偏头痛和我们的过敏脑
在退房时在“偏头痛世界”中发生了什么，我曾在亚利桑那州梅奥诊所的托德·施韦特博士遇到了一条推文，其中他提到了他在华盛顿大学对偏头痛和过敏大脑的讲座的讲座。那些最后两个词从页面跳跃，因为他们是我可以与之相关的那些。我经常想知道我的大脑是否实际上过敏，或者如果只是我的看法。多年来，我已经宣誓就可以通过墙壁听到东西，没有其他人能听到，并且可能闻到某人烹饪街区的东西。我也让我的兄弟在半夜过来，把管带放在我家中的每一个可想的光线，因为他们似乎都钻入了我的头骨，以掌握了手术刀的效率。我谈到施韦特博士，他们很乐意与健康中大海的读者分享他的信息。
He indicated that migraineurs "process and perceive individual modes of sensory stimuli differently than people without migraine." He also indicated that doctors and researchers know this not only because of patients' anecdotes, but also "because the hypersensitivity can be measured in the lab using physiologic tests, and because we can actually see the hyper-reactivity of sensory cortex with functional imaging of the migraine brain."
所以，它不仅仅是“我头脑中的一切”，而且实际上是在我的大脑中发生的事情，而这些敏感性实际上是我们大脑中的思考，但它们“也可能导致进一步的增强of hypersensitivities to other stimuli (e.g., exposure to light leads to greater hypersensitivity to touch of the skin) and may contribute to worsening headache intensity."
What are those things to which many migraineurs are hypersensitive? Dr. Schwedt identifies them as:
Somatosensory
Somatosensory refers to "reduced cutaneous pain threshold" and "cutaneous allodynia." Allodynia is when pain is caused by something that doesn't normally induce or cause pain. For example, some migraineurs experience scalp allodynia where the simple process of brushing their hair or having water from a shower fall on their head is painful. Dr. Schwedt notes that三分之二的偏头痛经历皮肤异室during a migraine attack. He also points that some migraineurs experience this allodynia even between migraine attacks and may be more sensitive to cold and to heat between attacks, in addition to pain.
视觉的视觉超敏感性被称为photophobia。根据Schwedt博士的说法50-90%
of migraineurs experience this. He points out that "light and visual patterns may cause generalized discomfort and increase the intensity of the headache pain." Of particular interest is his statement that "even after 72 hours of migraine freedom, migraineurs have significantly lower visual discomfort thresholds compared to non-migraine controls." Additionally, between attacks migraineurs "have increased sensitivity to white light (unfiltered), high-wavelength light (red), and low-wavelength light (blue).
audThis is also known asphonophobia, and52％-82％偏头痛在偏头痛袭击中经历这一点。类似于研究躯体感觉和视觉敏感性的研究，攻击率为75％的攻击之间报告了听觉敏感性。
嗅觉orsmophobia是敏感性嗅觉的医学术语。对香水，食品，化学品和香烟烟雾等异味的敏感性25％-43％在偏头痛袭击期间的偏头痛。35％的偏头痛在袭击之间具有蛇毒症，大约50％的偏头痛有一种与之相关的偏头痛触发器。
虽然这些定义和百分比对我来说非常感兴趣，因为我体验了所有四个，但由于有具体的数据支持和证明这些常见的偏头痛症状，我更加着迷。这不是我是一个超敏感的戏剧女王，但我的大脑真的非常过敏。
Schwedt博士写道：
“这些超敏点可以在实验室中使用物理学测试（例如视觉不适阈值）（导致视觉不适所需的最低光强度），听觉不适阈值（导致听觉所需的最低声音discomfort), and cutaneous pain thresholds (e.g., determining the lowest intensity of heat applied to the skin that is required to cause pain). Furthermore, functional magnetic resonance imaging studies have shown that the migraine brain has hyperactive responses to visual, olfactory, and painful stimuli."
那么根据这些测试，大脑会发生什么，当一个有异常的恋节，镜噬菌体，阴凉恐惧症和蛇食子恐惧症？
Neuroimaging Insights:
我争论是否包括以下内容，因为它是高度技术且肯定在我的脑海中。然而，我对偏头痛的大脑发生的实际生理变化太兴奋了，当上述超敏点发生遗漏时。正如我已经注意到的那样，有很多次偏头痛症状让我想知道我是否只是彻头彻尾的疯狂，或者让别人质疑我的理智或那样，我只是不禁兴奋地读关于大脑中真正发生的事情 - 即使我不完全理解它。我希望你也会发现这个验证。这是一个显示大脑某些区域的图像：
Allodynia
“Migraineurs are found to have hypofunctional activation of the nucleus cuneiformis in response to pain, and migraineurs with allodynia have atypical functional connectivity of the periaqueductal gray and nucleus cuneiformis compared to migraineurs without allodynia."
在审查斯特曼在线医学词典中的这些信息时，人们认为这与中脑的特定区域有关，这些区域在疼痛的调节中发挥作用。
畏光
“Neuroimaging has shown migraineurs to have atypical structure of visual motion processing areas (e.g., cortical thickening and lower fractional anisotropy) and greater activation of visual cortex and motion sensitive temporal cortex regions in response to visual stimulation."
The visual cortex is that part of the cerebral cortex "occupying the entire surface of the occipital lobe" that has to do with visual processing. (The cerebral cortex is the outermost level of the brain that is divided into four lobes that are responsible for higher thought processes.)
颞叶与听觉处理有关。
发音恐惧症
“Quantitative testing shows that theinterrictal.migraineur is more sensitive to sound compared to the non-migraine control and that the migraine patient is even more sensitive to sound during a migraine attack compared to the interictal period." Interictal refers to the period between attacks.
Osmophobia
“具有气味超敏反应的偏头痛的嵌入式宠物研究表明，与非偏头痛对照的反应和与非偏头痛对照相比，偏头痛在左颞杆和较少的前部，颞术术，后刺和基因座区的激活中具有更大的活化。与攻击之间的偏头痛相比，攻击期间的那些在几个嗅觉，肢体和疼痛基质区域中具有更大的激活，包括杏仁达拉，insula，颞杆，优越的颞克鲁，小脑和rostral pons的区域。“
The olfactory region is that region of the brain that has to do with smell.
肢体地区与大脑的那个区域有关，这些区域涉及情感和记忆的形成。
In Conclusion:
偏头痛患者,我们中的大多数人hyper-excitable brains, which predispose us to hypersensitivities in the areas of pain, temperature, vision, sound, and odor. These hypersensitivities not only increase our experience of pain, but also our level of disability. This is not a matter of perception, but rather of true physiological and chemical changes that take place in the brain of the migraineur. Many migraineurs experience this hypersensitivity even when they are not in the midst of a migraine attack. This is because the brain of a migraineur is different than that of a non-migraineur. A part of the complex picture of migraines is the existence of a hyper-excitable brain.
Schwedt，托德，MD，MSCI。“Multisensory Integration In Migraine。“神经内科目前的意见。2013; 26：248-253。
Interview:Dr. Todd Schwedt经过Cyndi Jordan. September 5, 2014.
Stedman, Thomas Lathrop.Stedman's Online Medical Dictionary。费城：Lippincott Williams＆Wilkins。（仅订阅）
