头面-脑膜传入会聚在头针治疗偏头痛中的作用机制

Scalp acupuncture produces prominent therapeutic effects on migraine, yet studies on its neuronal pathway and mechanism are still lack. Inputs from meningeal structure under physiological or pathological condition like migraine result in activation of neurons in the trigeminal nucleus caudalis (TNC) or C1-C3 spinal dorsal horn of the cervical spinal cord, which is a primary center receiving signals from both facial or occipital regions and meninges as well. Nerve tracing method will be applied to observe the double labeling of convergent neurons in primary sensory neurons in trigeminal ganglion or C1-C3 dorsal root ganglion, and in second sensory neurons in TNC, by different tracer injection in craniofacial or occipital region. Electrophysiological unit recording will be performed to check signal convergence and integration in wide dynamic range neurons in TNC by scalp acupuncture and meninges stimulation both in normal and migraine model rats. Furthermore, we will use biochemical and immunohistochemistry measures in the present study to evaluate peripheral sensitizations as neurogenic reaction caused by trigeminal nerve stimulation or migraine pathological condition. Finally, acute and chronic migraine model rats accept acupuncture intervention will be used to investigate the efficacy of acupuncture on nociceptive behaviors. Based on these studies, we aim to clarify the neural mechanism of scalp acupuncture in treating migraine mediated by trigeminovascular system, thus providing a beneficial direction for clinic.

头针治疗偏头痛疗效确切，在临床使用广泛，但其神经通路及作用机制尚缺乏系统性研究。三叉神经血管系统是头面部与脑膜共同联系的结构与功能基础，也是偏头痛病理情况下中枢敏化与外周敏化的机制所在。本研究拟采用神经束路示踪技术，观察头面部与脑膜的感觉传入在三叉神经节或C2背根节一级神经元、三叉神经脊束核尾侧亚核二级神经元的双标记表达；在正常及偏头痛模型大鼠采用在体电生理学单细胞记录法，验证头面部穴位与脑膜刺激在三叉神经脊束核会聚神经元的信号整合及相互作用；并观察由偏头痛病理改变诱发的神经源性炎性反应及痛相关因子的动态变化；复制急、慢性偏头痛模型，探讨针刺头面部穴位治疗偏头痛的优势效应和最佳介入时间。通过上述研究，系统阐明头针治疗偏头痛的神经调控机制，揭示头针对治疗偏头痛存在的天然优势和“捷径”通路。

头针治疗偏头痛疗效确切，在临床使用广泛，但其神经通路及作用机制尚缺乏系统性研究。三叉神经血管系统是头面部与脑膜共同联系的结构与功能基础，也是偏头痛病理情况下中枢敏化与外周敏化的机制所在。本研究通过形态学实验证明：头面部和脑膜传入的神经示踪在一级神经元（背根节，三叉神经节）、二级神经元（三叉神经脊束核尾侧亚核）出现双标；通过生化和免疫组化实验验证：偏头痛病理情况下因轴突反射或背根反射引起外周敏化和中枢敏化现象；通过电生理学实验说明：头面部针刺和脑膜传入在三叉神经脊束核尾侧亚核WDR会聚神经元出现信号会聚、整合与相互作用；通过急、慢性偏头痛模型大鼠行为学观察反证：针刺头面部穴位治疗偏头痛的干预效应与机制。通过以上四个部分探讨，系统阐明了头面部和颅内痛敏结构在生理及偏头痛病理状态下，通过头面-脑膜联系产生信号的会聚、整合与相互作用，为针刺头面部穴位治疗偏头痛的优势疗效提供科学性依据。