Functional magnetic resonance imaging in episodic cluster headache

Abstract

We have investigated the cerebral activation centre in four patients with episodic cluster headache (CH) with functional magnetic resonance imaging (f-MRI). The patients underwent MRI scans for anatomical and functional data acquisition in the asymptomatic state, during a headache attack and after subcutaneous administration of sumatriptan. Anatomical images were acquired by means of 3D-MPRAGE sequences and f-MRI images were obtained by means of echo-planar imaging. Data was analysed using the BrainVoyager QX version 1.7.81 software package. In all patients, the data showed significant hypothalamic activation of the hypothalamus ipsilateral to the pain side, attributable to a headache attack. Overall, we have demonstrated the anatomical location of central nervous system activation by means the first f-MRI study in CH patients. f-MRI offers a good balance of spatial and temporal resolution, and this method of study appears appropriate for investigating the pathogenetic aspects of primary headaches. Positron emission tomography and f-MRI may be regarded as little or no importance in a clinical context, they do, however, offer great potential for the exploration of headache physiopathology and the effects of pharmacological treatment.

Neurostimulation in cluster headache: A review of current progress

“…Neuroimaging has suggested an abnormal or dysfunctional posterior hypothalamus as being central (12)(13)(14)(15). Clinical observations regarding the circadian and circannual symptomatology also point to pathology in the hypothalamus, especially the suprachiasmatic nucleus (SCN) (16,17).…”

Cortical processing of facial tactile stimuli in temporomandibular disorder as revealed by magnetoencephalography

“…Interestingly, these structural changes, which correlated with the pain duration, age-at-onset, pain intensity, and cortical activity were frequently co-localized and correlated with functional allodynic SI and SII activations documented by fMRI, and they may be speciWc targets for evaluating therapeutic interventions (DaSilva et al 2008). Finally, investigation of the cerebral activation in cluster headache before, during and after an attack, showed signiWcant hypothalamic activation of the hypothalamus ipsilateral to the pain side (DaSilva et al 2007;Morelli et al 2008). …”

“…Several functional neuroimaging studies have been performed to investigate cortical function in patients suVering from orofacial pain, including positron emission tomography (PET) (Derbyshire et al 1994;Hagelberg et al 2003;Kupers et al 2000Kupers et al , 2004 and functional magnetic resonance imaging (fMRI) Blatow et al 2009;Borsook et al 2003;DaSilva et al 2007DaSilva et al , 2008de Leeuw et al 2005de Leeuw et al , 2006Jantsch et al 2005;Jiang et al 2006;Morelli et al 2008;Nash et al 2007). It has been found that SI and SII participate in the perception of sensory features of pain, together with other cortical areas (Apkarian et al 2005;Bushnell et al 1999).…”

Macro- and microstructural alterations in migraine and cluster headache

“…Functional and structural studies on cluster headache found activation and gray matter changes in the contralateral side of the pain [140][141][142][143]. Similar lateralisation of the white matter microstructural alterations were found in our investigation.…”