Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factor...Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factors. Recent studies have suggested that the pathogenesis of vestibular migraine may be associated with variations in the CACNA1A gene, which is an important gene target for controlling calcium ion channels. Such variations may further affect the functions of the vestibular nervous system, thereby causing a series of vestibular nervous system-related symptoms. This article will summarize the genetic association studies of vestibular migraine, vestibular function studies, and research on how to establish relevant animal models to illustrate the possible association between CACNA1A variations and the pathogenesis of VM, providing new ideas for clarifying the pathogenesis of VM.展开更多
OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target informa...OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target information of Baihui(GV20)and Fengchi(GB20)was retrieved,and after intersection with migraine,Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome,and Uni Prot Keywords were used for functional enrichment.After selecting the main pathway,rats were selected and nitroglycerin was used for modeling,and the behavioral scores,inflammatory factors,heme oxygenase 1(HMOX1),protein kinase B(AKT1),signal transducer and activator of transcription 3(STAT3),phosphorylated extracellular signal-regulated kinase 1/2(P-ERK1/ERK2)and other states of the rats in the acupuncture,twisting,and electroacupuncture groups were compared.RESULTS:A total of 135 Baihui(GV20)targets and 27 Fengchi(GB20)targets were collected.A total of 73 target information were obtained after the intersection of these targets in migraine.These 73 targets have three main pathways:hypoxia-inducible factor 1(HIF-1)signaling pathway,signaling by interleukins and inflammatory response.The main targets in the pathway were verified and found that interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)and HMOX1,AKT1,STAT3,P-ERK1/ERK2 can be regulated by Baihui(GV20)and Fengchi(GB20).CONCLUSION:Baihui(GV20)and Fengchi(GB20)can regulate migraine by regulating inflammatory factors and HMOX1,AKT1,STAT3,P-ERK1/ERK2 and other changes in HIF-1 signaling pathway,Signaling by Interleukins and Inflammatory response pathways.Based on systems biology and network pharmacology,and with the model of"acupoint-target-disease",explore the research methods of systematic acupuncture and moxibustion.We believe this is a usable research direction for exploring the mechanism of acupuncture stimulation.展开更多
BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch a...BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.展开更多
Objective:To analyze and validate how Jiawei Sanpian decoction treats migraines by integrating network pharmacology,molecular docking technology,and experimental studies.Method:Using network pharmacology,the chemical ...Objective:To analyze and validate how Jiawei Sanpian decoction treats migraines by integrating network pharmacology,molecular docking technology,and experimental studies.Method:Using network pharmacology,the chemical components and core target proteins of the Jiawei Sanpian decoction were analyzed.Key chemical components were docked with core targets using mo-lecular docking,and the results were visualized.Nitroglycerin was injected into the dorsal cervical region to establish a rat migraine model.Finally,experiments were conducted to verify the effects of Jiawei Sanpian on related pathways and targets.Results:Four notable chemical components were identified,namely,b-sitosterol,quercetin,mairin,and kaempferol.Five representative targets were identified,namely,insulin-like growth factor 1(IGF-1),matrix metallopeptidase 2(MMP-2),interleukin-2(IL-2),superoxide dismutase 2(SOD2),and inducible nitric oxide synthase(NOS2).Molecular docking results revealed that the minimum binding energies between the four chemical components and the five targets were below5 kcal/mol,indicating favor-able binding activity.Enzyme linked immunosorbent assay(ELISA)results demonstrated the efficacy of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).Real-time quantitative polymerase chain reaction(RT-qPCR)results demonstrated the effectiveness of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).After using erastin,the therapeutic effect of Jiawei Sanpian decoction declined.Conclusion:This study provides initial insights into the complex and multilayered therapeutic mecha-nisms of Jiawei Sanpian decoction in treating migraine,primarily through its diverse components,tar-gets,and pathways.These findings indicate that Jiawei Sanpian decoction may exert its effects mainly through processes linked to the mitochondrial inflammatory pathway,thereby providing therapeutic benefits for migraine.展开更多
Background:Vestibular migraine(VM)is a common disorder characterized by recurrent dizziness or vertigo,often aggravated by cold exposure.This study aimed to identify differentially expressed circular RNAs(circRNAs)in ...Background:Vestibular migraine(VM)is a common disorder characterized by recurrent dizziness or vertigo,often aggravated by cold exposure.This study aimed to identify differentially expressed circular RNAs(circRNAs)in cold-region VM and explore the underlying molecular mechanisms.Methods:Peripheral blood samples from long-term residents of Heilongjiang Province profiled by circRNA microarray,and differentially expressed circRNAs were validated by quantitative reverse transcription polymerase chain reaction(qRT-PCR).A competing endogenous RNA(ceRNA)network and enriched pathways were inferred by bioinformatics.A VM-like mouse model was established using nitroglycerin(NTG)and kainic acid(KA)and confirmed by behavioral testing and western blot.The hsa_circ_0003201/miR-31-5p/triggering receptor expressed on myeloid cells 2(TREM2)axis and related pathways were examined in clinical samples and in the trigeminal nucleus caudalis(TNC)and vestibular nuclei(VN)of mice using qRT-PCR,enzyme-linked immunosorbent assay(ELISA),and western blot.CircRNA microarray profiling also compared expression patterns between VM and migraine patients.Results:Hsa_circ_0003201 was significantly upregulated in cold-region VM patients.Bioinformatic analyses revealed that hsa_circ_0003201 may regulate the miR-31-5p/TREM2 axis and be associated with phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)signaling,pyruvate metabolism,and transient receptor potential(TRP)pathways.Clinical validation confirmed increased hsa_circ_0003201 and TREM2 and decreased miR-31-5p.VM-like mice exhibited central sensitization and vestibular dysfunction,with increased TREM2,decreased miR-31-5p,and PI3K/AKT activation in the TNC and VN.Comparative circRNA analysis between VM and migraine patients indicated distinct expression patterns.Conclusion:Hsa_circ_0003201 shows potential as a diagnostic biomarker for cold-region VM,and the hsa_circ_0003201/miR-31-5p/TREM2 axis may contribute to pathogenesis through PI3K/AKT signaling,pyruvate metabolism,and TRP-related pathways.展开更多
Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of the...Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder （autosomal dominant in females and autosomal recessive in males）. This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly ＂typical＂ migraine as well （dominantly on chromosome 19p, lq, and 2q）, male：female ratio of prevalence （1：2-1：4）, the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.展开更多
Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses(plasticity)of dural afferent neurons are initiated cont...Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses(plasticity)of dural afferent neurons are initiated contributing to migraine chronification.However,pathophysiological processes and neural circuitry involved in aversion(unpleasantness)-producing migraine chronification are still evolving.An interdisciplinary team conducted this narrative review aimed at reviewing neuronal plasticity for developing migraine chronicity and its relevant neurocircuits and providing the most cutting-edge information on neuronal mechanisms involved in the processing of affective aspects of pain and the role of unpleasantness evoked by internal and/or external cues in facilitating the chronification process of migraine headache.Thus,information presented in this review promotes the understanding of the pathophysiology of chronic migraine and contribution of unpleasantness(aversion)to migraine chronification.We hope that it will bring clinicians’attention to how the maladaptive neuroplasticity of the emotion brain in the aversive environment produces a significant impact on the chronification of migraine headache,which will in turn lead to new therapeutic strategies for this type of pain.展开更多
AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment wi...AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month(for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up.RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change(not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.展开更多
Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60...Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60 migraine patients with the symptom of hyperactivity of liver yang who met the inclusive criteria were randomly divided into a opposing needling group （group A） and a routine acupuncture group （group B） by using SPSS 15.0 software according to the registration order with 30 patients in each group. Patients in group A were treated with opposing needling. Taich6ng （太冲 LR 3）, Zhongzhu （中渚 TE 3）, ZOlfnqi （足临泣 GB 41） and QiOxu （丘墟 GB 40） in the uninjured side were selected. After deqi, reducing method was used. Then Taixi （太溪 KI 3） in the uninjured side was selected. After deqi, rein forcing method was used. Needles were retained for 30 rain. Patients in group B were treated with routine acupuncture. Local Ash point, Sishncong （ 四神聪EX-HN1）, Yifeng （翳风 TE 17）, Fengchi （风池 GB 20）, Sizhukong （丝竹空 TE 23）, Shuaigu （率谷GB 8）, Hegu （合谷 LI 4） and LiEque （列缺 LU 7） were selected. After puncturing, reducing method was used routinely and needles were retained for 30 rain. After 2 weeks treatment, migraine specific quality of life questionnaire （MSQ）, visual analogue scale （VAS） and nitric oxide （NO） level in plasma of patients in two groups were observed. Results After treatment, the MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41±10.22 in group A and 60.95 ± 10.15 in group B; the score of MSQ dysfunction was 86.11 ±8.22 in group A and 75.45±8.34 in group B; score of MSQ emotion was 80.51±10.16 in group A and 75.01± 10.20 in group B. The improvements of group A were superior to those of group B, and the differences were all statistically significant （all P〈0.05）. After treatment, the VAS score was 0.93 ± 1.25 in group A and 2.17± 1.70 in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. After treatment, blood plasma NO level was （42.15 ± 16.15） μmol/L in group A and （62.76±15.17） μmol/L in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. Overall response rate was 86.7% （26/30） in group A and 53.3% （16/30） in group B, and the difference between two groups was statistically significant （P〈0.05）. Conclusion Opposing needling is an effective method for the treatment of migraine with the symptom of hyperactivity of liver yong. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.展开更多
Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified ca...Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified cases were randomly divided into treatment group （146 cases according to the design） and control group （140 cases）, which were respectively treated with electro-acupuncture and drugs （Compound Aminopyrine Phenacetin Tablets, Ergotamine Caffeine Tablets, Diazepam Tablets）, and observed the overall effect and scores of headache, accompanying symptoms, psychological and social adaptability scores, life quality scores, TCM symptoms scores and follow-up results before and after the treatment. Results In treatment group, the successful rate of attack control was 47.3 %, the improvement rate was 73.3 %, and the total effectiveness was 90.4 %, the clinical control rate and improvement were much superior to control group （the clinical control rate 35.7 %, improvement 61.4 %, the total effectiveness 85. 7 % ）, P〈0. 01, the difference in effect was mainly reflected in patients with moderate severity; the total scores of TCM syndrome after the treatment was obviously significant or very obviously significant（ P〈0. 05, P〈0. 01 ）, but the headache scores between two groups was not obviously significant（P〉0.05）, the difference in accompanying symptoms was significant（ P〈0. 01 ） ;the long term attack control action in two groups was not satisfactory, the recurrence was similar （P〉0. 05） ,the severity of headache in recurrence cases of treatment group was alleviated and superior to control group（ P 〈 0. 01 ）, the occurrence of headache after the treatment is much less than that before the treatment and the situation after 2 months was superior to control group （P〈0. 01 ）. Sleepiness and redness of face in some patients which were seen in control group weren＇t seen in treatment group. Conclusion Electro-acupuncture on Tàiyáng （太阳 EX-HN5） can control the attack of migraine due to hyperactivity of liver yang, and it has advantages in improving the accompanying symptoms and reducing the toxic and side effects of western drugs.展开更多
Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center ...Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.展开更多
The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures i...The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.展开更多
Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their uti...Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.展开更多
Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion （indel） polymorphism in promoter region ofα 2B -adrenergic receptor gene （AD...Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion （indel） polymorphism in promoter region ofα 2B -adrenergic receptor gene （ADRA2B）.Methods A case-control study was carried out in Chinese Han population,including 368 cases of migraine and 517 controls.Genomic DNA was extracted from blood samples,and DNA fragments containing the site of polymorphism were amplified by PCR.Data were adjusted for sex,age,migraine history and family history,and analyzed using a logistic regression model.Results There was no association between indel polymorphism and migraine,at either the allele or the genotype level.Conclusion These findings do not support a functional significance of ADRA2B indel polymorphism at position-4825 relative to the start codon in the far upstream region of the promoter in the present migraine subjects.展开更多
Background:Vestibular migraine(VM)is a common cause of dizziness that is underrecognized,underdiagnosed,and challenging to effectively treat.The prevalence,appropriate diagnostic workup,and therapies for VM in low-and...Background:Vestibular migraine(VM)is a common cause of dizziness that is underrecognized,underdiagnosed,and challenging to effectively treat.The prevalence,appropriate diagnostic workup,and therapies for VM in low-and lower-middle-income countries(LLMICs)remain understudied.The objective of this scoping review is to evaluate the current state of VM research in LLMICs.Methods:PubMed,Embase,and Web of Science databases were searched to execute a scoping review of VM.Keywords“vestibular diseases”and“vertigo”were used in combination with terms referring to LLMICs as defined by the World Bank.Title and abstract screening,full-text review,and data collection were conducted by two authors independently.Results:Twenty-six studies were included in the scoping review.Most studies were cross-sectional(57.7%)or case studies/series(23.1%)and were conducted in urban settings only(92.3%).Geographic distribution of studies was skewed,with 65.4%of articles originating from India.The prevalence of VM among clinic patients ranged from 0.3%to 33.3%.VM most frequently presented as headache,nausea and vomiting,and photophobia.Radiographic imaging,audiometry,and electronystagmography/videonystagmography were the three most commonly utilized diagnostic modalities in the dizziness workup.The most studied pharmacotherapies included calcium channel blockers,followed by beta-blockers and antiepileptics.Case studies and series discussed less common VM pharmacotherapies,such as ayurvedic medicine.Conclusions:There is a need for more VM research in LLMICs,including innovative diagnostic approaches and therapies that can improve VM care globally.Equitable partnerships between LLMIC and highincome country researchers must expand vestibular research capacity and productivity in LLMICs.展开更多
To discuss the hazard of migraine in acute phase and analgesic effect, acupoint selection features, method as well as mechanism of acupuncture; to put forward relevant questions, answer these questions, propose relati...To discuss the hazard of migraine in acute phase and analgesic effect, acupoint selection features, method as well as mechanism of acupuncture; to put forward relevant questions, answer these questions, propose relative specificity hypothesis on neural pathway of analgesic effect of acupoints in different nerve distribution areas（trigeminal nerve distribution area, occipital nerve distribution area, and spinal nerve distribution area） in treatment of migraine in acute phase, and analyze the deficiencies of hypothesis.展开更多
Most migraine patients suffer from cutaneous allodynia; however, the underlying mechanisms are unclear. Calcitonin gene-related peptide（CGRP） plays an important role in the pathophysiology of migraine, and it is the...Most migraine patients suffer from cutaneous allodynia; however, the underlying mechanisms are unclear. Calcitonin gene-related peptide（CGRP） plays an important role in the pathophysiology of migraine, and it is therefore, a potential therapeutic target for treating the pain. In the present study, a rat model of conscious migraine, induced by repeated electrical stimulation of the superior sagittal sinus, was established and treated with electroacupuncture at Fengchi（GB20）（depth of 2–3 mm, frequency of 2/15 Hz, intensity of 0.5–1.0 m A, 15 minutes/day, for 7 consecutive days）. Electroacupuncture at GB20 significantly alleviated the decrease in hind paw and facial withdrawal thresholds and significantly lessened the increase in the levels of CGRP in the trigeminal ganglion, trigeminal nucleus caudalis and ventroposterior medial thalamic nucleus in rats with migraine. No CGRP-positive cells were detected in the trigeminal nucleus caudalis or ventroposterior medial thalamic nucleus by immunofluorescence. Our findings suggest that electroacupuncture treatment ameliorates migraine pain and associated cutaneous allodynia by modulating the trigeminovascular system ascending pathway, at least in part by inhibiting CGRP expression in the trigeminal ganglion.展开更多
Scorpion has strong analgesic effects, but its analgesic mechanisms remain unclear. This study investigated the effects of scorpion powder on enkephalin expression in the midbrain of rats with nitroglycerin-induced mi...Scorpion has strong analgesic effects, but its analgesic mechanisms remain unclear. This study investigated the effects of scorpion powder on enkephalin expression in the midbrain of rats with nitroglycerin-induced migraine at mRNA and protein levels. Results confirmed that migraine rat abnormal behavior was significantly improved, and proenkephalin mRNA expression was significantly increased following treatment with scorpion. The number of methionine-enkephalin- positive cells in the migraine rats following treatment with scorpion was significantly increased, but no significant difference in the number of leucine-enkephalin-positive cells was detectable compared with migraine and normal rats. Taken together, these results show that scorpion exerts potentially beneficial effects by promoting enkephalin expression in nitroglycerin-induced migraine rats.展开更多
Migraine is a recurrent and commonly disabling primary headache disorder that affects over 17% of women and 5%-8% of men. Migraine susceptibility is multifactorial with genetic, hormonal and environmental factors all ...Migraine is a recurrent and commonly disabling primary headache disorder that affects over 17% of women and 5%-8% of men. Migraine susceptibility is multifactorial with genetic, hormonal and environmental factors all playing an important role. The physiopathology of migraine is complex and still not fully understood. Many different neuropeptides, neurotransmitters and brain pathways have been implicated. In connection with the myriad mechanisms and pathways implicated in migraine, a variety of multisystemic comorbidities(e.g., cardiovascular, psychiatric and other neurological conditions) have been found to be closely associated with migraine. Recent reports demonstrate an increased frequency of gastrointestinal(GI) disorders in patients with migraine compared with the general population. Helicobacter pylori infection, irritable bowel syndrome, gastroparesis, hepatobiliary disorders, celiac disease and alterations in the microbiota have been linked to the occurrence of migraine. Several mechanisms involving the gut-brain axis, such as a chronic inflammatory response with inflammatory and vasoactive mediators passing to the circulatory system, intestinal microbiota modulation of the enteric immunological milieu and dysfunction of the autonomic and enteric nervous system, have been postulated to explain these associations. However, the precise mechanisms and pathways related to the gut-brain axis in migraine need to be fully elucidated. In this review, we survey the available literature linking migraine with GI disorders. We discuss the possible physiopathological mechanisms, and clinical implications as well as several future areas of interest for research.展开更多
Peripheral and central sensitizations are phenomena that occur during migraine. The role of gabapentin, a migraine preventive drug, on central sensitization remains unclear. In this study, a rat model of migraine was ...Peripheral and central sensitizations are phenomena that occur during migraine. The role of gabapentin, a migraine preventive drug, on central sensitization remains unclear. In this study, a rat model of migraine was established by electrical stimulation of the trigeminal ganglion, and the animals were given intragastric gabapentin. Changes in amino acid content in the cerebrospinal fluid and protein kinase C membrane translocation in the spinal trigeminal nucleus were examined to clarify the mechanisms underlying the efficacy of gabapentin in the treatment of central sensiti- zation during migraine. Electrophysiology, liquid chromatography-mass spectrometry and western blot analysis results revealed that gabapentin reduces neuronal excitability in the spinal nucleus in the trigeminal nerve, decreases excitatory amino acid content and inhibits the activation of protein kinase C. This provides evidence that excitatory amino acids and protein kinase C are involved in the formation and maintenance of central sensitization during migraine. Gabapentin inhibits mi- graine by reducing excitatory amino acid content in the cerebrospinal fluid and inhibiting protein kinase C activation.展开更多
文摘Vestibular Migraine (VM) is a common neurological disorder characterized by recurrent episodes of vertigo and migraine symptoms. The pathogenesis of VM is complex and involves multiple genetic and environmental factors. Recent studies have suggested that the pathogenesis of vestibular migraine may be associated with variations in the CACNA1A gene, which is an important gene target for controlling calcium ion channels. Such variations may further affect the functions of the vestibular nervous system, thereby causing a series of vestibular nervous system-related symptoms. This article will summarize the genetic association studies of vestibular migraine, vestibular function studies, and research on how to establish relevant animal models to illustrate the possible association between CACNA1A variations and the pathogenesis of VM, providing new ideas for clarifying the pathogenesis of VM.
基金the Study on the Mechanism of Action of Dutong and Tiaoshen Acupuncture in Improving Upper Limb Motor Function After Ischemic Stroke based on Functional Near-infrared Spectroscopy Technology(Science and Technology Program of Panyu,2022-Z04-107)。
文摘OBJECTIVE:To take Baihui(GV20)and Fengchi(GB20)targeting inflammatory response to regulate migraine as an example to describe a new method for studying the mechanism of stimulating acupoints.METHODS:The target information of Baihui(GV20)and Fengchi(GB20)was retrieved,and after intersection with migraine,Kyoto Encyclopedia of Genes and Genomes(KEGG),Reactome,and Uni Prot Keywords were used for functional enrichment.After selecting the main pathway,rats were selected and nitroglycerin was used for modeling,and the behavioral scores,inflammatory factors,heme oxygenase 1(HMOX1),protein kinase B(AKT1),signal transducer and activator of transcription 3(STAT3),phosphorylated extracellular signal-regulated kinase 1/2(P-ERK1/ERK2)and other states of the rats in the acupuncture,twisting,and electroacupuncture groups were compared.RESULTS:A total of 135 Baihui(GV20)targets and 27 Fengchi(GB20)targets were collected.A total of 73 target information were obtained after the intersection of these targets in migraine.These 73 targets have three main pathways:hypoxia-inducible factor 1(HIF-1)signaling pathway,signaling by interleukins and inflammatory response.The main targets in the pathway were verified and found that interleukin-1 beta(IL-1β),interleukin-6(IL-6),tumor necrosis factor-alpha(TNF-α)and HMOX1,AKT1,STAT3,P-ERK1/ERK2 can be regulated by Baihui(GV20)and Fengchi(GB20).CONCLUSION:Baihui(GV20)and Fengchi(GB20)can regulate migraine by regulating inflammatory factors and HMOX1,AKT1,STAT3,P-ERK1/ERK2 and other changes in HIF-1 signaling pathway,Signaling by Interleukins and Inflammatory response pathways.Based on systems biology and network pharmacology,and with the model of"acupoint-target-disease",explore the research methods of systematic acupuncture and moxibustion.We believe this is a usable research direction for exploring the mechanism of acupuncture stimulation.
文摘BACKGROUND Migraine has been proposed as a potential contributing factor to ischemic complications involving the retina and optic nerve.Ophthalmic disorders connected with migraine encompass occlusions of the branch and central retinal arteries and veins,alongside anterior and posterior ischemic optic neuropathy.With the advent of optical coherence tomography angiography(OCTA),it is easy to identify these macular subclinical microvascular and structural changes.AIM To evaluate macular and peripapillary structural and microvasculature changes in patients with migraine with aura(MA),migraine without aura(MW),and healthy control(HC)participants using OCTA.METHODS In this observational cross-sectional study,we studied a total of 100 eyes:(1)32 eyes of 16 patients with MA;(2)36 eyes of 18 patients with MW,recruited based on the International Classification of Headache Disorders;and(3)32 eyes of 16 age and sex-matched healthy participants.Foveal flux,foveal avascular zone(FAZ),peripapillary flux obtained from OCTA,and foveal and peripapillary ganglion cell layer(GCL)thickness calculated via optical coherence tomography were compared among the groups.RESULTS The mean FAZ area measured in patients with MA and MW was significantly larger than that in the control participants(P=0.002).However,there was no significant difference between the FAZ of the MA and MW groups.Macular perfusion in the superficial capillary plexus in patients with MA was significantly lower compared to MW(P=0.0018)and HCs(P=0.002).There was also significant thinning of the GCL in patients with MA and MW(P=0.001)compared to HCs.However,there was no significant difference in temporal GCL thickness between the MA and MW groups.CONCLUSION Significant changes have been found in structural and microvascular parameters in patients with migraines compared with HCs.OCTA can serve as a valuable non-invasive imaging technique for identifying microcirculatory disturbances,aiding in better understanding the pathogenesis of different types of migraine and establishing their link with other ischemic retinal and systemic pathologies.
基金funded by the National Natural Science Foundation of China(81873256)Natural Science Foundation of Xiamen(3502Z202371045).
文摘Objective:To analyze and validate how Jiawei Sanpian decoction treats migraines by integrating network pharmacology,molecular docking technology,and experimental studies.Method:Using network pharmacology,the chemical components and core target proteins of the Jiawei Sanpian decoction were analyzed.Key chemical components were docked with core targets using mo-lecular docking,and the results were visualized.Nitroglycerin was injected into the dorsal cervical region to establish a rat migraine model.Finally,experiments were conducted to verify the effects of Jiawei Sanpian on related pathways and targets.Results:Four notable chemical components were identified,namely,b-sitosterol,quercetin,mairin,and kaempferol.Five representative targets were identified,namely,insulin-like growth factor 1(IGF-1),matrix metallopeptidase 2(MMP-2),interleukin-2(IL-2),superoxide dismutase 2(SOD2),and inducible nitric oxide synthase(NOS2).Molecular docking results revealed that the minimum binding energies between the four chemical components and the five targets were below5 kcal/mol,indicating favor-able binding activity.Enzyme linked immunosorbent assay(ELISA)results demonstrated the efficacy of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).Real-time quantitative polymerase chain reaction(RT-qPCR)results demonstrated the effectiveness of high-dose Jiawei Sanpian decoction in treating migraine by targeting IGF-1,IL-2,MMP-2,and SOD2(P<0.001).After using erastin,the therapeutic effect of Jiawei Sanpian decoction declined.Conclusion:This study provides initial insights into the complex and multilayered therapeutic mecha-nisms of Jiawei Sanpian decoction in treating migraine,primarily through its diverse components,tar-gets,and pathways.These findings indicate that Jiawei Sanpian decoction may exert its effects mainly through processes linked to the mitochondrial inflammatory pathway,thereby providing therapeutic benefits for migraine.
基金supported by General Program of National Natural Science Foundation of China(No.82071549,82371483)Key Research&Development Program of Heilongjiang(No.2023ZX06C02)Youth Foundation of the first Affiliated Hospital of Harbin Medical University(No.2024YQ22).
文摘Background:Vestibular migraine(VM)is a common disorder characterized by recurrent dizziness or vertigo,often aggravated by cold exposure.This study aimed to identify differentially expressed circular RNAs(circRNAs)in cold-region VM and explore the underlying molecular mechanisms.Methods:Peripheral blood samples from long-term residents of Heilongjiang Province profiled by circRNA microarray,and differentially expressed circRNAs were validated by quantitative reverse transcription polymerase chain reaction(qRT-PCR).A competing endogenous RNA(ceRNA)network and enriched pathways were inferred by bioinformatics.A VM-like mouse model was established using nitroglycerin(NTG)and kainic acid(KA)and confirmed by behavioral testing and western blot.The hsa_circ_0003201/miR-31-5p/triggering receptor expressed on myeloid cells 2(TREM2)axis and related pathways were examined in clinical samples and in the trigeminal nucleus caudalis(TNC)and vestibular nuclei(VN)of mice using qRT-PCR,enzyme-linked immunosorbent assay(ELISA),and western blot.CircRNA microarray profiling also compared expression patterns between VM and migraine patients.Results:Hsa_circ_0003201 was significantly upregulated in cold-region VM patients.Bioinformatic analyses revealed that hsa_circ_0003201 may regulate the miR-31-5p/TREM2 axis and be associated with phosphoinositide 3-kinase(PI3K)/protein kinase B(AKT)signaling,pyruvate metabolism,and transient receptor potential(TRP)pathways.Clinical validation confirmed increased hsa_circ_0003201 and TREM2 and decreased miR-31-5p.VM-like mice exhibited central sensitization and vestibular dysfunction,with increased TREM2,decreased miR-31-5p,and PI3K/AKT activation in the TNC and VN.Comparative circRNA analysis between VM and migraine patients indicated distinct expression patterns.Conclusion:Hsa_circ_0003201 shows potential as a diagnostic biomarker for cold-region VM,and the hsa_circ_0003201/miR-31-5p/TREM2 axis may contribute to pathogenesis through PI3K/AKT signaling,pyruvate metabolism,and TRP-related pathways.
文摘Migraine is a complex and heterogeneous disorder. Although several genetic models has been proposed including autosomal-dominant/autosomal recessive, sex-linked, sex-limited, mitochondrial, and multi-gene, none of these models can well-explain the transmission of the disease. We hypothesied that migraine is a sex-conditioned inherited disorder （autosomal dominant in females and autosomal recessive in males）. This hypothesis is supported by the evidence such as the locations of genes associated with familial hemiplegic migraine, possibly ＂typical＂ migraine as well （dominantly on chromosome 19p, lq, and 2q）, male：female ratio of prevalence （1：2-1：4）, the mostly youth-onset, the provocation by the contraceptives, the induction by menstruation, and the self-limitation after menopause. Female sex-hormones appear to be the key contributor to a higher prevalence of migraine in female. Socio-environmental factors may also play an important role.
基金Supported by The Science and Technology Department of Yibin,No.2016YZY004.
文摘Clinical studies have suggested that internal and/or external aversive cues may produce a negative affective-motivational component whereby maladaptive responses(plasticity)of dural afferent neurons are initiated contributing to migraine chronification.However,pathophysiological processes and neural circuitry involved in aversion(unpleasantness)-producing migraine chronification are still evolving.An interdisciplinary team conducted this narrative review aimed at reviewing neuronal plasticity for developing migraine chronicity and its relevant neurocircuits and providing the most cutting-edge information on neuronal mechanisms involved in the processing of affective aspects of pain and the role of unpleasantness evoked by internal and/or external cues in facilitating the chronification process of migraine headache.Thus,information presented in this review promotes the understanding of the pathophysiology of chronic migraine and contribution of unpleasantness(aversion)to migraine chronification.We hope that it will bring clinicians’attention to how the maladaptive neuroplasticity of the emotion brain in the aversive environment produces a significant impact on the chronification of migraine headache,which will in turn lead to new therapeutic strategies for this type of pain.
文摘AIM To report the effects of greater occipital nerve(GON) blocks on refractory chronic migraine headache.METHODS Nine patients who were receiving the conventionally accepted preventive therapies underwent treatment with repeated GON block to control chronic migraine resistant to other treatments. GON blocking with lidocaine and normal saline mixture was administered by the same physician at hospital once a month(for three times in total). Patients were assessed before the injection and every month thereafter for pain frequency and severity, number of times analgesics were used and any appearant side effects during a 6 mo follow-up.RESULTS Eight of nine patients reported a marked decrease in frequency and severity of migraine attacks in comparison to their baseline symptoms; one reported no significant change(not more than 50%) from baseline and did not accept the second injection. GON block resulted in considerable reduction in pain frequency and severity and need to use analgesics up to three months after the injection in the present cases. The patients did not report any adverse effects. CONCLUSION Hereby we noticed a remarkable success with refractory chronic migraine patients. We believe that this intervention can result in rapid relief of pain with the effects lasting for perhaps several weeks or even months. Further controlled clinical trials are warranted to evaluate the effect of GON block in the treatment of refractory migraine cases.
基金Supported by Traditional Chinese Medicine Bureau of Guangdong Province,project number:20141240
文摘Objective To observe the clinical efficacy of opposing needling for the treatment of migraine with the symptom of hyperactivity of liver yang type and its effect on NO level in plasma of patients. Methods Atotal of 60 migraine patients with the symptom of hyperactivity of liver yang who met the inclusive criteria were randomly divided into a opposing needling group （group A） and a routine acupuncture group （group B） by using SPSS 15.0 software according to the registration order with 30 patients in each group. Patients in group A were treated with opposing needling. Taich6ng （太冲 LR 3）, Zhongzhu （中渚 TE 3）, ZOlfnqi （足临泣 GB 41） and QiOxu （丘墟 GB 40） in the uninjured side were selected. After deqi, reducing method was used. Then Taixi （太溪 KI 3） in the uninjured side was selected. After deqi, rein forcing method was used. Needles were retained for 30 rain. Patients in group B were treated with routine acupuncture. Local Ash point, Sishncong （ 四神聪EX-HN1）, Yifeng （翳风 TE 17）, Fengchi （风池 GB 20）, Sizhukong （丝竹空 TE 23）, Shuaigu （率谷GB 8）, Hegu （合谷 LI 4） and LiEque （列缺 LU 7） were selected. After puncturing, reducing method was used routinely and needles were retained for 30 rain. After 2 weeks treatment, migraine specific quality of life questionnaire （MSQ）, visual analogue scale （VAS） and nitric oxide （NO） level in plasma of patients in two groups were observed. Results After treatment, the MSQ, VAS and NO of two groups were significantly improved compared with those before treatment. After treatment, score of MSQ functional limitation was 73.41±10.22 in group A and 60.95 ± 10.15 in group B; the score of MSQ dysfunction was 86.11 ±8.22 in group A and 75.45±8.34 in group B; score of MSQ emotion was 80.51±10.16 in group A and 75.01± 10.20 in group B. The improvements of group A were superior to those of group B, and the differences were all statistically significant （all P〈0.05）. After treatment, the VAS score was 0.93 ± 1.25 in group A and 2.17± 1.70 in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. After treatment, blood plasma NO level was （42.15 ± 16.15） μmol/L in group A and （62.76±15.17） μmol/L in group B. The improvement of group A was superior to that of group B, and the difference was statistically significant （P〈0.05）. Overall response rate was 86.7% （26/30） in group A and 53.3% （16/30） in group B, and the difference between two groups was statistically significant （P〈0.05）. Conclusion Opposing needling is an effective method for the treatment of migraine with the symptom of hyperactivity of liver yong. Its mechanism is to regulate the generation of NO in migraine patients, and improve the relaxation and contraction of cerebral vascular smooth muscle, so as to adjust the cerebral circulation.
文摘Objective To discuss the difference of electro-acupuncture and drug in controlling the attack of migraine due to hyperactivity of liver yang. Methods Three-centered random control method was used, and 300 qualified cases were randomly divided into treatment group （146 cases according to the design） and control group （140 cases）, which were respectively treated with electro-acupuncture and drugs （Compound Aminopyrine Phenacetin Tablets, Ergotamine Caffeine Tablets, Diazepam Tablets）, and observed the overall effect and scores of headache, accompanying symptoms, psychological and social adaptability scores, life quality scores, TCM symptoms scores and follow-up results before and after the treatment. Results In treatment group, the successful rate of attack control was 47.3 %, the improvement rate was 73.3 %, and the total effectiveness was 90.4 %, the clinical control rate and improvement were much superior to control group （the clinical control rate 35.7 %, improvement 61.4 %, the total effectiveness 85. 7 % ）, P〈0. 01, the difference in effect was mainly reflected in patients with moderate severity; the total scores of TCM syndrome after the treatment was obviously significant or very obviously significant（ P〈0. 05, P〈0. 01 ）, but the headache scores between two groups was not obviously significant（P〉0.05）, the difference in accompanying symptoms was significant（ P〈0. 01 ） ;the long term attack control action in two groups was not satisfactory, the recurrence was similar （P〉0. 05） ,the severity of headache in recurrence cases of treatment group was alleviated and superior to control group（ P 〈 0. 01 ）, the occurrence of headache after the treatment is much less than that before the treatment and the situation after 2 months was superior to control group （P〈0. 01 ）. Sleepiness and redness of face in some patients which were seen in control group weren＇t seen in treatment group. Conclusion Electro-acupuncture on Tàiyáng （太阳 EX-HN5） can control the attack of migraine due to hyperactivity of liver yang, and it has advantages in improving the accompanying symptoms and reducing the toxic and side effects of western drugs.
文摘Objective To observe the therapeutic effect of electro acupuncture at QIǖXǖ（丘墟GB40） for treating migraine and provide clinical study for Acupoints Dictionary of People＇s Republic of China. Methods Multi-center （3 First-Class hospitals） study was adopted, and the involved 3 hospitals did clinical observation according to the requirements of the project. The methods are as follows. All cases were randomized into treatment group and control group according to their sequence. QIǖXǖ（丘墟GB40） was selected in treatment group, while Tiānshū （天枢 ST25） was selected in control group. Both groups were performed electro acupuncture, and syndromes indexes of migraine and 5-HT were observed before and after treatment. All data were analyzed by statistic software SPSS11.5. Results There was significant difference of VAS margin between two groups in each center and the combined center （u= -3. 362, P=0. 001 ）. There was significant difference of therapeutic effect of 4-week treatment between two groups in each clinical center and the combined center. The therapeutic effect of 3-month treatment between two groups in No. 1 and No. 3 hospitals, showed significant difference, the treatment group was better; while that of No. 2 hospital had no obvious difference. The therapeutic effect of 6-month treatment between two groups in each center and the combined center had significant difference, the treatment group was better. Conclusion The therapy of electro acupuncture at QIǖXǖ（丘墟GB40） is effective for migraine.
基金supported by the Natural Science Foundation of Hainan Province of China,No.818MS153(to ZYC)the National Natural Science Foundation of China,No.81771200(to ZD)+2 种基金the National Key Research and Development Projects of Beijing Science and Technology Plan of China,No.Z161100002616013(to SYY)the Special Financial Grant from the China Postdoctoral Science Foundation,No.2014T70960(to ZYC)the Nursery Technology Innovation Fund of Chinese PLA General Hospital,No.12KMM39(to XYC)
文摘The pathophysiology of migraine is complex.Neuroimaging studies reveal functional and structural changes in the brains of migraine patients.We sought to explore regional volume differences in intracranial structures in patients with episodic and chronic migraine.Sixteen episodic migraine patients,16 chronic migraine patients,and 24 normal controls were recruited and underwent 3.0 T MRI scanning.The volumes of 142 brain regions were calculated by an automatic volumetric algorithm and compared with clinical variables.Results demonstrated that the volumes of specific regions in the frontal and occipital lobes,and the right putamen,were increased and the volume of the fourth ventricle was decreased in the episodic migraine patients compared with controls.The volumes of the left basal forebrain,optic chiasm,and,the fourth ventricle were decreased in the chronic migraine patients,while the occipital cortex and the right putamen were larger.Compared to episodic migraine patiants,chronic migraine patients displayed larger left thalamus and smaller frontal regions.Correlation analysis showed that headache frequency was negatively correlated with the volume of the right frontal pole,right lateral orbital gyrus,and medial frontal lobes and positively correlated with the volume of the left thalamus.The sleep disturbance score was negatively correlated with the volume of the left basal forebrain.This suggests that migraine patients have structural changes in regions associated with pain processing and modulation,affective and cognitive processing,and visual perception.The remodeling of selective intracranial structures may be involved in migraine attacks.This study was approved by the Ethics Committee of Chinese PLA General Hospital(approval No.S2018-027-02)on May 31,2018.
文摘Objective:Saccades accompanied by normal gain in video head impulse tests(vHIT)are often observed in patients with vestibular migraine(VM).However,they are not considered as an independent indicator,reducing their utility in diagnosing VM.To better understand clinical features of VM,it is necessary to understand raw saccades data.Methods:Fourteen patients with confirmed VM,45 patients with probable VM(p-VM)and 14 agematched healthy volunteers were included in this study.Clinical findings related to spontaneous nystagmus(SN),positional nystagmus(PN),head-shaking nystagmus(HSN),caloric test and vHIT were recorded.Raw saccades data were exported and numbered by their sequences,and their features analyzed.Results:VM patients showed no SN,PN or HSN,and less than half of them showed unilateral weakness(UW)on caloric test.The first saccades from lateral semicircular canal stimulation were the most predominant for both left and right sides.Neither velocity nor time parameters were significantly different when compared between the two sides.Most VM patients(86%)exhibited small saccades,around 35%of the head peak velocity,with a latency of 200e400 ms.Characteristics of saccades were similar in patients with p-VM.Only four normal subjects showed saccades,all unilateral and seemingly random.Conclusions:Small saccades involving bilateral semicircular canals with a scattered distribution pattern are common in patients with VM and p-VM.
基金supported by the National Natural Science Foundation of China(No.30800621)China Postdoctoral Science Foundation(No.20080431121,200902530)
文摘Objective The present study aimed to estimate the association between susceptibility to migraine and the 12nucleotide insertion/deletion （indel） polymorphism in promoter region ofα 2B -adrenergic receptor gene （ADRA2B）.Methods A case-control study was carried out in Chinese Han population,including 368 cases of migraine and 517 controls.Genomic DNA was extracted from blood samples,and DNA fragments containing the site of polymorphism were amplified by PCR.Data were adjusted for sex,age,migraine history and family history,and analyzed using a logistic regression model.Results There was no association between indel polymorphism and migraine,at either the allele or the genotype level.Conclusion These findings do not support a functional significance of ADRA2B indel polymorphism at position-4825 relative to the start codon in the far upstream region of the promoter in the present migraine subjects.
文摘Background:Vestibular migraine(VM)is a common cause of dizziness that is underrecognized,underdiagnosed,and challenging to effectively treat.The prevalence,appropriate diagnostic workup,and therapies for VM in low-and lower-middle-income countries(LLMICs)remain understudied.The objective of this scoping review is to evaluate the current state of VM research in LLMICs.Methods:PubMed,Embase,and Web of Science databases were searched to execute a scoping review of VM.Keywords“vestibular diseases”and“vertigo”were used in combination with terms referring to LLMICs as defined by the World Bank.Title and abstract screening,full-text review,and data collection were conducted by two authors independently.Results:Twenty-six studies were included in the scoping review.Most studies were cross-sectional(57.7%)or case studies/series(23.1%)and were conducted in urban settings only(92.3%).Geographic distribution of studies was skewed,with 65.4%of articles originating from India.The prevalence of VM among clinic patients ranged from 0.3%to 33.3%.VM most frequently presented as headache,nausea and vomiting,and photophobia.Radiographic imaging,audiometry,and electronystagmography/videonystagmography were the three most commonly utilized diagnostic modalities in the dizziness workup.The most studied pharmacotherapies included calcium channel blockers,followed by beta-blockers and antiepileptics.Case studies and series discussed less common VM pharmacotherapies,such as ayurvedic medicine.Conclusions:There is a need for more VM research in LLMICs,including innovative diagnostic approaches and therapies that can improve VM care globally.Equitable partnerships between LLMIC and highincome country researchers must expand vestibular research capacity and productivity in LLMICs.
文摘To discuss the hazard of migraine in acute phase and analgesic effect, acupoint selection features, method as well as mechanism of acupuncture; to put forward relevant questions, answer these questions, propose relative specificity hypothesis on neural pathway of analgesic effect of acupoints in different nerve distribution areas（trigeminal nerve distribution area, occipital nerve distribution area, and spinal nerve distribution area） in treatment of migraine in acute phase, and analyze the deficiencies of hypothesis.
基金supported by the National Natural Science Foundation of China,No.81603683a grant from the National Basic Research Program of China,No.2014CB543203a grant from the Beijing Municipal Science&Technology Commission of China,No.Z171100001017033
文摘Most migraine patients suffer from cutaneous allodynia; however, the underlying mechanisms are unclear. Calcitonin gene-related peptide（CGRP） plays an important role in the pathophysiology of migraine, and it is therefore, a potential therapeutic target for treating the pain. In the present study, a rat model of conscious migraine, induced by repeated electrical stimulation of the superior sagittal sinus, was established and treated with electroacupuncture at Fengchi（GB20）（depth of 2–3 mm, frequency of 2/15 Hz, intensity of 0.5–1.0 m A, 15 minutes/day, for 7 consecutive days）. Electroacupuncture at GB20 significantly alleviated the decrease in hind paw and facial withdrawal thresholds and significantly lessened the increase in the levels of CGRP in the trigeminal ganglion, trigeminal nucleus caudalis and ventroposterior medial thalamic nucleus in rats with migraine. No CGRP-positive cells were detected in the trigeminal nucleus caudalis or ventroposterior medial thalamic nucleus by immunofluorescence. Our findings suggest that electroacupuncture treatment ameliorates migraine pain and associated cutaneous allodynia by modulating the trigeminovascular system ascending pathway, at least in part by inhibiting CGRP expression in the trigeminal ganglion.
文摘Scorpion has strong analgesic effects, but its analgesic mechanisms remain unclear. This study investigated the effects of scorpion powder on enkephalin expression in the midbrain of rats with nitroglycerin-induced migraine at mRNA and protein levels. Results confirmed that migraine rat abnormal behavior was significantly improved, and proenkephalin mRNA expression was significantly increased following treatment with scorpion. The number of methionine-enkephalin- positive cells in the migraine rats following treatment with scorpion was significantly increased, but no significant difference in the number of leucine-enkephalin-positive cells was detectable compared with migraine and normal rats. Taken together, these results show that scorpion exerts potentially beneficial effects by promoting enkephalin expression in nitroglycerin-induced migraine rats.
文摘Migraine is a recurrent and commonly disabling primary headache disorder that affects over 17% of women and 5%-8% of men. Migraine susceptibility is multifactorial with genetic, hormonal and environmental factors all playing an important role. The physiopathology of migraine is complex and still not fully understood. Many different neuropeptides, neurotransmitters and brain pathways have been implicated. In connection with the myriad mechanisms and pathways implicated in migraine, a variety of multisystemic comorbidities(e.g., cardiovascular, psychiatric and other neurological conditions) have been found to be closely associated with migraine. Recent reports demonstrate an increased frequency of gastrointestinal(GI) disorders in patients with migraine compared with the general population. Helicobacter pylori infection, irritable bowel syndrome, gastroparesis, hepatobiliary disorders, celiac disease and alterations in the microbiota have been linked to the occurrence of migraine. Several mechanisms involving the gut-brain axis, such as a chronic inflammatory response with inflammatory and vasoactive mediators passing to the circulatory system, intestinal microbiota modulation of the enteric immunological milieu and dysfunction of the autonomic and enteric nervous system, have been postulated to explain these associations. However, the precise mechanisms and pathways related to the gut-brain axis in migraine need to be fully elucidated. In this review, we survey the available literature linking migraine with GI disorders. We discuss the possible physiopathological mechanisms, and clinical implications as well as several future areas of interest for research.
基金financially sponsored by the Natural Science Foundation of Shandong Province,No.ZR2012HQ014a grant from the Science and Technology Plan Program of Universities in Shandong Province,No.J10LF14
文摘Peripheral and central sensitizations are phenomena that occur during migraine. The role of gabapentin, a migraine preventive drug, on central sensitization remains unclear. In this study, a rat model of migraine was established by electrical stimulation of the trigeminal ganglion, and the animals were given intragastric gabapentin. Changes in amino acid content in the cerebrospinal fluid and protein kinase C membrane translocation in the spinal trigeminal nucleus were examined to clarify the mechanisms underlying the efficacy of gabapentin in the treatment of central sensiti- zation during migraine. Electrophysiology, liquid chromatography-mass spectrometry and western blot analysis results revealed that gabapentin reduces neuronal excitability in the spinal nucleus in the trigeminal nerve, decreases excitatory amino acid content and inhibits the activation of protein kinase C. This provides evidence that excitatory amino acids and protein kinase C are involved in the formation and maintenance of central sensitization during migraine. Gabapentin inhibits mi- graine by reducing excitatory amino acid content in the cerebrospinal fluid and inhibiting protein kinase C activation.
