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Title: New insights into pathophysiology of vestibular migraine.
Authors: Espinosa-Sanchez, Juan M
Lopez-Escamez, Jose A
metadata.dc.contributor.authoraffiliation: [Espinosa-Sanchez,JM; Lopez-Escamez,JA] Otology and Neurotology Group CTS495, Human DNA Variability Department, GENYO Centre for Genomics and Oncological Research Pfizer - University of Granada - Junta de Andalucia, Granada, España. [Espinosa-Sanchez,JM] Department of Otolaryngology, Hospital San Agustin, Linares, Spain [Lopez-Escamez,JA] Department of Otolaryngology, Hospital de Poniente, El Ejido, Spain
Keywords: Migraine;Vestibular system;Aura;Migraña con Aura;Vertigo;Enfermedades del Nervio Vestibulococlear;Multisensory integration;Vértigo;Vestibulo-thalamo-cortical system;Enfermedad de Meniere;Meniere’s disease;Nervio Vestibular
metadata.dc.subject.mesh: Medical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Labyrinth Diseases::Endolymphatic Hydrops::Meniere Disease
Medical Subject Headings::Diseases::Nervous System Diseases::Central Nervous System Diseases::Brain Diseases::Headache Disorders::Headache Disorders, Primary::Migraine Disorders::Migraine with Aura
Medical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Labyrinth Diseases::Vestibular Diseases::Vertigo
Medical Subject Headings::Anatomy::Nervous System::Peripheral Nervous System::Peripheral Nerves::Cranial Nerves::Vestibulocochlear Nerve::Vestibular Nerve
Medical Subject Headings::Diseases::Otorhinolaryngologic Diseases::Ear Diseases::Retrocochlear Diseases::Vestibulocochlear Nerve Diseases
Issue Date: 6-Feb-2015
Publisher: Frontiers Research Foundation
Citation: Espinosa-Sanchez JM, Lopez-Escamez JA. New insights into pathophysiology of vestibular migraine. Front Neurol. 2015 6:12
Abstract: Vestibular migraine (VM) is a common disorder in which genetic, epigenetic, and environmental factors probably contribute to its development. The pathophysiology of VM is unknown; nevertheless in the last few years, several studies are contributing to understand the neurophysiological pathways involved in VM. The current hypotheses are mostly based on the knowledge of migraine itself. The evidence of trigeminal innervation of the labyrinth vessels and the localization of vasoactive neuropeptides in the perivascular afferent terminals of these trigeminal fibers support the involvement of the trigemino-vascular system. The neurogenic inflammation triggered by activation of the trigeminal-vestibulocochlear reflex, with the subsequent inner ear plasma protein extravasation and the release of inflammatory mediators, can contribute to a sustained activation and sensitization of the trigeminal primary afferent neurons explaining VM symptoms. The reciprocal connections between brainstem vestibular nuclei and the structures that modulate trigeminal nociceptive inputs (rostral ventromedial medulla, ventrolateral periaqueductal gray, locus coeruleus, and nucleus raphe magnus) are critical to understand the pathophysiology of VM. Although cortical spreading depression can affect cortical areas involved in processing vestibular information, functional neuroimaging techniques suggest a dysmodulation in the multimodal sensory integration and processing of vestibular and nociceptive information, resulting from a vestibulo-thalamo-cortical dysfunction, as the pathogenic mechanism underlying VM. The elevated prevalence of VM suggests that multiple functional variants may confer a genetic susceptibility leading to a dysregulation of excitatory-inhibitory balance in brain structures involved in the processing of sensory information, vestibular inputs, and pain. The interactions among several functional and structural neural networks could explain the pathogenic mechanisms of VM.
Description: Journal Article; Review;
metadata.dc.identifier.doi: 10.3389/fneur.2015.00012
ISSN: 1664-2295 (Online)
Appears in Collections:01- Artículos - AGS Norte de Jaén
01- Artículos - APES Hospital de Poniente

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