title: Migraine, vertigo and migrainous vertigo: Links between vestibular and pain mechanisms.
abstract: This review develops the hypothesis that co-morbid balance disorders and migraine can be understood as additive effects of processing afferent vestibular and pain information in pre-parabrachial and pre-thalamic pathways, that have consequences on cortical mechanisms influencing perception, interoception and affect. There are remarkable parallel neurochemical phenotypes for inner ear and trigeminal ganglion cells and these afferent channels appear to converge in shared central pathways for vestibular and nociceptive information processing. These pathways share expression of receptors targeted by anti-migraine drugs. New evidence is also presented regarding the distribution of serotonin receptors in the planum semilunatum of the primate cristae ampullaris, which may indicate involvement of inner ear ionic homeostatic mechanisms in audiovestibular symptoms that can accompany migraine.
authors.affiliation: Department of Otolaryngology, University of Pittsburgh, Pittsburgh, PA, USA. cbalaban@pitt.edu
authors.forename: Carey D
authors.initials: CD
authors.lastname: Balaban
mesh_terms: D000344:Afferent Pathways / Q000503:physiopathology; D015897:Comorbidity; D006706:Homeostasis; D006801:Humans; D012001:Hyperacusis / Q000209:etiology / Q000503:physiopathology; D008881:Migraine Disorders / Q000150:complications / Q000453:epidemiology / Q000503:physiopathology*; D008959:Models, Neurological; D009041:Motion Sickness / Q000503:physiopathology; D009619:Nociceptors / Q000502:physiology; D010146:Pain / Q000503:physiopathology*; D010487:Periaqueductal Gray / Q000503:physiopathology; D020795:Photophobia / Q000209:etiology / Q000503:physiopathology; D011985:Receptors, Serotonin / Q000502:physiology; D059326:Serotonergic Neurons / Q000502:physiology; D017366:Serotonin Receptor Agonists / Q000627:therapeutic use; D013136:Spiral Ganglion / Q000503:physiopathology; D013788:Thalamus / Q000503:physiopathology; D012668:Trigeminal Ganglion / Q000503:physiopathology; D014717:Vertigo / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology*; D014725:Vestibular Nerve / Q000503:physiopathology; D014722:Vestibule, Labyrinth / Q000503:physiopathology*
chemical_list: D011985:Receptors, Serotonin; D017366:Serotonin Receptor Agonists