Ferrari M D, Saxena P R
Department of Neurology, University Hospital, Leiden, The Netherlands.
Cephalalgia. 1993 Jun;13(3):151-65. doi: 10.1046/j.1468-2982.1993.1303151.x.
Migraine patients have chronically low systemic 5-HT, predisposing them to develop migrainous headache once an attack has been initiated. Changes in platelet 5-HT content are not causally related, but reflect similar changes at a neuronal level. Stimulation of vascular 5-HT1 receptors, probably located in the vessel wall within the dural vascular bed, may alleviate the headache and associated symptoms, but does not interact with earlier mechanisms within the pathophysiological cascade. These receptors are of an as yet unidentified 5-HT1 subtype, closely resembling, but not identical to 5-HT1D receptors. Activation of these receptors results in vasoconstriction, inhibiting depolarization of sensory perivascular afferents within the trigemino-vascular system and thus stopping the headache. Additional inhibition of the release of vasoactive neuropeptides may be involved, but seems to be of only secondary clinical importance.
偏头痛患者的全身5-羟色胺（5-HT）水平长期偏低，一旦发作，就容易引发偏头痛性头痛。血小板5-HT含量的变化并无因果关系，但反映了神经元水平的类似变化。刺激血管5-HT1受体（可能位于硬脑膜血管床内的血管壁）或许能缓解头痛及相关症状，但并不影响病理生理级联反应中的早期机制。这些受体属于尚未明确的5-HT1亚型，与5-HT1D受体极为相似，但并不相同。激活这些受体会导致血管收缩，抑制三叉神经血管系统内感觉性血管周围传入神经的去极化，从而终止头痛。可能还涉及对血管活性神经肽释放的额外抑制，但似乎仅具有次要的临床意义。
