Understanding the mechanisms of migraine remains challenging as migraine is not a static disorder, and even in its episodic form migraine remains an “evolutive” chronic condition. Considerable progress has been made in elucidating the pathophysiological mechanisms of migraine, associated genetic factors that may influence susceptibility to the disease, and functional and anatomical changes during the progression of a migraine attack or the transformation of episodic to chronic migraine. Migraine is a life span neurological disorder that follows an evolutive age-dependent change in its prevalence and even clinical presentations. As a disorder, migraine involves recurrent intense head pain and associated unpleasant symptoms. Migraine attacks evolve over different phases with specific neural mechanisms and symptoms being involved during each phase. In some patients, migraine can be transformed into a chronic form with daily or almost daily headaches. The mechanisms behind this evolutive process remain unknown, but genetic and epigenetic factors, inflammatory processes and central sensitization may play an important role.

中文翻译：

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偏头痛作为一种慢性演变性疾病的机制

了解偏头痛的机制仍然具有挑战性，因为偏头痛不是一种静态的疾病，即使是发作性的偏头痛仍然是一种“进化的”慢性疾病。在阐明偏头痛的病理生理机制、可能影响疾病易感性的相关遗传因素以及偏头痛发作或发作性偏头痛转变为慢性偏头痛过程中的功能和解剖学变化方面，已经取得了相当大的进展。偏头痛是一种终生神经系统疾病，其患病率甚至临床表现随年龄的变化而发生演变。作为一种疾病，偏头痛涉及反复发作的剧烈头痛和相关的不适症状。偏头痛发作会经历不同的阶段，每个阶段都涉及特定的神经机制和症状。在一些患者中，偏头痛可能会转化为慢性偏头痛，每天或几乎每天都会头痛。这一进化过程背后的机制仍不清楚，但遗传和表观遗传因素、炎症过程和中枢敏化可能发挥重要作用。