偏头痛中的脑血流和动脉反应:历史和未来的前景
1Translational Research Center and Danish Headache Center, Rigshospitalet, University of Copenhagen, Nordstjernevej 42, Glostrup, Copenhagen, 2600, Denmark. jes.olesen@regionh.dk.
The journal of headache and pain
|December 20, 2024
概括
皮层扩散抑郁症 (CSD) 与有光环的偏头痛 (MA) 有关,而没有光环的偏头痛 (MO) 显示出不同的大脑活动. 关于区域大脑血流 (rCBF) 的旧研究支持这些发现.
科学领域:
- 神经学 神经学
- 神经科学是一个神经科学.
- 医疗成像医学成像
背景情况:
- 人们普遍认为,偏头痛与光环 (MA) 是源于皮质扩散抑郁症 (CSD).
- 没有光环的偏头痛 (MO) 通常与CSD无关.
- 关于区域大脑血流 (rCBF) 和血管反应的先前研究构成了当前理解的基础.
研究的目的:
- 审查关于区域脑血流 (rCBF) 和偏头痛中的血管反应的历史研究.
- 重新评估皮层扩散抑郁症 (CSD) 在偏头痛与光环 (MA) 中的证据.
- 在偏头痛病理生理学中评估血管缩理论的有效性.
主要方法:
- 文献审查,重点关注20世纪80年代和90年代的研究.
- 从动脉内133-注射和SPECT成像数据的分析.
- 对脑动脉扩张的超声波和MR血管学发现的检查.
主要成果:
- 在MA中CSD的最有力的证据来自133-研究,表明rCBF下降.
- 发现偏头痛的血管的理论是不正确的;头痛发作与rCBF降低相关.
- MO显示正常的rCBF,后来的研究表明疼痛相关区域的激活;脑干显示流量增加.
- 在MO中观察到脑动脉扩张,但脑外动脉没有出现这种扩张.
结论:
- 使用rCBF和SPECT的历史研究为偏头痛机制提供了关键的见解.
- 现代PET和MR技术已经证实并扩展了这些早期发现.
- 虽然存在实质证据,但在MA中证券交易所的确切证据和在MO中缺席的证据需要进一步调查.
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