Harper A M, MacKenzie E T, McCulloch J, Pickard J D
Lancet. 1977 May 14;1(8020):1034-6. doi: 10.1016/s0140-6736(77)91262-4.
The prodromal (cerebral) symptoms of migraine are associated with a fall in cerebral blood-flow (C.B.F.). The suggestion that various circulating vasoactive agents might be the cause of this fall in C.B.F. ignores the contradictory findings that the cerebral vascular bed is normally unresponsive to such agents; but if the blood-barrier is disrupted, systemically administered monoamines and prostaglandins elicit pronounced changes in cerebral-tissue perfusion and metabolism. A defect in the blood-brain barrier of migraine patients (particularly those in whom an item of diet may trigger an attack) would make the cerebral circulation vulnerable to variations in circulating levels of vasoactive substances. Alternatively, the barrier could be intact in non-dietary patients, but release of monoamines or prostaglandins from the brain itself could account for the observed changes in the cerebral circulation.
偏头痛的前驱（脑部）症状与脑血流量（C.B.F.）下降有关。认为各种循环血管活性物质可能是导致C.B.F.下降的原因这一观点，忽略了相互矛盾的研究结果，即脑血管床通常对这类物质无反应；但如果血脑屏障被破坏，全身给药的单胺类物质和前列腺素会引起脑组织灌注和代谢的显著变化。偏头痛患者（尤其是那些饮食中的某一成分可能引发发作的患者）血脑屏障的缺陷会使脑循环易受循环血管活性物质水平变化的影响。或者，在非饮食诱发型患者中血脑屏障可能完好无损，但大脑自身释放的单胺类物质或前列腺素可能是观察到的脑循环变化的原因。
