Kamins Joshua L, Karimi Ramin, Hoffman Ann, Prins Mayumi L, Giza Christopher C
Goldberg Migraine Program, Department of Neurology, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.
UCLA Steve Tisch BrainSPORT Program, Department of Neurosurgery, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA.
Curr Pain Headache Rep. 2024 Dec;28(12):1185-1193. doi: 10.1007/s11916-024-01255-1. Epub 2024 Aug 13.
To review existing literature on biomarkers for post-traumatic headache (PTH).
Preclinical models and clinical findings have started to elucidate the biology that underlies PTH. Traumatic brain injury results in ionic flux, glutamatergic surge, and activation of the trigeminal cervical complex resulting in the release of pain neuropeptides. These neuropeptides, including calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating polypeptide (PACAP), play a key role in the pathophysiology of migraine and other primary headache disorders. Only two studies were identified that evaluated CGRP levels in PTH. Neither study found a consistent relationship between CGRP levels and PTH. One study did discover that nerve growth factor (NGF) was elevated in subjects with PTH. There is no conclusive evidence for reliable blood-based biomarkers for PTH. Limitations in assays, collection technique, and time since injury must be taken into account. There are multiple ideal candidates that have yet to be explored.
回顾有关创伤后头痛（PTH）生物标志物的现有文献。
临床前模型和临床研究结果已开始阐明PTH的生物学基础。创伤性脑损伤导致离子通量、谷氨酸能激增以及三叉神经颈复合体激活，从而导致疼痛神经肽释放。这些神经肽，包括降钙素基因相关肽（CGRP）和垂体腺苷酸环化酶激活多肽（PACAP），在偏头痛和其他原发性头痛疾病的病理生理学中起关键作用。仅确定了两项评估PTH中CGRP水平的研究。两项研究均未发现CGRP水平与PTH之间存在一致关系。一项研究确实发现PTH患者的神经生长因子（NGF）升高。尚无确凿证据表明存在可靠的基于血液的PTH生物标志物。必须考虑检测方法、采集技术和受伤后时间的局限性。有多种理想的候选生物标志物尚未得到探索。
