Welch KMA, Nagesh V, Aurora SK, et al. Periaqueductal gray matter dysfunction in migraine: cause or the burden of illness?
2002; Lippincott Williams & Wilkins; Volume: 22; Issue: 2 Linguagem: Inglês
10.1097/00041327-200206000-00043
ISSN1536-5166
Autores Tópico(s)Traumatic Brain Injury and Neurovascular Disturbances
ResumoWelch KMA, Nagesh V, Aurora SK, et al. Periaqueductal gray matter dysfunction in migraine: cause or the burden of illness? Headache 2001;41:629–637. The authors looked for non-heme iron deposition in the periaqueductal gray matter on 3.0 Tesla MRI in 17 patients with episodic migraine (EM), 17 patients with chronic daily headache (CDH), control subjects. They found that there was a significant increase in iron in both of the EM and CDH patients as compared with control subjects. There was no difference between the CDH and EM patients no difference between migraine patients with or without aura. The authors concluded that iron homeostasis in the periaqueductal gray area is progressively impaired by repeated attacks of migraine. They propose that the periaqueductal gray area is the “generator” of migraine attacks by loss of inhibitory control of nociceptive spinal afferents. Iron deposition, perhaps a marker of oxidative stress free radical damage, may be the burden of “illness.” This study is important because it not only corroborates earlier PET studies that showed increased regional blood flow to the midbrain structures (periaqueductal gray, midbrain reticular formation locus ceruleus) as a “generator” of migraine, but also because of the implications for the pathophysiology long-term sequelae of migraine.
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