偏头痛与扩大的血管周围间隙之间的关系

The Relationship between Migraine and Enlarged Perivascular Spaces

偏头痛(Migraine)是一种原发性、终身性神经系统疾病,其反复发作可能与脑小血管病(Cerebral Small Vessel Disease, CSVD)有关。偏头痛缺乏特异影像学特征,由偏头痛引起的脑小血管病的特征在磁共振上可能表现为无症状腔隙性梗死(LIs)、脑白质病变(WMLs)、血管周围间隙扩大(Enlarged Perivascular Spaces, EPVS)和脑微出血(CMBs)。目前已有越来越多的研究探讨了偏头痛与血管周围间隙扩大之间的关系。胶质淋巴系统(Glymphatic System, GS)是近年来神经科学领域的新方向,是脑内代谢废物清除的重要途径,其与偏头痛之间的关系的研究也日渐增多,而血管周围间隙(Perivascular Spaces, PVS)可作为GS发挥作用的重要环节之一。本综述总结了GS、EPVS的形成机制以及二者与偏头痛之间的相关关系,以期临床上对GS、EPVS以及偏头痛有更多的关注及研究,为偏头痛的诊断、预防及治疗提供新思路。Migraine is a primary, lifespan neurological disorder with recurrent attacks that may be associated with Cerebral Small Vessel Disease (CSVD). Migraine lacks specific neuroimaging findings, and CSVD caused by migraine may be characterized by silent Lacunar Infarcts (LIs), White-Matter Lesions (WMLs), Enlarged Perivascular Spaces (EPVS) and Cerebral Microbleeds (CMBs) on magnetic resonance. There is growing evidence to shed light on the relevant relationship between EPVS and migraine. Recently, Glymphatic System (GS), a new direction in neuroscience, is an important pathway for the removal of metabolic wastes from the brain, and a growing number of studies have explored the relationship between GS and migraine. Meanwhile, the Perivascular Spaces (PVS) can be one of the important links in the role of GS. This review summarizes the formation mechanism of GS and EPVS and the potential correlation between them and migraine, aims to have more clinical attention and research on GS, EPVS, and migraine and provide new ideas for the diagnosis, prevention, and treatment of migraine.