Rinsho Shinkeigaku (Clinical Neurology)

Symposium 04

Cortical spreading depression and pain: A missing link in the pathophysiology of migraine?

Hisanori Kowa, M.D., Ph.D.1), Hiroshi Takigawa, M.D., Ph.D.1) and Kenji Nakashima, M.D., Ph.D.1)

1)Division of Neurology, Department of Brain and Neurological Sciences, Faculty of Medicine, Tottori University

It is generally believed that cortical spreading depression (CSD) demonstrated by Leao underlie migraine aura and migraine headache depends on the activation of the trigeminovascular pain pathway proposed by Moskowitz. The onset of migraine attack and the association between CSD and the trigeminovascular pain pathway have remained largely unknown. Recent animal studies indicate that CSD can activate trigeminal nociception and thus trigger headache mechanism. Meanwhile, the nature and mechanism of migraine without aura is still an open question. It is considered that the pain in migraineur is affected by hereditary factors, internal factors such as female sex hormone, and external factors as medication, meal, weather, stress, etc. We review here the current understanding of the migraine pathophysiology, focusing on recent advance regarding cortical spreading depression and pain.
Full Text of this Article in Japanese PDF (240K)

(CLINICA NEUROL, 54: 1006|1008, 2014)
key words: migraine, aura, trigeminovascular theory, missing link

(Received: 21-May-14)