似的年龄依赖性。此外，社会衰老与氧化应激有关，氧化应激在衰老的许多方面都很重要。从长远来看，应该进一步探索社会衰老的分子机制，并将其与偏头痛联系起来，与偏头痛易感性和性别差异的患病率更密切地联系起来。
