neurojourНеврологический журнал имени Л.О. БадалянаL.O. Badalyan Neurological Journal2686-89972712-794XФГАУ «НМИЦ здоровья детей» Минздрава России10.46563/2686-8997-2022-3-1-35-41neurojour-59Research ArticleЛЕКЦИИLECTURESРоль перинатальных факторов в генезе первичных головных болей у детей и взрослыхThe role of perinatal factors in the development of primary headaches in childrenhttps://orcid.org/0000-0002-4276-8400НестеровскийЮрий ЕвгеньевичNesterovskiyYuriy E.

Доцент кафедры неврологии, нейрохирургии и медицинской генетики им. академика Л.О. Бадаляна педиатрического факультета ФГАОУ ВО РНИМУ им. Н.И. Пирогова Минздрава России.

e-mail: yenest@bk.ru

Assistant professor, Neurology, Neurosurgery and Medical Genetics Department named after academician L.O. Badalian, Faculty of Pediatrics, N.I. Pirogov Russian National Research Medical University, Moscow, 125412, Russian Federation.

e-mail: yenest@bk.ru

yenest@bk.ruhttps://orcid.org/0000-0002-8104-0068ШипиловаЕ. М.ShypilovaElena M.noemail@neicon.ruhttps://orcid.org/0000-0003-0103-7422ЗаваденкоН. Н.ZavadenkoNikolay N.noemail@neicon.ruФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н.И. Пирогова» Минздрава РоссииРоссияN.I. Pirogov Russian National Research Medical UniversityRussian Federation202208042022313541Copyright © Нестеровский Ю.Е., Шипилова Е.М., Заваденко Н.Н., 20222022Нестеровский Ю.Е., Шипилова Е.М., Заваденко Н.Н.Nesterovskiy Y.E., Shypilova E.M., Zavadenko N.N.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.neuro-journal.ru/jour/article/view/59

Как у детей, так и у взрослых мигрень и головная боль напряжения (ГБН) являются наиболее часто встречающимися первичными головными болями, ими страдают около 15% и 21% населения мира соответственно. В генезе первичных головных болей (ПГБ) традиционно рассматривается роль генетических, социально-психологических, гормональных факторов. Очевидно, что в формировании патофизиологической основы ПГБ участвуют нейробиологические факторы (раннее повреждение центральной нервной системы, генетическая предрасположенность), которые взаимодействуют с комплексом других факторов, в том числе внешних (социально-психологических), приводя к изменениям механизмов боли как на периферическом, так и на центральном уровнях.

В статье представлены современные данные о влиянии пре- и перинатальных факторов на риск развития ПГБ. Анализируются факторы риска развития мигрени у детей и взрослых: задержка внутриутробного развития, курение и употребление алкоголя матерями во время беременности. Рассматривается связь между проявлениями повышенной возбудимости у детей в первые 6 мес и развитием ПГБ в последующие периоды жизни. Приводятся данные сопоставления результатов оценки раннего анамнеза в клинических группах пациентов с частыми эпизодическими и хроническими ГБН. Рассматриваются возможные механизмы функциональных нарушений нервной системы, приводящие к возникновению ПГБ.

Необходимо продолжение исследований, посвящённых роли перинатальных факторов в генезе ПГБ, для уточнения прогноза в отношении возможной хронизации болевых синдромов, а также разработки дифференцированных подходов к выбору тактики лечения пациентов.

In both children and adult patients, migraine and tension type headache (TTH) are the most common primary headaches, they affect about 15% and 21% of the world’s population, respectively. The role of genetic, psychosocial, hormonal factors is traditionally considered in the genesis of primary headaches. Obviously, neurobiological factors including early brain damage, genetic predisposition are involved in the formation of the pathophysiological basis of primary headaches, which interact with a complex of other factors, including external (psychosocial) factors, leading to changes in the pain mechanisms both at the peripheral and central levels.

The literature review presents up-to-date data on the influence of pre- and perinatal factors on the risk of developing primary headaches. Intrauterine growth retardation, smoking and alcohol consumption by mothers during pregnancy are analyzed as risk factors for the development of migraine in children. The connection between the manifestations of increased neuroexcitability in children in the first 6 months with the development of primary headaches in subsequent periods of life is considered.

The data of comparison of the results of the assessment of early anamnesis in clinical groups of patients with frequent episodic and chronic TTH are presented.

The review examines the possible mechanisms of functional disorders of the nervous system that lead to the occurrence of primary headaches in the future.

It is necessary to continue research on the role of perinatal factors in the genesis of primary headaches, to clarify the prognosis regarding the possible chronization of pain syndromes and develop differentiated approaches to the treatment tactics for these patients.

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The authors declare that there are no conflicts of interest present.