颈源性头痛发病机制的研究进展
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摘要
颈源性头痛是一种牵涉痛,国际头痛协会认为这是一种特殊类型的疾病,ICHD-II中被归入继发性头痛。目前关于颈源性头痛的发病机制尚存在争议,我们回顾了最近2年的文献,并总结了其可能的机制。除了颈椎的病变之外,扳机点的形成,中枢神经系统的广泛敏感化,局部伤害感受器阈值下降均在颈源性头痛的发生中起重要作用。本文就颈源性头痛发病机制作一综述。
Cervicogenic headache is characterized by pain referred from the cervical spine to the headache. The International Headache Society recognizes this type of headache as a distinct disorder. It was classified into the secondary headache in the ICHD-II. However, the exact mechanisms of the development of cervicogenic headache remain ambiguous. We reviewed literatures during the last 2 decades and intended to summarize the possible mechanisms. We found that besides the initial disorders in the cervical spine, the formation of trigger points, the hyper-sensitization of the central nervous system and the local areas where the referred pain occurs, and the convergence between the cervical afferents all play important roles in the development of cervicogenic headache.
Cervicogenic headache is characterized by pain referred from the cervical spine to the headache. The International Headache Society recognizes this type of headache as a distinct disorder. It was classified into the secondary headache in the ICHD-II. However, the exact mechanisms of the development of cervicogenic headache remain ambiguous. We reviewed literatures during the last 2 decades and intended to summarize the possible mechanisms. We found that besides the initial disorders in the cervical spine, the formation of trigger points, the hyper-sensitization of the central nervous system and the local areas where the referred pain occurs, and the convergence between the cervical afferents all play important roles in the development of cervicogenic headache.
引文
[1] Schrot R J,Mathew J S,Yueju L,et al.Headache relief after anterior cervical discectomy:post hoc analysis of a randomized investigational device exemption trial:clinical article[J].Journal of Neurosurgery Spine,2014,21(2):217-222.
[2] Armbrust K R,Kosmorsky G S,Lee M S,et al.A pain in the eye[J].Survey of Ophthalmology,2014,59(4):474-477.
[3] Hargraves W D.'Referred pain'[J].British Dental Journal,1994,176(7):248-249.
[4] Jensen S.Neck related causes of headache[J].Australian Family Physician,2005,34(8):635-639.
[5] Reggars J W.A likely mechanism for headache of cervicogenic origin[J].Comsig Review,1992,1(1):7-8.
[6] Pearce J M.Cervicogenic headache:a personal view[J].Cephalalgia,1995,15(6):463-469.
[7] Silberstein S D,Olesen J,Bousser M G,et al.The International Classification of Headache Disorders,2nd Edition (ICHD-II)-revision of criteria for 8.2 Medication-overuse headache[J].Cephalalgia An International Journal of Headache,2005,25(6):460-465.
[8] Jaeger,Bernadette.Are "cervicogenic" headaches due to myofascial pain and cervical spine dysfunction[J].Cephalalgia,1989,9(3):157-164.
[9] Sjaastad O,Fredriksen T A,Pfaffenrath V.Cervicogenic headache:diagnostic criteria[J].Headache the Journal of Head & Face Pain,1990,30(11):725-726.
[10] Alix M E,Bates D K.A proposed etiology of cervicogenic headache:The neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle[J].J Manipulative Physiol Ther,1999,22(8):534-539.
[11] Narouze S N,Casanova J,Mekhail N,The longitudinal effectiveness of lateral atlantoaxial intra-articular steroid injection in the treatment of cervicogenic headache[J].Pain Med,2007,8(2):184-188
[12] Antonaci,F.and O.Sjaastad,Cervicogenic headache:a real headache[J].Curr Neurol Neurosci Rep,2011,11(2):149-155.
[13] Bovim G.Cervicogenic headache,migraine,and tension-type headache.Pressure-pain threshold measurements[J].Pain,1992,51(2):169-173.
[14] Reggars J W.A Likely mechanism for headache of cervicogenic oricin[J].Comsig Review,1992,1(1):7-8
[15] Fernández-De-Las-Peas C,Dommerholt J.Myofascial trigger points:peripheral or central phenomenon[J].Current Rheumatology Reports,2014,16(1):395.1-6
[16] Fernández-De-Las-Peas C.Myofascial Head Pain[J].Current Pain & Headache Reports,2015,19(7):28-29.
[17] Fernándezdelaspeas C,Dommerholt J.International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points:A Delphi Study[J].Pain Medicine,2017,19(1):142-150
[18] Gerwin R.Trigger Point Diagnosis:At Last,the First Word on Consensus[J].Pain Medicine,2017,19(1):1-2
[19] Srbely J Z,Kumbhare D,Grosmanrimon L.A narrative review of new trends in the diagnosis of myofascial trigger points:diagnostic ultrasound imaging and biomarkers[J].Journal of the Canadian Chiropractic Association,2016,60(3):220-225
[20] Borg-Stein J.Cervical myofascial pain and headache[J].Current Pain & Headache Reports,2002,6(4):324-330.
[21] Huang Q.M.Myoelectrical activity and muscle morphology in a rat model of myofascial trigger points induced by blunt trauma to the vastus medialis[J].Acupunct Med,2013,31(1):65-73.
[22] Kuan T S.Current studies on myofascial pain syndrome[J].Current Pain & Headache Reports,2009,13(5):365-369.
[23] Huang Q M,Lv J J,Ruanshi Q M,et al.Spontaneous electrical activities at myofascial trigger points at different stages of recovery from injury in a rat model[J].Acupuncture in Medicine,2015,33(4):319-324.
[24] Carel B,Dommerholt J D.Etiology of Myofascial Trigger Points[J].Current Pain & Headache Reports,2012,16(5):439-444.
[25] Sikdar S,Ortiz R,Gebreab T,et al.Understanding the Vascular Environment of Myofascial Trigger Points using Ultrasonic Imaging and Computational Modeling[C]// Engineering in Medicine and Biology Society.IEEE,2010:5302-5305
[26] Cojocaru M C,Cojocaru I M,Voiculescu V M,et al.Trigger points-ultrasound and thermal findings[J].Journal of Medicine & Life,2015,8(3):315-318.
[27] Morikawa Y,Takamoto K,Nishimaru H,et al.Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System:A Pilot Study[J].Frontiers in Neuroscience,2017,11:186.
[28] Park S K,Yang D J,Kim J H,et al.Analysis of mechanical properties of cervical muscles in patients with cervicogenic headache[J].Journal of Physical Therapy Science,2017,29(2):332-335.
[29] Diener H C,Kaminski M,Stappert G,et al.Lower cervical disc prolapse may cause cervicogenic headache:prospective study in patients undergoing surgery[J].Cephalalgia,2007,27(9):1050-1054.
[30] Liu,J.J,et al.Relief of Cervicogenic Headaches after Single-Level and Multilevel Anterior Cervical Diskectomy:A 5-Year Post Hoc Analysis[J].Global Spine J,2016.6(6):563-570.
[31] Chua,N.H.Understanding cervicogenic headache[J].Anesth Pain Med,2012.2(1):3-4.
[32] Arendt-Nielsen,L.Central sensitization in humans:assessment and pharmacology[J].Handb Exp Pharmacol,2015.227:79-102.
[33] Curatolo M,Petersenfelix S,Arendtnielsen L,et al.Central hypersensitivity in chronic pain after whiplash injury[J].Clinical Journal of Pain,2006,17(2):287-302.
[34] Curatolo M,Arendtnielsen L,Petersenfelix S.Evidence,mechanisms,and clinical implications of central hypersensitivity in chronic pain after whiplash injury[J].Clinical Journal of Pain,2004,20(6):469-476.
[35] naseer Nasir ,Hicham Mahboubi,Sandeep Gyawali.Consistent sex-dependent effects of PKMf gene ablation and pharmacological inhibition on the maintenance of referred pain[J].Molecular Pain,2016,12:1-14.
[36] Arendtnielsen L.Central sensitization in humans:assessment and pharmacology[J].Handbook of Experimental Pharmacology,2015,227:79-102.
[37] Kuan T S.Current studies on myofascial pain syndrome[J].Current Pain & Headache Reports,2009,13(5):365-369.
[38] Ge H Y,Nie H,Madeleine P,et al.Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome[J].Pain,2009,147(1-3):233-240.
[39] Calvillo O,Skaribas I,Turnipseed J.Anatomy and pathophysiology of the sacroiliac joint[J].Curr Rev Pain,2000,4(5):356-361.
[40] C Afferent Axons/Fibers[M].Springer Berlin Heidelberg,2013:309-309
[2] Armbrust K R,Kosmorsky G S,Lee M S,et al.A pain in the eye[J].Survey of Ophthalmology,2014,59(4):474-477.
[3] Hargraves W D.'Referred pain'[J].British Dental Journal,1994,176(7):248-249.
[4] Jensen S.Neck related causes of headache[J].Australian Family Physician,2005,34(8):635-639.
[5] Reggars J W.A likely mechanism for headache of cervicogenic origin[J].Comsig Review,1992,1(1):7-8.
[6] Pearce J M.Cervicogenic headache:a personal view[J].Cephalalgia,1995,15(6):463-469.
[7] Silberstein S D,Olesen J,Bousser M G,et al.The International Classification of Headache Disorders,2nd Edition (ICHD-II)-revision of criteria for 8.2 Medication-overuse headache[J].Cephalalgia An International Journal of Headache,2005,25(6):460-465.
[8] Jaeger,Bernadette.Are "cervicogenic" headaches due to myofascial pain and cervical spine dysfunction[J].Cephalalgia,1989,9(3):157-164.
[9] Sjaastad O,Fredriksen T A,Pfaffenrath V.Cervicogenic headache:diagnostic criteria[J].Headache the Journal of Head & Face Pain,1990,30(11):725-726.
[10] Alix M E,Bates D K.A proposed etiology of cervicogenic headache:The neurophysiologic basis and anatomic relationship between the dura mater and the rectus posterior capitis minor muscle[J].J Manipulative Physiol Ther,1999,22(8):534-539.
[11] Narouze S N,Casanova J,Mekhail N,The longitudinal effectiveness of lateral atlantoaxial intra-articular steroid injection in the treatment of cervicogenic headache[J].Pain Med,2007,8(2):184-188
[12] Antonaci,F.and O.Sjaastad,Cervicogenic headache:a real headache[J].Curr Neurol Neurosci Rep,2011,11(2):149-155.
[13] Bovim G.Cervicogenic headache,migraine,and tension-type headache.Pressure-pain threshold measurements[J].Pain,1992,51(2):169-173.
[14] Reggars J W.A Likely mechanism for headache of cervicogenic oricin[J].Comsig Review,1992,1(1):7-8
[15] Fernández-De-Las-Peas C,Dommerholt J.Myofascial trigger points:peripheral or central phenomenon[J].Current Rheumatology Reports,2014,16(1):395.1-6
[16] Fernández-De-Las-Peas C.Myofascial Head Pain[J].Current Pain & Headache Reports,2015,19(7):28-29.
[17] Fernándezdelaspeas C,Dommerholt J.International Consensus on Diagnostic Criteria and Clinical Considerations of Myofascial Trigger Points:A Delphi Study[J].Pain Medicine,2017,19(1):142-150
[18] Gerwin R.Trigger Point Diagnosis:At Last,the First Word on Consensus[J].Pain Medicine,2017,19(1):1-2
[19] Srbely J Z,Kumbhare D,Grosmanrimon L.A narrative review of new trends in the diagnosis of myofascial trigger points:diagnostic ultrasound imaging and biomarkers[J].Journal of the Canadian Chiropractic Association,2016,60(3):220-225
[20] Borg-Stein J.Cervical myofascial pain and headache[J].Current Pain & Headache Reports,2002,6(4):324-330.
[21] Huang Q.M.Myoelectrical activity and muscle morphology in a rat model of myofascial trigger points induced by blunt trauma to the vastus medialis[J].Acupunct Med,2013,31(1):65-73.
[22] Kuan T S.Current studies on myofascial pain syndrome[J].Current Pain & Headache Reports,2009,13(5):365-369.
[23] Huang Q M,Lv J J,Ruanshi Q M,et al.Spontaneous electrical activities at myofascial trigger points at different stages of recovery from injury in a rat model[J].Acupuncture in Medicine,2015,33(4):319-324.
[24] Carel B,Dommerholt J D.Etiology of Myofascial Trigger Points[J].Current Pain & Headache Reports,2012,16(5):439-444.
[25] Sikdar S,Ortiz R,Gebreab T,et al.Understanding the Vascular Environment of Myofascial Trigger Points using Ultrasonic Imaging and Computational Modeling[C]// Engineering in Medicine and Biology Society.IEEE,2010:5302-5305
[26] Cojocaru M C,Cojocaru I M,Voiculescu V M,et al.Trigger points-ultrasound and thermal findings[J].Journal of Medicine & Life,2015,8(3):315-318.
[27] Morikawa Y,Takamoto K,Nishimaru H,et al.Compression at Myofascial Trigger Point on Chronic Neck Pain Provides Pain Relief through the Prefrontal Cortex and Autonomic Nervous System:A Pilot Study[J].Frontiers in Neuroscience,2017,11:186.
[28] Park S K,Yang D J,Kim J H,et al.Analysis of mechanical properties of cervical muscles in patients with cervicogenic headache[J].Journal of Physical Therapy Science,2017,29(2):332-335.
[29] Diener H C,Kaminski M,Stappert G,et al.Lower cervical disc prolapse may cause cervicogenic headache:prospective study in patients undergoing surgery[J].Cephalalgia,2007,27(9):1050-1054.
[30] Liu,J.J,et al.Relief of Cervicogenic Headaches after Single-Level and Multilevel Anterior Cervical Diskectomy:A 5-Year Post Hoc Analysis[J].Global Spine J,2016.6(6):563-570.
[31] Chua,N.H.Understanding cervicogenic headache[J].Anesth Pain Med,2012.2(1):3-4.
[32] Arendt-Nielsen,L.Central sensitization in humans:assessment and pharmacology[J].Handb Exp Pharmacol,2015.227:79-102.
[33] Curatolo M,Petersenfelix S,Arendtnielsen L,et al.Central hypersensitivity in chronic pain after whiplash injury[J].Clinical Journal of Pain,2006,17(2):287-302.
[34] Curatolo M,Arendtnielsen L,Petersenfelix S.Evidence,mechanisms,and clinical implications of central hypersensitivity in chronic pain after whiplash injury[J].Clinical Journal of Pain,2004,20(6):469-476.
[35] naseer Nasir ,Hicham Mahboubi,Sandeep Gyawali.Consistent sex-dependent effects of PKMf gene ablation and pharmacological inhibition on the maintenance of referred pain[J].Molecular Pain,2016,12:1-14.
[36] Arendtnielsen L.Central sensitization in humans:assessment and pharmacology[J].Handbook of Experimental Pharmacology,2015,227:79-102.
[37] Kuan T S.Current studies on myofascial pain syndrome[J].Current Pain & Headache Reports,2009,13(5):365-369.
[38] Ge H Y,Nie H,Madeleine P,et al.Contribution of the local and referred pain from active myofascial trigger points in fibromyalgia syndrome[J].Pain,2009,147(1-3):233-240.
[39] Calvillo O,Skaribas I,Turnipseed J.Anatomy and pathophysiology of the sacroiliac joint[J].Curr Rev Pain,2000,4(5):356-361.
[40] C Afferent Axons/Fibers[M].Springer Berlin Heidelberg,2013:309-309