- 편두통의 병태생리학
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Won Suk Lee
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Korean J Headache. 2002;3(1):1-6. Published online June 30, 2002
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- 삼차신경 - 혈관계과 세로토닌 수용체
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Won Suk Lee
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Korean J Headache. 2000;1(1):18-24. Published online June 30, 2000
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Abstract
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- The trigeminal nerve transmits migraine headache from blood vessels of the dura mater. Triggers of this pain are not well understood, but probably are multiple and largely chemical, and develop within the brain parenchyma, the blood vessel wall, and the blood itself. These unknown triggers stimulate the trigeminovascular nerve fibers, causing pain, and releasing vasoactive neuropeptides(e.g. substance P, neurokinin A, and calcitonin generelated peptide) from perivascular nerve fibers. Released neuropeptides activate endothelial cells, mast cells, and platelets, and mediate the neurogenic inflammation including the endothelium-dependent vasodilation and the enhanced permeability. Electric stimulation of trigeminal ganglion or intravenous administration of capsaicin induces neurogenic plasma protein extravasation within the dura mater. This extravasation is markedly attenuated or absent in animals whose perivascular afferent fibers have been destroyed by capsaicin treatment during the neonatal period. Antimigraine drugs such as sumatriptan and dihydroergotamine significantly reduce the neurogenic plasma protein extravasation via prejunctional mechanisms involving 5-HT1D receptors or analogous 5-HT1B receptors in rats. On the basis of these results, it is concluded that the neurogenic inflammation in dura mater caused from activation of trigeminovascular system is important in the pathophysiology of migraine and related headaches, and to the action of antimigraine drugs. Korean Journal of Headache 1(1):18-24, 2000
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