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Nervenheilkunde 2019; 38(10): 722-727
DOI: 10.1055/a-0990-2624
Schwerpunkt
© Georg Thieme Verlag KG Stuttgart · New York

Pathophysiologie der Migräne

Aktuelles Verständnis und AusblickPathophysiology of migraine
Christian Ziegeler∗
1   Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf
,
Arne May
1   Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg-Eppendorf
› Author Affiliations
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Publication History

Publication Date:
15 October 2019 (online)

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ZUSAMMENFASSUNG

Lange Zeit wurde das pathophysiologische Verständnis der Migräne von der Vorstellung geprägt, dass die Gefäße des Kopfes den Schmerz bedingen und die Migräne also ein vaskulärer Kopfschmerz sei. Diese Theorie kann als überholt, zumindest jedoch lückenhaft angesehen werden. Mittlerweile deutet vieles darauf hin, dass es sich bei der Migräne um eine oszillierende Schwellen-/Filterstörung des zentralen Nervensystems handelt, wobei der im Vordergrund stehende Kopfschmerz nur einen Teil des vielfältigen Symptomkomplexes darstellt. Neuere Befunde der funktionellen Bildgebung zeigen zyklische Veränderungen von Aktivitätsmustern im Hypothalamus, Thalamus und Hirnstamm, welche besser erklären können, wie der Kopfschmerz und die migränetypischen Begleitsymptome entstehen. Die zukünftige Grundlagenforschung wird sich auf Kerngebiete im Diencephalon als mögliche Ursprungsorte der Attackengenerierung bei Migräne fokussieren. Große Hoffnung ruhen auf der Erforschung der Wirkweisen neuer Antikörpertherapien, welche helfen werden, molekulare Mechanismen der Schmerzentstehung der Migräne zu entschlüsseln.

ABSTRACT

For a long time, the pathophysiology of migraine was considered to be of vascular origin and that the intracranial vessels cause the pain and that migraine therefore would be a vascular headache. This theory is not valid any more, or at least not complete. Meanwhile, there is a lot of evidence that migraine is an oscillating disturbance of levels/filters within the central nervous system with the prominent headache as only one symptom in a complex of symptoms. Recent findings in functional imaging show cyclic changes of activities in hypothalamus, thalamus and brainstem which can better explain how the headache and the accompanying symptoms develop. Future basic research will probably focus on nuclei in the diencephalon as probable loci of generating migraine attacks. There is hope that the research on the mechanisms of the new antibodies for migraine treatment will help to identify the molecular mechanisms of migraine.

Schlüsselwörter

Migräne - Pathophysiologie - funktionelle Bildgebung - Diencephalon

Key words

Migraine - pathophysiology - functional imaging - diencephalon
 

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