r-n-jРоссийский неврологический журналRussian neurological journal2658-79472686-7192МИА10.30629/2658-7947-2022-27-2-22-33r-n-j-294Research ArticleОБЗОРЫREVIEWSСовременные представления о патогенезе головной боли напряжения и о механизмах развития фенотипа «головная боль напряжения и артериальная гипертония»Modern concepts about pathogenesis of the tension-type headache and mechanisms of development of the tension-type headache and arterial hypertension phenotypehttps://orcid.org/0000-0002-8833-1052МоскалеваП. В.MoskalevaP. V.

Москалева Полина Викторовна – аспирант центра коллективного пользования «Молекулярные и клеточные технологии»

Красноярск

Polina V. Moskaleva – post graduate student of the Collective Use Center «Molecular and cellular technologies»

Krasnoyarsk

Polina-Moscaleva@yandex.ruhttps://orcid.org/0000-0002-6164-1659ХрамченкоМ. А.KhramchenkoM. A.

Красноярск

Krasnoyarsk

clery6796.ru@mail.ruhttps://orcid.org/0000-0002-9058-8818КарпенковаА. Д.KarpenkovaA. D.

Красноярск

Krasnoyarsk

pobejdaujay@mail.ruhttps://orcid.org/0000-0002-8493-0058ПетроваМ. М.PetrovaM. M.

Красноярск

Krasnoyarsk

stk99@yandex.ruhttps://orcid.org/0000-0002-2840-837XШнайдерН. А.ShnayderN. A.

Красноярск; Санкт-Петербург

Krasnoyarsk; Saint Petersburg

naschnaider@yandex.ruКрасноярский государственный медицинский университет имени профессора В.Ф. Войно-ЯсенецкогоРоссияProfessor V.F. Voino-Yasenetsky Krasnoyarsk State Medical UniversityRussian FederationКрасноярский государственный медицинский университет имени профессора В.Ф. Войно-Ясенецкого; Национальный медицинский исследовательский центр психиатрии и неврологии имени В.М. БехтереваРоссияProfessor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University; V.M. Bekhterev National Medical Research Center of Psychiatry and NeurologyRussian Federation2022130520222722233Copyright © Москалева П.В., Храмченко М.А., Карпенкова А.Д., Петрова М.М., Шнайдер Н.А., 20222022Москалева П.В., Храмченко М.А., Карпенкова А.Д., Петрова М.М., Шнайдер Н.А.Moskaleva P.V., Khramchenko M.A., Karpenkova A.D., Petrova M.M., Shnayder N.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.r-n-j.com/jour/article/view/294

Целью обзора явился анализ отечественных и зарубежных публикаций, отражающих основные существующие на сегодняшний день теории развития головной боли напряжения (ГБН) и поиск общих с артериальной гипертонией (АГ) патогенетических звеньев как потенциальных триггеров развития клинического фенотипа «ГБН и АГ».

Материал и методы

Материал и методы: проведен поиск статей в базах данных (eLibrary.ru, Web of Science, Scopus, PubMed, Clinical Case) по ключевым словам. Глубина поиска – 2006–2021 гг.

Результаты

Результаты. Проведенный анализ позволил выделить ведущие патогенетические теории развития ГБН, так или иначе нашедшие отражение в публикациях последних лет: психогенную, сосудистую, миофасциальную, биохимическую и неврогенную. В то же время описана нейробиологическая теория, которая объединяет некоторые механизмы ранее изученных патогенетических теорий ГБН. Кроме того, выделены наиболее важные с клинической точки зрения механизмы коморбидности ГБН и АГ, лежащие в основе формирования фенотипа «ГБН и АГ». В последние годы представляет научный интерес изучение роли оксида азота (NO) и NO-синтаз, поскольку они играют важную роль не только в развитии коморбидности двух параллельно существующих у одного пациента заболеваний (фенотипа «ГБН и АГ»), но и в модуляции ответа на препараты для лечения ГБН и АГ. Модуляторы NO и NO-синтаз, которые разрабатываются в последние годы, могут улучшить эффективность и безопасность терапии рассматриваемых заболеваний, составляющих фенотип.

Заключение

Заключение. Новые подходы к прогнозированию и болезнь-модифицирующей терапии фенотипа «ГБН + АГ» могут увеличить эффективность и безопасность лечения и улучшить качество жизни пациентов, уменьшить риск сердечно-сосудистых осложнений.

The aim of this review was to analyze domestic and foreign publications reflecting the main existing theories of tension-type headache (TTH) development and the search for common pathogenetic links of TTH with arterial hypertension (AH) as potential triggers for the development of the clinical TTH and AH phenotype.

Methods

Methods. We searched for articles in databases (eLibrary.ru, Web of Science, Scopus, PubMed, Clinical Case) by keywords. Search depth – 2006–2021.

Results

Results. The analysis allowed us to identify the leading theories underlying the development of TTH: psychogenic, vascular, myofascial, biochemical and neurogenic. At the same time, a neurobiological theory has been considered: it combines some of the mechanisms of previously studied pathogenetic theories of TTH. In addition, there are the most important (from the clinical point of view) mechanisms of the comorbidity of TTH and AH, which underlie the development of the TTH + AH phenotype. In terms of these mechanisms, in recent years, it is of scientific interest to study the role of nitric oxide (NO) and NO-synthases, since they play an important role not only in the development of the comorbidity of two diseases simultaneously existing in one patient (phenotype «TTH and AH», but also in modulating the response to drugs for the treatment of TTH and AH. Modulators of NO and NO-synthases, which have been developed in recent years, can improve the efficacy and safety of therapy for this phenotype.

Conclusion

Conclusion. New approaches to predicting and disease-modifying therapy of the TTH and AH phenotype can increase the efficiency and safety of treatment, and improve the quality of life of patients, and reduce the risk of cardiovascular complications.

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