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2017 ; 7
(1
): e42210
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Parasympathetic Cholinergic and Neuropeptide Mechanisms of Migraine
#MMPMID28920040
Mikhailov N
; V Mamontov O
; A Kamshilin A
; Giniatullin R
Anesth Pain Med
2017[Feb]; 7
(1
): e42210
PMID28920040
show ga
CONTEXT: Migraine mechanisms remain largely uncovered for various reasons
including a very high complexity of the neurophysiological mechanisms implicated
in this disorder and a plethora of endogenous biologically active compounds
involved in the pathological process. The functional role of parasympathetic
innervation of meninges and cholinergic mechanisms of migraine are among little
explored issues despite multiple evidence indirectly indicating the role of
acetylcholine (ACh) and its analogues in migraine and other types of headache. In
the current short review, we discuss morphological, functional, and clinical
issues related to the role of ACh and its analogues such as carbachol and
nicotine in this most common neurological disorder. EVIDENCE ACQUISITION: In the
present work, studies published from 1953 to 2016 were investigated. Literature
was searched with following keywords: acetylcholine (ACh), carbachol, nicotine,
parasympathetic, mast cells, vasoactive intestinal polypeptide (VIP), and
pituitary adenylate cyclase-activating polypeptide (PACAP). RESULTS:
Parasympathetic fibers originated from SPG and trigeminal nerves can interact at
the level of meninges which is considered to be the origin site of migraine pain.
Here, in dura mater, ACh, VIP, and PACAP released by parasympathetic afferents
can both affect mast cells provoking its degranulation and additional release of
neurotransmitters, or they can directly affect trigeminal nerves inducing
nociception. CONCLUSIONS: In summary, cholinergic mechanisms in migraine and
other types of headache remain little elucidated and future studies should
clarify the role of parasympathetic nerves and molecular mechanisms of
cholinergic modulation within the nociceptive system.