Hypothalamic dopaminergic stimulation in cluster headache

Lepper, Anne; Frese, A.; Summ, Oliver; Nofer, Jerzy–Roch; Evers, Stefan

doi:10.1177/0333102413487445

Cited by 15 publications

(25 citation statements)

References 22 publications

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“…First, KD can induce an increase in brain dopaminergic activity, as measured in the meso-cortical dopaminergic system of mice ( 6 ). This datum is relevant to our study because it is known that CH is associated with impaired dopaminergic stimulation ( 7 ). Nonetheless, in a previous report about a drug-resistant chronic patient, we observed that treatment with a dopaminergic agonist improved CH and reverted his trigeminal neurophysiological abnormalities ( 8 ), typical of the active phase of cluster ( 9 ).…”

Section: Discussionmentioning

confidence: 98%

Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial

et al. 2018

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IntroductionDrug-resistant cluster headache (CH) is still an open clinical challenge. Recently, our group observed the clinical efficacy of a ketogenic diet (KD), usually adopted to treat drug-resistant epilepsies, on migraine.AimHere, we aim to detect the effect of KD in a group of drug-resistant chronic CH (CCH) patients.Materials and methodsEighteen drug-resistant CCH patients underwent a 12-week KD (Modified Atkins Diet, MAD), and the clinical response was evaluated in terms of response (≥50% attack reduction).ResultsOf the 18 CCH patients, 15 were considered responders to the diet (11 experienced a full resolution of headache, and 4 had a headache reduction of at least 50% in terms of mean monthly number of attacks during the diet). The mean monthly number of attacks for each patient at the baseline was 108.71 (SD = 81.71); at the end of the third month of diet, it was reduced to 31.44 (SD = 84.61).ConclusionWe observed for the first time that a 3-month ketogenesis ameliorates clinical features of CCH.Clinical Trial Registration, identifier NCT03244735.

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Section: Discussionmentioning

confidence: 98%

Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial

et al. 2018

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“…Moreover, rotigotine is generally well tolerated even if the duration of treatment lasts up to 6 years, without serious adverse side-effects (the most common of which are somnolence, falls, peripheral oedema, nausea and reactions at the application site). 12,13 So far, a possible relationship between CH and the dopaminergic system is under scrutiny, although CH is associated with impaired dopaminergic stimulation, 14 whereas dopamine inhibits the nociception in the trigeminovascular transmission in animals. 15 Moreover, it is known that the dopaminergic system is strictly involved with pain modulation 16 and its chronification.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of transdermal rotigotine in chronic cluster headache: A case series

Lorenzo

Pellesi

Parisi

et al. 2018

Cephalalgia Reports

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Cluster headache (CH) is one of the most severe forms of headache, but the number of effective treatments is still limited. Recently, we reported the case of a drug-resistant CH patient responsive to the rotigotine transdermal patch, which is used in the treatment of Parkinson's disease. This report formed the basis for a case series where other drug-resistant CH patients were treated with rotigotine. Here are the results of this study. Twenty-two CH patients underwent the treatment. Eight were episodic cluster headache (ECH) patients and 14 were chronic cluster headache (CCH) patients. Of the eight ECH patients, four reported that their CH had been stopped by the treatment. Of the 14 CCH patients, 11 were considered responders to the treatment (5 experienced a full resolution of headache, and 6 had a headache reduction of at least 50% in terms of mean monthly number of attacks). Our case series confirms the previous observation that rotigotine could be helpful in the treatment of CH. It may even influence the monoaminergic system that has a key role in the pathogenesis of CH.

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“…VIP and AVP are peptides found in a large proportion of SCN neurons: VIP‐positive neurons are primarily found in the core area of the SCN, and AVP‐positive neurons are found in the shell area . Preliminary studies also suggest cluster headache‐associated changes in other molecules indirectly modulated by the SCN, including PACAP, orexin, orexin receptors, testosterone, prolactin and growth hormone …”

Section: Circadian Rhythms In Painmentioning

confidence: 99%

“…20 Preliminary studies also suggest cluster headache-associated changes in other molecules indirectly modulated by the SCN, including PACAP, orexin, orexin receptors, testosterone, prolactin and growth hormone. [76][77][78][79][80][81][82] Although earlier attempts did not identify a molecular association of clock genes with cluster headache, [83][84][85] more recent studies elucidated changes in circadian transcriptiontranslation feedback loops. In an association study of large Swedish cohorts, a single-nucleotide polymorphism (SNP: rs12649507) in the Clock gene was found to be significantly associated with cluster headache.…”

Section: Cluster Headachementioning

confidence: 99%

Emerging relevance of circadian rhythms in headaches and neuropathic pain

2018

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Circadian rhythms of physiology are the keys to health and fitness, as dysregulation, by genetic mutations or environmental factors, increases disease risk and aggravates progression. Molecular and physiological studies have shed important light on an intrinsic clock that drives circadian rhythms and serves essential roles in metabolic homoeostasis, organ physiology and brain functions. One exciting new area in circadian research is pain, including headache and neuropathic pain for which new mechanistic insights have recently emerged. For example, cluster headache is an intermittent pain disorder with an exceedingly precise circadian timing, and preliminary evidence is emerging linking several circadian components (eg, Clock and Nr1d1) with the disease. In this review, we first discuss the broad metabolic and physiological relevance of the circadian timing system. We then provide a detailed review of the circadian relevance in pain disease and physiology, including cluster headache, migraine, hypnic headache and neuropathic pain. Finally, we describe potential therapeutic implications, including existing pain medicines and novel clock-modulating compounds. The physiological basis for the circadian rhythms in pain is an exciting new area of research with profound basic and translational impact.

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Hypothalamic dopaminergic stimulation in cluster headache

Cited by 15 publications

References 22 publications

Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial

Efficacy of Modified Atkins Ketogenic Diet in Chronic Cluster Headache: An Open-Label, Single-Arm, Clinical Trial

Efficacy of transdermal rotigotine in chronic cluster headache: A case series

Emerging relevance of circadian rhythms in headaches and neuropathic pain

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