Despite it is commonly accepted that migraine is a disorder of the nervous system with a prominent genetic basis, it is comorbid with a plethora of medical conditions. Several studies have found bidirectional comorbidity between migraine and different disorders including neurological, psychiatric, cardio- and cerebrovascular, gastrointestinal, metaboloendocrine, and immunological conditions. Each of these has its own genetic load and shares some common characteristics with migraine. The bi-directional mechanisms that are likely to underlie this extensive comorbidity between migraine and other diseases are manifold. Comorbid pathologies can induce and promote thalamocortical network dysexcitability, multi-organ transient or persistent pro-inflammatory state, and disproportionate energetic needs in a variable combination, which in turn may be causative mechanisms of the activation of an ample defensive system with includes the trigeminovascular system in conjunction with the neuroendocrine hypothalamic system. This strategy is designed to maintain brain homeostasis by regulating homeostatic needs, such as normal subcortico-cortical excitability, energy balance, osmoregulation, and emotional response. In this light, the treatment of migraine should always involve a multidisciplinary approach, aimed at identifying and, if necessary, eliminating possible risk and comorbidity factors.

中文翻译：

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偏头痛合并症的病理生理基础

尽管人们普遍认为偏头痛是具有突出遗传基础的神经系统疾病，但它与多种医学疾病并存。几项研究发现偏头痛与不同疾病（包括神经系统疾病，精神病学，心脑血管疾病，胃肠道疾病，代谢性内分泌疾病和免疫学疾病）之间存在双向合并症。这些中的每一个都有其自己的遗传负荷，并且与偏头痛具有一些共同的特征。可能是偏头痛和其他疾病之间广泛合并症的基础的双向机制是多种多样的。共病可通过多种组合诱导和促进丘脑皮质网络异常兴奋性，多器官短暂或持续性促炎状态以及过多的能量需求，继而可能是激活充分防御系统的原因机制，其中包括三叉神经血管系统和神经内分泌下丘脑系统。此策略旨在通过调节体内稳态需求（例如正常的皮层下皮质兴奋性，能量平衡，渗透压和情绪反应）来维持大脑稳态。有鉴于此，偏头痛的治疗应始终采用多学科方法，旨在确定并在必要时消除可能的风险和合并症因素。例如正常的皮层下皮质兴奋性，能量平衡，渗透调节和情绪反应。有鉴于此，偏头痛的治疗应始终采用多学科方法，旨在确定并在必要时消除可能的风险和合并症因素。例如正常的皮层下皮质兴奋性，能量平衡，渗透调节和情绪反应。有鉴于此，偏头痛的治疗应始终采用多学科方法，旨在确定并在必要时消除可能的风险和合并症因素。