Affaitati Giannapia, Costantini Raffaele, Fiordaliso Michele, Giamberardino Maria Adele, Tana Claudio
Department of Innovative Technologies in Medicine and Dentistry, Center for Advanced Studies and Technology (CAST), G. D'Annunzio University of Chieti, 66100 Chieti, Italy.
G. D'Annunzio University of Chieti, 66100 Chieti, Italy.
Diagnostics (Basel). 2024 Aug 12;14(16):1750. doi: 10.3390/diagnostics14161750.
Headache and visceral pain are common clinical painful conditions, which often co-exist in the same patients. Numbers relative to their co-occurrence suggest possible common pathophysiological mechanisms. The aim of the present narrative review is to describe the most frequent headache and visceral pain associations and to discuss the possible underlying mechanisms of the associations and their diagnostic and therapeutic implications based on the most recent evidence from the international literature. The conditions addressed are as follows: visceral pain from the cardiovascular, gastrointestinal, and urogenital areas and primary headache conditions such as migraine and tension-type headache. The most frequent comorbidities involve the following: cardiac ischemic pain and migraine (possible shared mechanism of endothelial dysfunction, oxidative stress, and genetic and hormonal factors), functional gastrointestinal disorders, particularly IBS and both migraine and tension-type headache, primary or secondary dysmenorrhea and migraine, and painful bladder syndrome and headache (possible shared mechanisms of peripheral and central sensitization processes). The data also show that the various visceral pain-headache associations are characterized by more than a simple sum of symptoms from each condition but often involve complex interactions with the frequent enhancement of symptoms from both, which is crucial for diagnostic and treatment purposes.
头痛和内脏痛是常见的临床疼痛病症,常共存于同一患者身上。有关它们共现的一些数据提示了可能存在的共同病理生理机制。本叙述性综述的目的是描述最常见的头痛与内脏痛关联,并基于国际文献的最新证据,讨论这些关联可能的潜在机制及其诊断和治疗意义。涉及的病症如下:心血管、胃肠道和泌尿生殖系统区域的内脏痛,以及偏头痛和紧张型头痛等原发性头痛病症。最常见的共病情况包括:心脏缺血性疼痛与偏头痛(可能存在内皮功能障碍、氧化应激以及遗传和激素因素等共同机制)、功能性胃肠疾病,尤其是肠易激综合征与偏头痛和紧张型头痛均有关、原发性或继发性痛经与偏头痛、以及膀胱疼痛综合征与头痛(可能存在外周和中枢敏化过程等共同机制)。数据还表明,各种内脏痛与头痛的关联并非简单地表现为每种病症症状的叠加,而是常常涉及两者症状频繁增强的复杂相互作用,这对诊断和治疗目的至关重要。
Diagnostics (Basel). 2024-8-12
J Neural Transm (Vienna). 2020-4
J Minim Invasive Gynecol. 2023-1
Gastroenterology. 2024-6
Handb Clin Neurol. 2024
Arterioscler Thromb Vasc Biol. 2024-3
Life (Basel). 2024-1-2
CJC Open. 2023-9-7
Obstet Gynecol Surv. 2023-12
Handb Clin Neurol. 2023