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The metabolic face of migraine - from pathophysiology to treatment.
Nature Reviews Neurology ( IF 28.2 ) Pub Date : 2019-10-04 , DOI: 10.1038/s41582-019-0255-4
Elena C Gross 1 , Marco Lisicki 2 , Dirk Fischer 1 , Peter S Sándor 3 , Jean Schoenen 2
Affiliation  

Migraine can be regarded as a conserved, adaptive response that occurs in genetically predisposed individuals with a mismatch between the brain's energy reserve and workload. Given the high prevalence of migraine, genotypes associated with the condition seem likely to have conferred an evolutionary advantage. Technological advances have enabled the examination of different aspects of cerebral metabolism in patients with migraine, and complementary animal research has highlighted possible metabolic mechanisms in migraine pathophysiology. An increasing amount of evidence - much of it clinical - suggests that migraine is a response to cerebral energy deficiency or oxidative stress levels that exceed antioxidant capacity and that the attack itself helps to restore brain energy homeostasis and reduces harmful oxidative stress levels. Greater understanding of metabolism in migraine offers novel therapeutic opportunities. In this Review, we describe the evidence for abnormalities in energy metabolism and mitochondrial function in migraine, with a focus on clinical data (including neuroimaging, biochemical, genetic and therapeutic studies), and consider the relationship of these abnormalities with the abnormal sensory processing and cerebral hyper-responsivity observed in migraine. We discuss experimental data to consider potential mechanisms by which metabolic abnormalities could generate attacks. Finally, we highlight potential treatments that target cerebral metabolism, such as nutraceuticals, ketone bodies and dietary interventions.

中文翻译:

偏头痛的代谢面——从病理生理学到治疗。

偏头痛可以被视为一种保守的适应性反应,发生在遗传易感个体中,大脑的能量储备和工作量之间不匹配。鉴于偏头痛的高患病率,与该病症相关的基因型似乎可能具有进化优势。技术进步已经能够检查偏头痛患者脑代谢的不同方面,补充动物研究突出了偏头痛病理生理学中可能的代谢机制。越来越多的证据——其中大部分是临床证据——表明偏头痛是对大脑能量不足或超过抗氧化能力的氧化应激水平的反应,而偏头痛本身有助于恢复大脑能量稳态并降低有害的氧化应激水平。对偏头痛代谢的更深入了解提供了新的治疗机会。在这篇综述中,我们描述了偏头痛中能量代谢和线粒体功能异常的证据,重点关注临床数据(包括神经影像学、生化、遗传和治疗研究),并考虑这些异常与异常感觉处理和在偏头痛中观察到脑高反应性。我们讨论实验数据以考虑代谢异常可能产生攻击的潜在机制。最后,我们强调了针对脑代谢的潜在治疗方法,例如营养保健品、酮体和饮食干预。我们描述了偏头痛中能量代谢和线粒体功能异常的证据,重点关注临床数据(包括神经影像学、生化、遗传和治疗研究),并考虑这些异常与异常感觉处理和大脑高反应性之间的关系在偏头痛中观察到。我们讨论实验数据以考虑代谢异常可能产生攻击的潜在机制。最后,我们强调了针对脑代谢的潜在治疗方法,例如营养保健品、酮体和饮食干预。我们描述了偏头痛中能量代谢和线粒体功能异常的证据,重点关注临床数据(包括神经影像学、生化、遗传和治疗研究),并考虑这些异常与异常感觉处理和大脑高反应性之间的关系在偏头痛中观察到。我们讨论实验数据以考虑代谢异常可能产生攻击的潜在机制。最后,我们强调了针对脑代谢的潜在治疗方法,例如营养保健品、酮体和饮食干预。并考虑这些异常与偏头痛中观察到的异常感觉处理和脑高反应性之间的关系。我们讨论实验数据以考虑代谢异常可能产生攻击的潜在机制。最后,我们强调了针对脑代谢的潜在治疗方法,例如营养保健品、酮体和饮食干预。并考虑这些异常与偏头痛中观察到的异常感觉处理和脑高反应性之间的关系。我们讨论实验数据以考虑代谢异常可能产生攻击的潜在机制。最后,我们强调了针对脑代谢的潜在治疗方法,例如营养保健品、酮体和饮食干预。
更新日期:2019-10-07
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