Brain stem activation in spontaneous human migraine attacks.
Evidence from animal experiments shows that the brain stem is involved in the pathophysiology of migraine. To investigate human migraine, we used positron emission tomography to examine the changes in regional cerebral blood flow as an index of neuronal activity in the human brain during spontaneous migraine attacks. During the attacks, increased blood flow was found in the cerebral hemispheres in cingulate, auditory and visual association cortices and in the brain stem. However, only the brain stem activation persisted after the injection of sumatriptan had induced complete relief from headache and phono- and photophobia. These findings support the idea that the pathogenesis of migraine is related to an imbalance in activity between brain stem nuclei regulating antinociception and vascular control.
Weiller
C
C
Department of Neurology, University of Essen, Germany.
May
A
A
Limmroth
V
V
Jüptner
M
M
Kaube
H
H
Schayck
R V
RV
Coenen
H H
HH
Diener
H C
HC
D000328:Adult; D001303:Auditory Cortex / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D001933:Brain Stem / Q000098:blood supply / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000187:drug effects; D005260:Female; D006179:Gyrus Cinguli / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000000981:diagnostic imaging / Q000188:drug therapy / Q000503:physiopathology*; D044346:Receptor, Serotonin, 5-HT1D; D011985:Receptors, Serotonin / Q000187:drug effects; D017366:Serotonin Receptor Agonists / Q000494:pharmacology / Q000627:therapeutic use; D018170:Sumatriptan / Q000494:pharmacology / Q000627:therapeutic use; D014055:Tomography, Emission-Computed; D014662:Vasoconstrictor Agents / Q000494:pharmacology / Q000627:therapeutic use; D014793:Visual Cortex / Q000098:blood supply / Q000187:drug effects / Q000503:physiopathology
D044346:Receptor, Serotonin, 5-HT1D; D011985:Receptors, Serotonin; D017366:Serotonin Receptor Agonists; D014662:Vasoconstrictor Agents; D018170:Sumatriptan