RT Journal Article
T1 New insights into pathophysiology of vestibular migraine.
A1 Espinosa-Sanchez, Juan M
A1 Lopez-Escamez, Jose A
K1 Migraine
K1 Vestibular system
K1 Aura
K1 Migraña con Aura
K1 Vertigo
K1 Enfermedades del Nervio Vestibulococlear
K1 Multisensory integration
K1 Vértigo
K1 Vestibulo-thalamo-cortical system
K1 Enfermedad de Meniere
K1 Meniere’s disease
K1 Nervio Vestibular
AB 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.
PB Frontiers Research Foundation
YR 2015
FD 2015-02-06
LK http://hdl.handle.net/10668/2073
UL http://hdl.handle.net/10668/2073
LA en
NO Espinosa-Sanchez JM, Lopez-Escamez JA. New insights into pathophysiology of vestibular migraine. Front Neurol. 2015 6:12
NO Journal Article; Review;
DS RISalud
RD Apr 12, 2025