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Migraine
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DOI：10.1038/s41572-021-00328-4.png)
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摘要
En 中文
Migraine is a common headache disorder. This Primer by Ferrari and colleagues summarizes the epidemiology, pathophysiology, diagnosis and treatment of migraine. Moreover, quality of life issues faced by patients with migraine and future research avenues are discussed. Migraine is a common, chronic, disorder that is typically characterized by recurrent disabling attacks of headache and accompanying symptoms, including aura. The aetiology is multifactorial with rare monogenic variants. Depression, epilepsy, stroke and myocardial infarction are comorbid diseases. Spreading depolarization probably causes aura and possibly also triggers trigeminal sensory activation, the underlying mechanism for the headache. Despite earlier beliefs, vasodilation is only a secondary phenomenon and vasoconstriction is not essential for antimigraine efficacy. Management includes analgesics or NSAIDs for mild attacks, and, for moderate or severe attacks, triptans or 5HT(1B/1D) receptor agonists. Because of cardiovascular safety concerns, unreliable efficacy and tolerability issues, use of ergots to abort attacks has nearly vanished in most countries. CGRP receptor antagonists (gepants) and lasmiditan, a selective 5HT1(F) receptor agonist, have emerged as effective acute treatments. Intramuscular onabotulinumtoxinA may be helpful in chronic migraine (migraine on >= 15 days per month) and monoclonal antibodies targeting CGRP or its receptor, as well as two gepants, have proven effective and well tolerated for the preventive treatment of migraine. Several neuromodulation modalities have been approved for acute and/or preventive migraine treatment. The emergence of new treatment targets and therapies illustrates the bright future for migraine management.
Keyword:
CORTICAL SPREADING DEPRESSION
FAMILIAL HEMIPLEGIC MIGRAINE
GENE-RELATED PEPTIDE
MEDICATION-OVERUSE HEADACHE
TRANSCRANIAL MAGNETIC STIMULATION
CENTRAL TRIGEMINOVASCULAR NEURONS
CERVICAL ARTERY DISSECTION
VAGUS NERVE-STIMULATION
DOUBLE-BLIND
BRAIN-STEM
期刊
N
IF:
60.6
论文数:
652
被引数:
3.8W
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Migraine remains second among the world's causes of disability, and first among young women: findings from GBD2019偏头痛仍然是世界残疾原因中的第二位，在年轻女性中排名第一: 来自GBD2019的调查结果
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