实验性偏头痛动物模型研究现状

偏头痛是一种原发性头痛,其发病机制及病理机制至今不明,目前占有主导地位的理论有血管源学说、三叉神经血管学说和皮层扩布性抑制学说。动物模型正是在上述理论基础上建立的。本文拟对偏头痛动物模型的研究现状进行综述。     

哈慈五行针吸附翳风穴治疗偏头痛30例体会

偏头痛是头痛的常见类型之一,为发作性的颅内和颅外血管功能障碍,以反复发生头痛为特征,属祖国医学中“偏头痛”、“少阳头痛”、“头风”范畴。迄今,尚无特效疗法和药物。我们以五行针吸附翳风穴治疗偏头痛３０例,取得了比较满意的疗效。一般资料病例选择：选择的３０例偏头痛患者均符合《吉林省疾病诊断与疗效判定标准》（吉林人民出版社,１９８３年５月第１版）中偏头痛之诊断标准。其中,男性１３例,女性１７例。年龄最小的１４岁,最大的６７岁。病程最长者１２年,最短者１年。且１２例有偏头痛家族史。治疗方法：均以五行针吸…     

82例偏头痛患者甲襞微循环观察研究

偏头痛是以一侧或双侧发作性搏动性头痛为特征的脑血管疾病,其病因和病理生理基础还不十分清楚.有人认为本病与中枢性血管功能紊乱,包括颅内外血管及微循环功能紊乱有关.我们从1992年3月～1995年12月对82例偏头痛病人甲襞微循环进行观察研究,现报告如下.1 对象与方法1.1 一般资料 本组选择82例已确诊为偏头痛的患者作为观察对象.男56例,女26例,其中21～30岁35例,31～40岁32例,41～50岁10例,50岁以上5例.1.2 检查方法 ①被检查者在室温平均22℃室内安静休息16～30分钟;②填写检查表格、询问必要病;③记录室温、检查询问左手无名指有无局部损伤史;④将左手无名指放在固定架上、上肢放松,使手     

针刺对偏头痛治疗机制的神经影像学研究现状

偏头痛是以中重度头痛及各种神经症状为特征的神经系统疾病.针刺作为常用的非药物疗法,在偏头痛防治方面具有疗效佳、副作用少的优势,但其作用机制尚不明确.近年来,神经影像学技术的进步有助于客观评估针刺治疗偏头痛的疗效,并为探索针刺治疗偏头痛的中枢机制提供了机会.本文从针刺治疗偏头痛急性发作和针刺预防偏头痛发作的中枢机制两个方...     

偏头痛患者体感刺激下脑电信号的功能连接（英文）

目的 偏头痛是一种复杂的脑功能障碍性疾病,全球范围内患病率为14.4%。功能连接测量两个神经信号之间的统计学相互依赖性,不同的功能连接反映了大脑区域协同工作的不同模式。因此,研究不同脑区的功能连接对于理解偏头痛的病理生理机制具有十分重要的意义。以往基于脑电图对偏头痛患者脑功能连接的分析主要集中在视觉和疼痛刺激。本文尝试研究偏头痛患者在发作间期对体感刺激的皮质反应,以进一步了解偏头痛的神经功能障碍,为偏头痛的预防和治疗提供线索。方法 招募23例无先兆偏头痛患者,10例有先兆偏头痛患者,28名健康对照者。所有受试者均进行详细的基本资料和病史采集,完善量表评估,在正中神经体感刺激下进行脑电图记录。计算68个脑区的相干性作为功能连接,并评估功能连接与临床参数的相关性。结果 在正中神经体感刺激下,无先兆偏头痛和有先兆偏头痛患者的脑电功能连接与对照组相比存在差异,异常的脑电功能连接主要位于感觉辨别、疼痛调节、情绪认知和视觉处理等区域。无先兆偏头痛和有先兆偏头痛患者的大脑皮层对体感刺激可能具有相同的反应方式。偏头痛患者的功能连接异常与临床特征之间存在相关性,可以部分反映偏头痛的严重程度。结论 本研究...     

川芎当归不同配伍对偏头痛大鼠体内5-HT, NO和NOS的影响研究

目的:研究不同比例的川芎当归配伍对偏头痛大鼠体内内源性物质影响。方法:采用雄性SD大鼠,皮下注射硝酸甘油混悬液制作偏头痛大鼠模型,以偏头痛模型大鼠体内三种内源性物质5-HT、NO和NOS含量为考察指标,观察给予川芎-当归不同配比(1:9,2:8~9:1)提取液后,模型大鼠体内5-HT、NO和NOS含量变化。结果:在不同配伍比例川芎当归给药后,模型大鼠脑内5-HT含量随川芎比例增加而增加,当川芎比例超过5:5是变化显著,达到8:2时变化最显著;NO而NOS含量变化差异不显著。结论:川芎当归药预防给药对能够减少脑内5-HT在偏头痛发作时的消耗,发挥收缩血管作用,且随着川芎比例增大,作用逐渐增强;阿魏酸对偏头痛的预防有效,但不是唯一有效成分,不能作为药对作用的决定因素。     

肌电生物反馈疗法预防偏头痛发作疗效的对比研究

目的:探讨肌电生物反馈疗法对偏头痛的治疗效果。方法:40例偏头痛患者随机分为治疗组(n=20)和对照组(n=20),治疗组接受生物反馈治疗,每周两次,每次30分钟,共2个月,并随访2个月。记录基线期、治疗期及随访期头痛发作频率的变化。结果:肌电反馈组的头痛发作频率明显低于对照组,两组差别有显著性统计学意义(P=0.025)。结论:肌电生物反馈疗法能有效预防偏头痛发作。     

实验性偏头痛动物模型c-fos、c-jun基因表达

目的　复制实验性偏头痛动物模型并探讨其c -fos、c -jun基因表达。方法　采用CristinaTassorelli硝酸甘油法复制大鼠实验性偏头痛模型。免疫组化ABC法研究偏头痛大鼠脑组织即刻早期基因c -fos、c -jun的表达。结果　硝酸甘油型实验性偏头痛大鼠出现双耳发红、甩头、前肢频繁搔头 ,活动增加等外在表现 ,脑组织c -fos、c -jun基因表达阳性细胞数增加 ,基因表达阳性细胞的面积扩大、灰度降低或变化不大。结论　硝酸甘油型实验偏头痛大鼠模型复制方法简单、重复性较好、脑组织c -fos和c -jun基因异常表达明显 ,可以作为偏头痛治疗药物筛选、药效评价和发病机理研究的动物模型。     

典型偏头痛治验一得

典型偏头痛治验一得沈亚标（江西省修水县中医院３３２４００）笔者采用人体倒立自身疗法,阻断典型偏头痛发作过程,取得满意疗效。现举验案如下,以飨读者。患者,男性,３０岁,头痛反复发作十余年,每次发作前感畏光,闪光视幻觉,恶心,四肢麻木。此种先兆症状历时约...     

心脏右向左分流对偏头痛患者临床症状的影响

目的:探讨心脏右向左分流(RLS)对偏头痛患者临床特征是否存在影响,并研究RLS分级与头痛强度之间的关系。方法:选择2016年6月-2018年12月青岛大学附属医院收治的偏头痛患者216例作为偏头痛组,选择于青岛大学附属医院体检的健康志愿者60例作为对照组。216例偏头痛患者根据有无RLS分为有RLS偏头痛组(127例)和无RLS偏头痛组(89例)。有RLS偏头痛患者根据RLS分级将其分为大分流组(n=51)、中分流组(n=11)和小分流组(n=65)。观察对照组与偏头痛组RLS情况,比较有RLS偏头痛组和无RLS偏头痛组患者的一般资料情况,比较大分流组、中分流组和小分流组患者的一般资料情况,采用多因素Logistic回归分析偏头痛患者产生RLS的危险因素。结果:对照组与偏头痛组小分流、中分流患病率比较差异无统计学意义(P0.05),而偏头痛组大分流患病率高于对照组(P0.05)。有RLS偏头痛组患者的视觉先兆、感觉先兆的比例均大于无RLS偏头痛组,头痛初始年龄均小于无RLS偏头痛组,头痛强度均高于无RLS偏头痛组(P0.05),两组患者年龄、性别、吸烟、饮酒、高血压、糖尿病、高血脂、运动先兆、遗传、头痛频率、头痛持续时间比较差异无统计学意义(P0.05)。不同RLS分级的偏头痛患者的视觉先兆、感觉先兆、头痛初始年龄、头痛强度整体比较差异有统计学意义(P0.05)。多因素Logistic回归分析显示,视觉先兆、感觉先兆、头痛初始年龄是偏头痛患者产生RLS的独立危险因素(P0.05)。结论:偏头痛发病年龄较小或有视觉先兆、感觉先兆可能提示偏头痛患者伴有RLS,RLS分级与头痛强度没有关系。     

Absorption of Effervescent Aspirin during Migraine

The absorption of effervescent aspirin was studied in 42 patients during acute attacks of migraine. When compared with normal controls and with themselves between attacks 19 out of the 42 patients showed impairment of absorption. Impairment of absorption seemed to correlate with the severity of the headache and the gastro-intestinal symptoms at the time of treatment but not with the duration of the attack or with the type of migraine. This study probably underestimated the prevalence of impairment of absorption in migraine attacks, and it is concluded that the treatment of acute migraine symptoms by oral drugs should use those formulations which are rapidly absorbed under normal conditions.     

Reversal of migraine symptoms by Helicobacter pylori eradication therapy in patients with hepatitis-B-related liver cirrhosis

Helicobacter pylori infection might be associated with vascular diseases, such as primary Raynaud phenomenon and coronary heart diseases. The possible mechanism might be due to H. pylori antigens causing intermittent vasospasm of arterioles, which also played roles in the development of liver cirrhosis. Migraine, a functional vascular disease, was observed in many patients with cirrhosis in the clinic. This study aimed to assess the effects of H. pylori eradication on migraine symptoms in patients with hepatitis-B-virus-related cirrhosis. The results clearly showed that the intensity, duration, and frequency of attacks of migraine were significantly reduced in all the patients in whom H. pylori has been eradicated. Thus, the study pushed further insight into the mechanisms of migraine pathogenesis.     

Increased permeability of the blood-brain barrier following administration of glyceryl trinitrate in common carp (Cyprinus carpio L.)

Nitric oxide (NO) has been implicated in the pathogenesis of migraine and treatment with its exogenous donor glyceryl trinitrate (GTN) represents widely accepted experimental "migraine model". In this study, glyceryl trinitrate was administered intraperitoneally to carps, serum nitrite and nitrate levels were determined, permeability of blood-brain barrier was investigated, and histological changes of brain tissue were analyzed. Serum nitrite and nitrate levels displayed characteristic biphasic pattern with moderate initial increase and maximal terminal increase, suggesting the GTN-induced endogenous NO synthesis. Increased permeability of the blood-brain barrier in GTN-treated animals was determined based on Evans blue capillary leakage into the brain tissue. Histological analysis revealed changes consistent with vasodilatation and oedema. Our study strongly supports the importance of the NO role in the pathogenesis of migraine attacks and increase in blood-brain barrier permeability during the attack. The study has also provided evidence that this mechanism of action is conserved to the lower vertebrate.     

Aberrant Neuromagnetic Activation in the Motor Cortex in Children with Acute Migraine: A Magnetoencephalography Study

Migraine attacks have been shown to interfere with normal function in the brain such as motor or sensory function. However, to date, there has been no clinical neurophysiology study focusing on the motor function in children with migraine during headache attacks. To investigate the motor function in children with migraine, twenty-six children with acute migraine, meeting International Classification of Headache Disorders criteria and age- and gender-matched healthy children were studied using a 275-channel magnetoencephalography system. A finger-tapping paradigm was designed to elicit neuromagnetic activation in the motor cortex. Children with migraine showed significantly prolonged latency of movement-evoked magnetic fields (MEF) during finger movement compared with the controls. The correlation coefficient of MEF latency and age in children with migraine was significantly different from that in healthy controls. The spectral power of high gamma (65–150 Hz) oscillations during finger movement in the primary motor cortex is also significantly higher in children with migraine than in controls. The alteration of responding latency and aberrant high gamma oscillations suggest that the developmental trajectory of motor function in children with migraine is impaired during migraine attacks and/or developmentally delayed. This finding indicates that childhood migraine may affect the development of brain function and result in long-term problems.     

Women with endometriosis are more likely to suffer from migraines: a population-based study

Previous research suggests that a co-morbid relationship exists between migraine and endometriosis; however, results have been inconsistent. In addition, female hormones, which are important in the pathogenesis and management of endometriosis, have been reported to precipitate migraine attacks and may confound the results. The aim of this population-based cohort study was to explore the relationship between migraine and endometriosis in women of reproductive age (18-51 years). Data were derived from the National Health Insurance Research Database of Taiwan, which contains outpatient and inpatient records from 2000 to 2007. Our study cohort included 20,220 endometriosis patients and 263,767 controls without endometriosis. We analyzed the prevalence of migraine in these women as recorded during the eight years of the database. Our results found that patients with endometriosis were more likely to suffer migraine headaches compared to controls (odds ratio [OR], 1.70; 95% confidence interval [CI] [1.59, 1.82]; p<0.001). In addition, the co-morbid association between migraine and endometriosis remained significant after the data were controlled for age and frequently utilized hormone therapies (OR, 1.37; 95% CI, [1.27, 1.47]; p<0.001). The results of this cohort study support the existence of a co-morbid relationship between migraine and endometriosis, even after adjusting for the possible effects of female hormone therapies on migraine attacks.     

Migraine prodromes separated from the aura: complete migraine.

Detailed questioning of 50 patients with uncomplicated migraine has shown that 17 had symptoms that preceded the headache phase by several hours. These prodromes consisted of changes in mood, behaviour, wakefulness, appetite, bowel activity, or fluid balance. The term "complete migraine" is proposed for attacks that include prodromal symptoms, whose occurrence implies an initial diffuse cerebral or hypothalamic disturbance.     

Migraine, Helicobacter pylori, and oxidative stress

BACKGROUND: The aim of this study was to ascertain whether oxidative stress is a causative factor of migraine attacks for Helicobacter pylori-infected migraineurs. MATERIALS AND METHODS: A total of 35 consecutive migraine patients without aura who came to gastroenterology polyclinic with various complaints and diagnosed H. pylori infection were included in the study group and compared with a group of 29 patients (control group) without migraine and H. infection. H. pylori infection was diagnosed by histopathological biopsies, which were taken by endoscopy (Olympus-GIFXQ240 endoscope). Both the diagnosis and the classification of migraine were made according to the International Headache Society criteria. Blood samples for nitric oxide were taken from patients with migraine during headache-free period as well as the control group. The interaction of nitric oxide was measured by the determination of both nitrite and nitrate concentrations in the sample. RESULTS: The study group included 31 women and 4 men (mean age 49 +/- 8 years) and the control group included 25 women and 4 men (mean age 52.6 +/- 11 years). The mean frequency of migraine attacks was 2.94 +/- 1.58 days/month and the mean duration of attacks was 21.2 +/- 3 hours. It was found that the study group has lower nitrate levels than the control group. CONCLUSIONS: Our results do not support the role of oxidative stress in patients suffering from H. pylori infection and migraine.     

Association study of the calcitonin gene-related polypeptide-alpha (CALCA) and the receptor activity modifying 1 (RAMP1) genes with migraine

Migraine is a common neurovascular brain disorder characterised by recurrent attacks of severe headache that may be accompanied by various neurological symptoms. Migraine is thought to result from activation of the trigeminovascular system followed by vasodilation of pain-producing intracranial blood vessels and activation of second-order sensory neurons in the trigeminal nucleus caudalis. Calcitonin gene-related peptide (CGRP) is a mediator of neurogenic inflammation and the most powerful vasodilating neuropeptide, and has been implicated in migraine pathophysiology. Consequently, genes involved in CGRP synthesis or CGRP receptor genes may play a role in migraine and/or increase susceptibility. This study investigates whether variants in the gene that encodes CGRP, calcitonin-related polypeptide alpha (CALCA) or in the gene that encodes a component of its receptor, receptor activity modifying protein 1 (RAMP1), are associated with migraine pathogenesis and susceptibility. The single nucleotide polymorphisms (SNPs) rs3781719 and rs145837941 in the CALCA gene, and rs3754701 and rs7590387 at the RAMP1 locus, were analysed in an Australian Caucasian population of migraineurs and matched controls. Although we find no significant association of any of the SNPs tested with migraine overall, we detected a nominally significant association (p = 0.031) of the RAMP1 rs3754701 variant in male migraine subjects, although this is non-significant after Bonferroni correction for multiple testing.     

Primary Somatosensory Cortices Contain Altered Patterns of Regional Cerebral Blood Flow in the Interictal Phase of Migraine

The regulation of cerebral blood flow (CBF) is a complex integrated process that is critical for supporting healthy brain function. Studies have demonstrated a high incidence of alterations in CBF in patients suffering from migraine with and without aura during different phases of attacks. However, the CBF data collected interictally has failed to show any distinguishing features or clues as to the underlying pathophysiology of the disease. In this study we used the magnetic resonance imaging (MRI) technique—arterial spin labeling (ASL)—to non-invasively and quantitatively measure regional CBF (rCBF) in a case-controlled study of interictal migraine. We examined both the regional and global CBF differences between the groups, and found a significant increase in rCBF in the primary somatosensory cortex (S1) of migraine patients. The CBF values in S1 were positively correlated with the headache attack frequency, but were unrelated to the duration of illness or age of the patients. Additionally, 82% of patients reported skin hypersensitivity (cutaneous allodynia) during migraine, suggesting atypical processing of somatosensory stimuli. Our results demonstrate the presence of a disease-specific functional deficit in a known region of the trigemino-cortical pathway, which may be driven by adaptive or maladaptive functional plasticity. These findings may in part explain the altered sensory experiences reported between migraine attacks.     

Interictal Dysfunction of a Brainstem Descending Modulatory Center in Migraine Patients

Background

The brainstem contains descending circuitry that can modulate nociceptive processing (neural signals associated with pain) in the dorsal horn of the spinal cord and the medullary dorsal horn. In migraineurs, abnormal brainstem function during attacks suggest that dysfunction of descending modulation may facilitate migraine attacks, either by reducing descending inhibition or increasing facilitation. To determine whether a brainstem dysfunction could play a role in facilitating migraine attacks, we measured brainstem function in migraineurs when they were not having an attack (i.e. the interictal phase).

Methods and Findings

Using fMRI (functional magnetic resonance imaging), we mapped brainstem activity to heat stimuli in 12 episodic migraine patients during the interictal phase. Separate scans were collected to measure responses to 41°C and noxious heat (pain threshold+1°C). Stimuli were either applied to the forehead on the affected side (as reported during an attack) or the dorsum of the hand. This was repeated in 12 age-gender-matched control subjects, and the side tested corresponded to that in the matched migraine patients. Nucleus cuneiformis (NCF), a component of brainstem pain modulatory circuits, appears to be hypofunctional in migraineurs. 3 out of the 4 thermal stimulus conditions showed significantly greater NCF activation in control subjects than the migraine patients.

Conclusions

Altered descending modulation has been postulated to contribute to migraine, leading to loss of inhibition or enhanced facilitation resulting in hyperexcitability of trigeminovascular neurons. NCF function could potentially serve as a diagnostic measure in migraine patients, even when not experiencing an attack. This has important implications for the evaluation of therapies for migraine.