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文献 PubMed−ID

文献タイトル (日本語)

TCD と SPECT で片頭痛患者の発作間欠期で差があるかどうかの検討．

Pain Research & Treatment Unit, Institute of Neurosurgery , University of Milan , Italy .

健常人： 14 名，前兆を伴う片頭痛患者： 13 名，前兆を伴わない片頭痛患者： 35 名

濱田潤一，永田栄一郎

Migraine is considered to be a functional neurological disorder. For several years cerebral blood flow studies have been fueling the controversy surrounding the pathophysiology of migraine headache. Tc-99m HMPAO SPECT brain imaging was performed during the headache-free period in 44 migraineurs. The findings were compared with those of age 17 and sex-matched controls. The SPECT analysis was performed by using a 360 degrees rotating single head gamma camera system (Toshiba GCA 602A/SA, Japan), equipped with a LEAP collimator, interfaced to a Toshiba computer system, after 20 minutes following the injection of 350-550 MBq of Tc-99m HMPAO. The SPECT images revealed clear interhemispheric asymmetry in the upper frontal and occipital parts of the brain in migraineurs. It is suggested that an impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from migraine.

片頭痛患者における Tc-99m HMPAO を用いた SPECT の検討

片頭痛患者の脳血流を Tc-99m HMPAO を用いた SPECT で検討した．

Department of Neurology, University of Erciyes , Kayseri , Turkey .

健常人： 17 名，片頭痛患者： 44 名

片頭痛患者において明らかに前頭部と後頭部において非対称性の血流分布を示した．

片頭痛の分類が明確でない．

濱田潤一，永田栄一郎

BACKGROUND: Spreading depression of Leao has been hypothesized as the basis for the visual aura of the migraine attack, supported by cerebral blood flow measurements of spreading hypoperfusion. The early depolarizing or activation phase of experimental spreading depression, however, is associated with a transient but pronounced cerebral blood flow increase that precedes spreading hypoperfusion. OBJECTIVE: To study this early phase of the migraine attack, we investigated visually triggered attacks of headache and visual symptoms using a red-green checkerboard stimulus in patients with migraine. INTERVENTIONS: We studied occipital cortex activation during visual stimulation by measuring occipital cortex perfusion with functional magnetic resonance imaging-blood oxygenation level-dependent contrast in 10 patients with migraine with aura and 2 patients with migraine without aura and 6 healthy subjects. RESULTS: In 6 patients with migraine with aura and 2 patients with migraine without aura, their typical headache with (n = 2) or without visual change was visually triggered at 7.3 minutes (mean time) after visual stimulation began. In 5 of these patients, the onset of headache or visual change, or both, was preceded by suppression of initial activation (mean onset time, 4.3 minutes; P<.001) The suppression slowly propagated into contiguous occipital cortex at a rate ranging from 3 to 6 mm/ min. This neuronal suppression was accompanied by baseline contrast intensity increases that indicated vasodilatation and tissue hyperoxygenation. CONCLUSIONS: We conclude that visually triggered headache and visual change in patients with migraine is accompanied by spreading suppression of initial neuronal activation and increased occipital cortex oxygenation. We postulate that this spreading suppression may be associated with initial activation of a migraine attack, independent of whether there are associated aura symptoms. We further postulate that there may be an association between vasodilation accompanying the initial stage of suppression and the induction of headache.

片頭痛患者における視覚誘発頭痛発作の functional MRI

皮質拡延性抑制と片頭痛の病態について functional MRI を用いた研究．

Headache Research Center, Department of Neurology, Henry Ford Health Sciences Center, Case Western Reserve University, Detroit, Mich. 48202-2689, USA.

前兆のある片頭痛患者： 10名，前兆のない片頭痛患者：2名，健常者：6名

片頭痛患者の視覚刺激の初期において後頭様において組織の酸化が増加したが，前兆のある，なしには関係なかった．

皮質拡延性抑制と片頭痛の病態についての最新の研究．

視覚刺激で頭痛を誘発しているため本来の頭痛発作と同様のものかは疑問．

MeSH Terms:
• Adult
• Female
• Human
• Magnetic Resonance Imaging
• Male
• Migraine/physiopathology*
• Neurons, Afferent/physiology
• Occipital Lobe/blood supply*
• Occipital Lobe/pathology
• Oxygen/blood
• Regional Blood Flow
• Support , U.S. Gov't, P.H.S.
• Visual Perception/physiology*

Substances:
• Oxygen

Grant Support:
• P50 NS32399/NS/NINDS

濱田潤一，永田栄一郎

Cortical spreading depression (CSD) is a well-characterized phenomenon in experimental animals. Recent data show that CSD actually can occur in the injured human brain and compelling evidence is accumulating to support the concept that CSD is responsible for migraine aura. The aim of this review is to highlight recent key advances regarding our understanding of CSD in animal and human studies and its relevance to the pathophysiology of migraine and its potential treatment options.

皮質拡延性抑制：片頭痛病態における役割と可能な治療戦略

皮質拡延性抑制と片頭痛の病態についての研究．

Neurology and GI Centre of Excellence for Drug Discovery, New Frontiers Science Park , GlaxoSmithKline, Harlow , Essex CM19 5AW , UK .

皮質拡延性抑制と片頭痛の病態についての最新の研究．

濱田潤一，永田栄一郎

Perfusion- and diffusion-weighted magnetic resonance imaging was performed during spontaneous visual auras in four migraineurs. Alterations in relative cerebral blood flow (16-53% decrease), cerebral blood volume (6-33% decrease), and tissue mean transit time (10-54% increase) were observed in the gray matter of occipital cortex contralateral to the affected visual hemifield. No changes in the apparent diffusion coefficient were observed either while the patients were symptomatic or after resolution of the visual symptoms but before the onset of headache. Functional magnetic resonance imaging can be a useful noninvasive tool to study hemodynamic changes during spontaneous attacks of migraine with aura.

片頭痛患者の前兆期における拡散強調画像．

片頭痛患者の前兆期における拡散強調画像で脳血流の変化を検討．

Stroke and Neurovascular Regulation, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, USA.

前兆のある片頭痛患者： 4名．

片頭痛患者の前兆期において視覚異常をきたした側の対側の後頭葉において脳血流量が 16-53% 減少，脳血液含量が 6-33% 減少，組織 mean transient time が 10-54% 減少した．

片頭痛患者の前兆期の病態画像ということで貴重．

その後頭痛発作が起きたかどうかは不明．

Publication Types:
• Case Reports

MeSH Terms:
• Adult
• Blood Volume/physiology
• Cerebrovascular Circulation/physiology*
• Comparative Study
• Female
• Hemodynamic Processes/physiology
• Human
• Magnetic Resonance Imaging/methods*
• Male
• Middle Aged
• Migraine/diagnosis*
• Support, Non-U.S. Gov't
• Support , U.S. Gov't, P.H.S.
• Time Factors
• Vision Disorders/diagnosis*
• Vision Disorders/physiopathology*
• Visual Fields/physiology*

Grant Support:
• K08 NS 01803/NS/NINDS
• P01-CA48729/CA/NCI
• R01-CA40303/CA/NCI

濱田潤一，永田栄一郎

Using perfusion weighted imaging, we studied 28 spontaneous migraine episodes; 7 during visual aura (n = 6), 7 during the headache phase following visual aura (n = 3), and 14 cases of migraine without aura (n = 13). The data were analyzed using a region-of-interest-based approach. During aura, relative cerebral blood flow (rCBF) was significantly decreased (27% +/- 0.07) in occipital cortex contralateral to the affected hemifield. rCBV was decreased (15% +/- 0.12) and mean transit time increased (32% +/- 0.3), persisting up to 2.5 h into the headache phase. Other brain regions did not show significant perfusion changes. During migraine without aura, no significant hemodynamic changes were observed. In one patient who experienced both migraine with and without aura, perfusion deficits were observed only during migraine with aura. These findings suggest that decremental blood flow changes in occipital lobe are most characteristic of migraine with aura.

片頭痛患者の前兆期及び発作期における拡散強調画像．

片頭痛患者の前兆期及び発作期における拡散強調画像で脳血流の変化を検討．

Department of Neurology, Magnetic Resonance Center , Boston , MA , USA .

前兆のある片頭痛患者： 14名（内7名は視覚前兆期，7名は頭痛発作期．），前兆のない片頭痛患者：14名．

片頭痛患者の前兆期において視覚異常をきたした側の対側の後頭葉において脳血流量が 27% 減少，脳血液含量が 15% 減少，組織 mean transient time が 32% 減少した．また，頭痛発作が始まってから 2.5時間までこのような状態が続いた．前兆のない片頭痛患者では，このような変化は認められなかった．

片頭痛患者の前兆期及び発作期の病態画像ということで貴重．

他の文献では，前兆のない片頭痛でも脳血流変化を起こす報告が散見されており，それらの論文との整合性が必要．

Publication Types:
• Clinical Trial
• Controlled Clinical Trial

MeSH Terms:
• Adult
• Brain Mapping
• Cerebrovascular Circulation/physiology*
• Classic Migraine/diagnosis*
• Classic Migraine/physiopathology
• Common Migraine/diagnosis*
• Common Migraine/physiopathology
• Contrast Media
• Female
• Human
• Magnetic Resonance Imaging/methods*
• Male
• Middle Aged
• Occipital Lobe/pathology
• Occipital Lobe/physiopathology
• Perfusion
• Reproducibility of Results
• Support, Non-U.S. Gov't
• Support , U.S. Gov't, P.H.S.

Substances:
• Contrast Media

Grant Support:
• K08 NS 01803/NS/NINDS
• PO1-CA48729/CA/NCI
• R01-CA40303/CA/NCI
• etc.

濱田潤一，永田栄一郎

1) De Benedittis G, Ferrari Da Passano C, Granata G, Lorenzetti A. CBF 　 changes during headache-free periods and spontaneous/induced 　 attacks in migraine with and without aura: a TCD and SPECT 　 comparison study. Neurosurg Sci. 1999 Jun;43(2):141-6; discussion 　 146-7.
論文抄録	BACKGROUND: The aim of the present study was to compare cranial arteries blood flow velocity as measured by means of transcranial Doppler sonography (TCD) with mean regional cerebral blood flow (rCBF) as measured by means of single photon emission computed tomography (SPECT) in migraine with and without aura during headache-free periods and spontaneous and/or induced attacks. METHODS: Regional cerebral blood flow (rCBF) and systematic ultrasonic Doppler flow were studied by Technetium-99m hexamethylpropilaminoxime (99mTc-HM-PAO) single photon emission computed tomography (SPECT) and transcranial Doppler sonography (TCD) respectively in controls (n=14) and in migraine with (n=13) and without aura (n=35) during headache free-intervals and spontaneous/histamine-induced attacks. RESULTS: In the migraine without aura group, Doppler flow examinations of the common carotid artery, external and internal carotid artery, ophthalmic artery and middle cerebral artery bilaterally did not reveal significant changes as compared with controls. During attacks, TCD examinations showed a moderate, although not statistically significant, reduction of blood flow velocity in the middle cerebral artery and in the internal carotid artery bilaterally as related to the interictal phase, concomitant with an increase of the flow velocity in the ophthalmic and external carotid artery. SPECT of these patients did not show, on the average, rCBF asymmetries during pain-free periods, although positive findings (i.e., focal hypoperfusion) were found in approximately half of the cases. During attacks, 74% of patients displayed a unilateral hypoperfusion, mainly in the occipital region. Low-flow areas were generally but not always consistent with the site of pain. In the migraine with aura group, significant reduction of blood flow velocity in middle cerebral artery was recorded by TCD on the affected side during attacks, as compared with the pain-free side. Hypoperfusion was registered between attacks by SPECT in approximately 2/3 of the patients. During attacks, a marked reduction of rCBF occurred in most patients (85%), mainly in the parieto-occipital region. The posterior rCBF asymmetries revealed at the SPECT and consistent with the general reduction of blood flow velocity documented by TCD may be related to cerebrovascular tone instability. CONCLUSIONS: Our findings do not support the paradigm that migraine with and without aura are two different entities.
文献 PubMed−ID	PMID: 10735768
文献タイトル (日本語)	前兆を伴う及び伴わない片頭痛患者における発作間欠期の脳血流変化： TCD と SPECT の比較
目的	TCD と SPECT で片頭痛患者の発作間欠期で差があるかどうかの検討．
研究施設	Pain Research & Treatment Unit, Institute of Neurosurgery , University of Milan , Italy .
対象患者	健常人： 14 名，前兆を伴う片頭痛患者： 13 名，前兆を伴わない片頭痛患者： 35 名
備考	Publication Types: • Clinical Trial MeSH Terms: • Adult • Carotid Arteries/physiology • Cerebrovascular Circulation/physiology* • Classic Migraine/physiopathology* • Classic Migraine/radionuclide imaging • Classic Migraine/ultrasonography • Common Migraine/physiopathology* • Common Migraine/radionuclide imaging • Common Migraine/ultrasonography • Female • Human • Male • Radiopharmaceuticals/diagnostic use • Technetium Tc 99m Exametazime/diagnostic use • Tomography, Emission-Computed, Single-Photon Substances: • Radiopharmaceuticals • Technetium Tc 99m Exametazime
作成者	濱田潤一，永田栄一郎

2) Mirza M, Tutus A, Erdogan F, Kula M, Tomar A, Silov G, Koseoglu 　 E.Interictal SPECT with Tc-99m HMPAO studies in migraine patients. 　 Acta Neurol Belg. 1998 Jun;98(2):190-4.
論文抄録	Migraine is considered to be a functional neurological disorder. For several years cerebral blood flow studies have been fueling the controversy surrounding the pathophysiology of migraine headache. Tc-99m HMPAO SPECT brain imaging was performed during the headache-free period in 44 migraineurs. The findings were compared with those of age 17 and sex-matched controls. The SPECT analysis was performed by using a 360 degrees rotating single head gamma camera system (Toshiba GCA 602A/SA, Japan), equipped with a LEAP collimator, interfaced to a Toshiba computer system, after 20 minutes following the injection of 350-550 MBq of Tc-99m HMPAO. The SPECT images revealed clear interhemispheric asymmetry in the upper frontal and occipital parts of the brain in migraineurs. It is suggested that an impaired regional cerebral vascular autoregulation may exist even during headache-free intervals in patients suffering from migraine.
文献 PubMed−ID	PMID: 9686279
文献タイトル (日本語)	片頭痛患者における Tc-99m HMPAO を用いた SPECT の検討
目的	片頭痛患者の脳血流を Tc-99m HMPAO を用いた SPECT で検討した．
研究施設	Department of Neurology, University of Erciyes , Kayseri , Turkey .
対象患者	健常人： 17 名，片頭痛患者： 44 名
介入	片頭痛発作間欠期に測定．
結果	片頭痛患者において明らかに前頭部と後頭部において非対称性の血流分布を示した．
結論	片頭痛患者は発作間欠期でも局所脳血流に不均衡が存在する．
コメント	片頭痛の分類が明確でない．
備考	MeSH Terms: • Adolescent • Adult • Case-Control Studies • Cerebrovascular Circulation/physiology* • Female • Human • Male • Middle Aged • Migraine/radionuclide imaging* • Radiopharmaceuticals/diagnostic use* • Technetium Tc 99m Exametazime/diagnostic use* • Tomography, Emission-Computed, Single-Photon* Substances: • Radiopharmaceuticals • Technetium Tc 99m Exametazime
作成者	濱田潤一，永田栄一郎

3) Cao Y, Welch KM, Aurora S, Vikingstad EM. Functional MRI-BOLD of 　 visually triggered headache in patients with migraine. Arch Neurol. 1999 　 May;56(5):548-54.
論文抄録	BACKGROUND: Spreading depression of Leao has been hypothesized as the basis for the visual aura of the migraine attack, supported by cerebral blood flow measurements of spreading hypoperfusion. The early depolarizing or activation phase of experimental spreading depression, however, is associated with a transient but pronounced cerebral blood flow increase that precedes spreading hypoperfusion. OBJECTIVE: To study this early phase of the migraine attack, we investigated visually triggered attacks of headache and visual symptoms using a red-green checkerboard stimulus in patients with migraine. INTERVENTIONS: We studied occipital cortex activation during visual stimulation by measuring occipital cortex perfusion with functional magnetic resonance imaging-blood oxygenation level-dependent contrast in 10 patients with migraine with aura and 2 patients with migraine without aura and 6 healthy subjects. RESULTS: In 6 patients with migraine with aura and 2 patients with migraine without aura, their typical headache with (n = 2) or without visual change was visually triggered at 7.3 minutes (mean time) after visual stimulation began. In 5 of these patients, the onset of headache or visual change, or both, was preceded by suppression of initial activation (mean onset time, 4.3 minutes; P<.001) The suppression slowly propagated into contiguous occipital cortex at a rate ranging from 3 to 6 mm/ min. This neuronal suppression was accompanied by baseline contrast intensity increases that indicated vasodilatation and tissue hyperoxygenation. CONCLUSIONS: We conclude that visually triggered headache and visual change in patients with migraine is accompanied by spreading suppression of initial neuronal activation and increased occipital cortex oxygenation. We postulate that this spreading suppression may be associated with initial activation of a migraine attack, independent of whether there are associated aura symptoms. We further postulate that there may be an association between vasodilation accompanying the initial stage of suppression and the induction of headache.
文献 PubMed−ID	PMID: 10328249
文献タイトル (日本語)	片頭痛患者における視覚誘発頭痛発作の functional MRI
目的	皮質拡延性抑制と片頭痛の病態について functional MRI を用いた研究．
研究施設	Headache Research Center, Department of Neurology, Henry Ford Health Sciences Center, Case Western Reserve University, Detroit, Mich. 48202-2689, USA.
対象患者	前兆のある片頭痛患者： 10名，前兆のない片頭痛患者：2名，健常者：6名
結果	片頭痛患者の視覚刺激の初期において後頭様において組織の酸化が増加したが，前兆のある，なしには関係なかった．
結論	皮質拡延性抑制は片頭痛の初期興奮のときに関係しているのだろうという結論．
コメント -1	皮質拡延性抑制と片頭痛の病態についての最新の研究．
コメント -2	視覚刺激で頭痛を誘発しているため本来の頭痛発作と同様のものかは疑問．
備考	MeSH Terms: • Adult • Female • Human • Magnetic Resonance Imaging • Male • Migraine/physiopathology* • Neurons, Afferent/physiology • Occipital Lobe/blood supply* • Occipital Lobe/pathology • Oxygen/blood • Regional Blood Flow • Support , U.S. Gov't, P.H.S. • Visual Perception/physiology* Substances: • Oxygen Grant Support: • P50 NS32399/NS/NINDS
作成者	濱田潤一，永田栄一郎

5) Cutrer FM, Sorensen AG, Weisskoff RM, Ostergaard L, Sanchez del Rio 　 M, Lee EJ, Rosen BR, Moskowitz MA. Perfusion-weighted imaging 　 defects during spontaneous migrainous aura. Ann Neurol. 1998 　 Jan;43(1):25-31.
論文抄録	Perfusion- and diffusion-weighted magnetic resonance imaging was performed during spontaneous visual auras in four migraineurs. Alterations in relative cerebral blood flow (16-53% decrease), cerebral blood volume (6-33% decrease), and tissue mean transit time (10-54% increase) were observed in the gray matter of occipital cortex contralateral to the affected visual hemifield. No changes in the apparent diffusion coefficient were observed either while the patients were symptomatic or after resolution of the visual symptoms but before the onset of headache. Functional magnetic resonance imaging can be a useful noninvasive tool to study hemodynamic changes during spontaneous attacks of migraine with aura.
文献 PubMed−ID	PMID: 10328249
文献タイトル (日本語)	片頭痛患者の前兆期における拡散強調画像．
目的	片頭痛患者の前兆期における拡散強調画像で脳血流の変化を検討．
研究施設	Stroke and Neurovascular Regulation, Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Charlestown 02129, USA.
対象患者	前兆のある片頭痛患者： 4名．
結果	片頭痛患者の前兆期において視覚異常をきたした側の対側の後頭葉において脳血流量が 16-53% 減少，脳血液含量が 6-33% 減少，組織 mean transient time が 10-54% 減少した．
結論	拡散強調画像は片頭痛の前兆期の脳血流を観察するには，非侵襲的であり有用である．
コメント -1	片頭痛患者の前兆期の病態画像ということで貴重．
コメント -2	その後頭痛発作が起きたかどうかは不明．
備考	Publication Types: • Case Reports MeSH Terms: • Adult • Blood Volume/physiology • Cerebrovascular Circulation/physiology* • Comparative Study • Female • Hemodynamic Processes/physiology • Human • Magnetic Resonance Imaging/methods* • Male • Middle Aged • Migraine/diagnosis* • Support, Non-U.S. Gov't • Support , U.S. Gov't, P.H.S. • Time Factors • Vision Disorders/diagnosis* • Vision Disorders/physiopathology* • Visual Fields/physiology* Grant Support: • K08 NS 01803/NS/NINDS • P01-CA48729/CA/NCI • R01-CA40303/CA/NCI
作成者	濱田潤一，永田栄一郎

6) Sanchez del Rio M, Bakker D, Wu O, Agosti R, Mitsikostas DD, 　 Ostergaard L, Wells WA, Rosen BR, Sorensen G, Moskowitz MA, Cutrer 　 FM. Perfusion weighted imaging during migraine: spontaneous visual 　 aura and headache. Cephalalgia. 1999 Oct;19(8):701-7.
論文抄録	Using perfusion weighted imaging, we studied 28 spontaneous migraine episodes; 7 during visual aura (n = 6), 7 during the headache phase following visual aura (n = 3), and 14 cases of migraine without aura (n = 13). The data were analyzed using a region-of-interest-based approach. During aura, relative cerebral blood flow (rCBF) was significantly decreased (27% +/- 0.07) in occipital cortex contralateral to the affected hemifield. rCBV was decreased (15% +/- 0.12) and mean transit time increased (32% +/- 0.3), persisting up to 2.5 h into the headache phase. Other brain regions did not show significant perfusion changes. During migraine without aura, no significant hemodynamic changes were observed. In one patient who experienced both migraine with and without aura, perfusion deficits were observed only during migraine with aura. These findings suggest that decremental blood flow changes in occipital lobe are most characteristic of migraine with aura.
文献 PubMed−ID	PMID: 10570723
文献タイトル (日本語)	片頭痛患者の前兆期及び発作期における拡散強調画像．
目的	片頭痛患者の前兆期及び発作期における拡散強調画像で脳血流の変化を検討．
研究施設	Department of Neurology, Magnetic Resonance Center , Boston , MA , USA .
対象患者	前兆のある片頭痛患者： 14名（内7名は視覚前兆期，7名は頭痛発作期．），前兆のない片頭痛患者：14名．
結果	片頭痛患者の前兆期において視覚異常をきたした側の対側の後頭葉において脳血流量が 27% 減少，脳血液含量が 15% 減少，組織 mean transient time が 32% 減少した．また，頭痛発作が始まってから 2.5時間までこのような状態が続いた．前兆のない片頭痛患者では，このような変化は認められなかった．
結論	前兆のある片頭痛患者では後頭葉の血流変化が特徴的である．
コメント -1	片頭痛患者の前兆期及び発作期の病態画像ということで貴重．
コメント -2	他の文献では，前兆のない片頭痛でも脳血流変化を起こす報告が散見されており，それらの論文との整合性が必要．
備考	Publication Types: • Clinical Trial • Controlled Clinical Trial MeSH Terms: • Adult • Brain Mapping • Cerebrovascular Circulation/physiology* • Classic Migraine/diagnosis* • Classic Migraine/physiopathology • Common Migraine/diagnosis* • Common Migraine/physiopathology • Contrast Media • Female • Human • Magnetic Resonance Imaging/methods* • Male • Middle Aged • Occipital Lobe/pathology • Occipital Lobe/physiopathology • Perfusion • Reproducibility of Results • Support, Non-U.S. Gov't • Support , U.S. Gov't, P.H.S. Substances: • Contrast Media Grant Support: • K08 NS 01803/NS/NINDS • PO1-CA48729/CA/NCI • R01-CA40303/CA/NCI • etc.
作成者	濱田潤一，永田栄一郎

4) Parsons AA. Cortical spreading depression: its role in migraine 　 pathogenesis and possible therapeutic intervention strategies. Curr Pain 　 Headache Rep. 2004 Oct;8(5):410-6.
論文抄録	Cortical spreading depression (CSD) is a well-characterized phenomenon in experimental animals. Recent data show that CSD actually can occur in the injured human brain and compelling evidence is accumulating to support the concept that CSD is responsible for migraine aura. The aim of this review is to highlight recent key advances regarding our understanding of CSD in animal and human studies and its relevance to the pathophysiology of migraine and its potential treatment options.
文献 PubMed−ID	PMID: 15361327
文献タイトル (日本語)	皮質拡延性抑制：片頭痛病態における役割と可能な治療戦略
目的	皮質拡延性抑制と片頭痛の病態についての研究．
研究施設	Neurology and GI Centre of Excellence for Drug Discovery, New Frontiers Science Park , GlaxoSmithKline, Harlow , Essex CM19 5AW , UK .
コメント	皮質拡延性抑制と片頭痛の病態についての最新の研究．
作成者	濱田潤一，永田栄一郎