May A, Kaube H, Büchel C, Eichten C, Rijntjes M, Jüptner M, Weiller C, Diener C H
Department of Neurology, University of Essen, Hufelandstr. 55, 45122 Essen, Germany Wellcome Department of Cognitive Neurology, Institute of Neurology, Queen Square, London WC1N 3BG, UK Department of Neurology, University of Jena, Philosophenweg 3, 07740 Jena, Germany.
Pain. 1998 Jan;74(1):61-66. doi: 10.1016/S0304-3959(97)00144-9.
Using a positron emission tomography (PET) study it was shown recently that in migraine without aura certain areas in the brain stem were activated during the headache state, but not in the headache free interval. It was suggested that this brain stem activation is inherent to the migraine attack itself and represents the so called 'migraine generator'. To test this hypothesis we performed an experimental pain study in seven healthy volunteers, using the same positioning in the PET scanner as in the migraine patients. A small amount of capsaicin was administered subcutaneously in the right forehead to evoke a burning painful sensation in the first division of the trigeminal nerve. Increases of regional cerebral blood flow (rCBF) were found bilaterally in the insula, in the anterior cingulate cortex, the cavernous sinus and the cerebellum. Using the same stereotactic space limits as in the above mentioned migraine study no brain stem activation was found in the acute pain state compared to the pain free state. The increase of activation in the region of the cavernous sinus however, suggests that this structure is more likely to be involved in trigeminal transmitted pain as such, rather than in a specific type of headache as was suggested for cluster headache.
最近一项正电子发射断层扫描（PET）研究表明，在无先兆偏头痛中，脑干的某些区域在头痛发作时被激活，但在无头痛间歇期未被激活。有人提出，这种脑干激活是偏头痛发作本身所固有的，代表了所谓的“偏头痛发生器”。为了验证这一假设，我们对7名健康志愿者进行了一项实验性疼痛研究，在PET扫描仪中采用与偏头痛患者相同的定位。在右前额皮下注射少量辣椒素，以诱发三叉神经第一分支的灼痛。在岛叶、前扣带回皮质、海绵窦和小脑中双侧发现局部脑血流量（rCBF）增加。与上述偏头痛研究使用相同的立体定向空间限制，与无痛状态相比，在急性疼痛状态下未发现脑干激活。然而，海绵窦区域激活的增加表明，该结构更可能参与三叉神经传导性疼痛本身，而不是像丛集性头痛那样参与特定类型的头痛。
