Moskowitz M A, Macfarlane R
Department of Neurology, Harvard Medical School, Massachusetts General Hospital, Boston 02114.
Cerebrovasc Brain Metab Rev. 1993 Fall;5(3):159-77.
This chapter reviews the evidence that challenges traditional and unproven notions which perpetuate the singular importance of constriction and dilation to the genesis of migraine pain. New data in experimental laboratory models suggest that migraine headache may develop primarily from metabolic/neurophysiological events (as yet unidentified) within the cortical mantle, or from a disturbance in those regions of brain which closely approximate the distribution of trigeminovascular fibers innervating meningeal blood vessels. Accordingly, this chapter will review the consequences of trigeminovascular activation to pain and meningeal inflammation, and will summarize emerging molecular and pharmacological data suggesting that ergot alkaloids and sumatriptan alleviate pain primarily via activation of pre-junctional 5-HT1 heteroreceptors residing on primary afferent trigeminovascular fibers.
本章回顾了相关证据，这些证据对一些传统且未经证实的观念提出了挑战，这些观念一直认为收缩和扩张对偏头痛疼痛的产生具有唯一重要性。实验实验室模型中的新数据表明，偏头痛可能主要源于皮质层内的代谢/神经生理事件（尚未明确），或者源于与支配脑膜血管的三叉神经血管纤维分布紧密相邻的脑区的紊乱。因此，本章将回顾三叉神经血管激活对疼痛和脑膜炎症的影响，并总结新出现的分子和药理学数据，这些数据表明麦角生物碱和舒马曲坦主要通过激活位于初级传入三叉神经血管纤维上的突触前5-HT1异受体来缓解疼痛。
