title: Migraine and psychiatric disorders co-morbidity explained by sinus hypoxic nitric oxide theory - a new hypothesis on the Sino rhinogenic theory.
abstract: Migraine is an extremely common incapacitating neurovascular disorder and has co morbidity with many psychiatric illnesses which are caused by neurotransmitter imbalance, neurodegenerative changes and genetic predisposition. The sinus hypoxic nitric oxide theory presents, diffused paranasal sinus nitric oxide in the nasal mucosa has been hypothesized as the primary molecule that initiates migraine. Existence of such pathophysiology in human beings is termed as sinus hypoxic nitric oxide phenomena. According to this new hypothesis the sinorhinogenic trigeminal nerve impulse distribution of the central nervous system, is suggested to cause central neurotransmitter track dysfunction and cortical spreading depression with neurodegeneration that may relate to co morbidity. Moreover, avoidance of the excess sinorhinogenic central neuronal influence to the brain in early child hood and early intervention in the case of genetic susceptible history with psychiatric illnesses would help to prevent the progression or aggravation of psychiatric illnesses according to this hypothesis. This article explains a new pathophysiological initiation between central effects of sinorhinogenic nitric oxide phenomena and psychiatric disorders. It also provides an etiologically important neuro vascular impulse generating pathway to cause or aggravate psychiatric disorders. Therefore patients who are clinically suspected of having migraine headache and psychiatric disorders should receive a comprehensive sinorhinological examination and evaluation based on the sinus hypoxic nitric oxide phenomena.
authors.affiliation: Psychiatry Unit, Teaching Hospital Gampola, 11/1 "ISURU" Gannoruwa Road, Peradeniya, Kandy, Sri Lanka. Electronic address: rathnasirib@yahoo.com.
authors.forename: Senanayake Mudiyanselage
authors.initials: SM
authors.lastname: Rathnasiri Bandara
mesh_terms: D006801:Humans; D000860:Hypoxia / Q000503:physiopathology*; D001523:Mental Disorders / Q000150:complications*; D008881:Migraine Disorders / Q000150:complications*; D009569:Nitric Oxide / Q000502:physiology*; D010256:Paranasal Sinuses / Q000503:physiopathology*
chemical_list: D009569:Nitric Oxide