Del Zompo M, Cherchi A, Palmas M A, Ponti M, Bocchetta A, Gessa G L, Piccardi M P
Headache Center, Department of Neurosciences B.B. Brodie, University of Cagliari, Italy.
Neurology. 1998 Sep;51(3):781-6. doi: 10.1212/wnl.51.3.781.
Migraine seems to be caused by a combination of environmental and genetic factors. Clinical and pharmacologic evidence supports the hypothesis that dopaminergic transmission is involved in the pathogenesis of migraine.
The current report concerns a genetic study to test the involvement of genes for dopamine (DA) receptors D2 (DRD2), D3 (DRD3), and D4 (DRD4) in migraine without aura, particularly in a subgroup with enhanced DA sensitivity.
For the first time, a family-based association method--the Transmission Disequilibrium Test (TDT)--was used to examine an isolated population, such as Sardinians. We studied 50 nuclear families of patients affected by migraine without aura. The subgroup of dopaminergic migraineurs was selected based on the presence of both nausea and yawning immediately before or during the pain phase of migraine.
No association was detected using the TDT between DRD3, DRD4, and migraine without aura either in the overall sample or in the subgroup. No difference was observed in DRD2 allelic distribution in the overall sample, although the allelic distribution at the DRD2 locus differed significantly in the subgroup of dopaminergic migraineurs (p = 0.004). Allele 1 of the TG dinucleotide intronic noncoding polymorphism of the DRD2 locus was the individual allele that appeared to be in disequilibrium with migraine without aura (p = 0.02).
Our data suggest that a genetic approach could be useful in providing molecular support to the hypothesis that hypersensitivity of the dopaminergic system may represent the pathophysiologic basis of migraine, at least in a subgroup of patients.
偏头痛似乎是由环境因素和遗传因素共同引起的。临床和药理学证据支持多巴胺能传递参与偏头痛发病机制的假说。
本报告涉及一项基因研究,以检测多巴胺(DA)受体D2(DRD2)、D3(DRD3)和D4(DRD4)基因在无先兆偏头痛中的作用,特别是在多巴胺敏感性增强的亚组中。
首次采用基于家系的关联方法——传递不平衡检验(TDT)来研究撒丁岛人等孤立人群。我们研究了50个无先兆偏头痛患者的核心家庭。根据偏头痛疼痛阶段之前或期间出现恶心和打哈欠的情况,选择多巴胺能偏头痛患者亚组。
在整个样本或亚组中,使用TDT未检测到DRD3、DRD4与无先兆偏头痛之间存在关联。在整个样本中,DRD2等位基因分布未观察到差异,尽管在多巴胺能偏头痛患者亚组中,DRD2基因座的等位基因分布存在显著差异(p = 0.004)。DRD2基因座的TG二核苷酸内含子非编码多态性的等位基因1似乎是与无先兆偏头痛不平衡的单个等位基因(p = 0.02)。
我们的数据表明,基因方法可能有助于为多巴胺能系统超敏反应可能代表偏头痛病理生理基础这一假说提供分子支持,至少在一部分患者中是这样。