Peroutka S J
Spectra Biomedical, Inc., Menlo Park, CA 94025, USA.
Neurology. 1997 Sep;49(3):650-6. doi: 10.1212/wnl.49.3.650.
This review summarizes a growing body of biological, pharmacologic, and genetic data that support a role for dopamine in the pathophysiology of certain subtypes of migraine. Most migraine symptoms can be induced by dopaminergic stimulation. Moreover, there is dopamine receptor hypersensitivity in migraineurs, as demonstrated by the induction of yawning, nausea, vomiting, hypotension, and other symptoms of a migraine attack by dopaminergic agonists at doses that do not affect nonmigraineurs. Conversely, dopamine receptor antagonists are effective therapeutic agents in migraine. Recent genetic data suggest that molecular variations within dopamine receptor genes play a modifying role in the pathophysiology of migraine with aura. Therefore, modulation of dopaminergic neurotransmission should be considered in the therapeutic management of migraine.
本综述总结了越来越多的生物学、药理学和遗传学数据，这些数据支持多巴胺在某些偏头痛亚型的病理生理学中发挥作用。大多数偏头痛症状可由多巴胺能刺激诱发。此外，偏头痛患者存在多巴胺受体超敏反应，这表现为多巴胺能激动剂在不影响非偏头痛患者的剂量下可诱发打哈欠、恶心、呕吐、低血压及偏头痛发作的其他症状。相反，多巴胺受体拮抗剂是偏头痛的有效治疗药物。最近的遗传学数据表明，多巴胺受体基因内的分子变异在伴先兆偏头痛的病理生理学中起修饰作用。因此，在偏头痛的治疗管理中应考虑调节多巴胺能神经传递。
