颈交感神经对血管源性头痛痛觉传导的影响

The role of the sympathetic nervous system in the pain transmission of vascular headache

目的采用电刺激大鼠上矢状窦(SSS)区硬脑膜,观察颈上交感神经节(SCG)摘除术前后在延髓和上颈段三叉神经脊束核一氧化氮合酶(NOS)阳性神经元数目的变化,以探讨交感神经系统在血管源性头痛(如偏头痛)涉及的伤害觉信息传递中的作用。方法以雄性SD大鼠(体重为220～250g)为实验对象,行颈上交感神经节摘除术后再手术暴露其SSS,然后电刺激SSS区硬脑膜,应用免疫组织化学染色技术,观察延髓和上颈段三叉神经脊束核NOS表达的变化。结果NOS免疫反应阳性神经元主要分布在三叉神经脊束核和上颈段脊髓的第Ⅰ、Ⅱ板层,双侧对称。假手术对照组、SCG摘除组每张切片的NOS阳性神经元数分别为150.2±10.3、223.0±11.6,SCG摘除组NOS阳性神经元数目较假手术对照组明显增加(P<0.05)。结论颈交感神经系统参与了头部血管源性疼痛(如偏头痛)中伤害性感觉信息导致的疼痛的产生、传导及调节过程。

Objective To investigate the sympathetic nervous system potentially involved in the transmission of nociceptive information related to vascular headache such as migraine, and to observe the NOS expression in the spinal nucleus of trigeminal nerve induced by electrical stimulation of dural matter near the superior sagittal sinus （SSS） of the rat before and after the extirpation of the superior cervical ganglion （SCG） respectively. Methods The rats were prepared by extirpation of SCG and exposure of SSS. The dura mater near the SSS was stimulated and NOS was detected in coronal brain sections using standard avidin-biotin immunohistochemistry. Results NOS positive neurons were observed bilaterally symmetrical in the layers Ⅰ-Ⅱ of spinal nucleus of trigeminal nerve and the upper cervical spinal cord. NOS expression remarkably increased to 223.0±11.6 in SCG extirpated group, compared with 150.2±10.3 in sham-operated group （P〈0.05）. Conclusion The sympathetic nervous system may be involved in the generation and modulation of pain in vascular headache such as migraine.