Migraine attacks are of peripheral origin: the debate goes on.
J Headache Pain
; 24(1): 3, 2023 Jan 10.
Article
em En
| MEDLINE
| ID: mdl-36627561
ABSTRACT
BACKGROUND:
Despite the pervasiveness of migraine, the underlying pathophysiological mechanisms initiating migraine attacks are far from well understood and are matter of scientific debate.OBJECTIVE:
In this narrative review, we discuss key evidence for that suggest a peripheral origin or central origin and provide directions for future studies that may provide further clarification.DISCUSSION:
Migraine pathogenesis is considered to involve the trigeminovascular system, a term that encompasses the trigeminal nerve and its axonal projections to the intracranial blood vessels. Beyond any doubt both peripheral and central mechanisms are involved in migraine pathogenesis, but an unresolved question is the how the initial activation occurs in a migraine attack. Evidence favoring a peripheral origin of migraine attacks, i.e., initial events occur outside of the blood-brain barrier, include the importance of sensitization of perivascular sensory afferents early on in a migraine attack. Evidence favoring a central origin include the occurrence of prodromal symptoms, migraine aura, and activation of structures within the central nervous system early in and during a migraine attack.CONCLUSIONS:
Both peripheral and central mechanisms are likely involved in a migraine attack, e.g., peripheral nociceptive input is necessary for pain transmission and cortical activity is necessary for pain perception. Yet, the debate of whether migraine attacks are initiated a peripheral or central site remains unresolved. The increased focus on prodromal symptoms and on the development of a human model of migraine aura will possibly provide key arguments needed to answer this question in the near future. Until then, we cannot draw firm conclusions and the debate goes on. VIDEO LINK Video recording of the debate held at the 1st International Conference on Advances in Migraine Sciences (ICAMS 2022, Copenhagen, Denmark) is available at https//www.youtube.com/watch?v=NC0nlcKohz0 .Palavras-chave
Texto completo:
1
Bases de dados:
MEDLINE
Assunto principal:
Enxaqueca com Aura
/
Epilepsia
/
Transtornos de Enxaqueca
Tipo de estudo:
Prognostic_studies
Limite:
Humans
Idioma:
En
Revista:
J Headache Pain
Assunto da revista:
MEDICINA INTERNA
/
NEUROLOGIA
/
PSICOFISIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article
País de afiliação:
Dinamarca