Perivascular neurotransmitters: Regulation of cerebral blood flow and role in primary headaches.

Abstract

In order to understand the nature of the relationship between cerebral blood flow (CBF) and primary headaches, we have conducted a literature review with particular emphasis on the role of perivascular neurotransmitters. Primary headaches are in general considered complex polygenic disorders (genetic and environmental influence) with pathophysiological neurovascular alterations. Identified candidate headache genes are associated with neuro- and gliogenesis, vascular development and diseases, and regulation of vascular tone. These findings support a role for the vasculature in primary headache disorders. Moreover, neuronal hyperexcitability and other abnormalities have been observed in primary headaches and related to changes in hemodynamic factors. In particular, this relates to migraine aura and spreading depression. During headache attacks, ganglia such as trigeminal and sphenopalatine (located outside the blood-brain barrier) are variably activated and sensitized which gives rise to vasoactive neurotransmitter release. Sympathetic, parasympathetic and sensory nerves to the cerebral vasculature are activated. During migraine attacks, altered CBF has been observed in brain regions such as the somatosensory cortex, brainstem and thalamus. In regulation of CBF, the individual roles of neurotransmitters are partly known, but much needs to be unraveled with respect to headache disorders.

• Authors: Simona D Frederiksen, Kristian A Haanes, Karin Warfvinge, Lars Edvinsson
• Journal: Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism (J Cereb Blood Flow Metab) Vol. 39 Issue 4 Pg. 610-632 (04 2019) ISSN: 1559-7016 [Electronic] United States
• PMID: 29251523 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Chemical References

• Neurotransmitter Agents

Topics

• Blood Vessels (innervation)
• Cerebrovascular Circulation (physiology)
• Headache (etiology)
• Hemodynamics
• Humans
• Migraine with Aura (physiopathology)
• Neurotransmitter Agents (metabolism)