The origin of nausea in migraine–A PET study

The Journal of Headache and Pain

Research Article

Till Sprenger¹  Christoph Schankin²  Farooq H Maniyar³  Peter J Goadsby⁴ 

[1] Department of Neurology, University of California, San Francisco, San Francisco, CA, USA;Department of Neurology and Division of Neuroradiology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland;Department of Neurology, University of California, San Francisco, San Francisco, CA, USA;Department of Neurology, University of Munich Hospital – Großhadern, Marchioninistr. 15, D-81377, Munich, Germany;Headache Group – Basic & Clinical Neurosciences, King’s College London, London, UK;Department of Neurology, University of California, San Francisco, San Francisco, CA, USA;Basildon and Thurrock University Hospital, SS16 5NL, Nethermayne, Basildon, UK;The Royal London Hospital, E1 1BB, London, Whitechapel, UK;Headache Group – Basic & Clinical Neurosciences, King’s College London, London, UK;Department of Neurology, University of California, San Francisco, San Francisco, CA, USA;NIHR-Wellcome Trust King’s Clinical Research Facility, King’s College Hospital, SE5 9PJ, London, UK;

关键词: Nausea;    Premonitory;    PET;    NTS;    Trigeminal;   

DOI  :  10.1186/1129-2377-15-84

 received in 2014-10-13, accepted in 2014-11-24,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundNausea is a common and disabling symptom of migraine. The origin of nausea is not well understood although functional connections between trigeminal neurons and the nucleus tractus solitarius may explain occurrence of nausea with pain. However, nausea occurs as a premonitory symptom in about a quarter of patients, suggesting that a primary brain alteration unrelated to the experience of pain may be the reason for nausea.MethodsWe performed positron emission tomography scans with H215O PET in premonitory phase of nitroglycerin-induced migraine and compared patients with and without nausea.ResultsThe results showed activation in rostral dorsal medulla and periaqueductal grey (PAG) in the nausea group, which was absent in the no nausea group. The rostral dorsal medullary area included the nucleus tractus solitarius, dorsal motor nucleus of the vagus nerve and the nucleus ambiguus, all of which are thought to be involved in brain circuits mediating nausea.ConclusionsThe results demonstrate that nausea can occur as a premonitory symptom in migraine, independent of pain and trigeminal activation. This is associated with activation of brain structures known to be involved in nausea. We conclude that nausea is a centrally driven symptom in migraine.

【 授权许可】

Unknown   
© Maniyar et al.; licensee Springer. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.