The electrophysiology of cluster headache

Holle, Dagny; Obermann, Mark; Katsarava, Zaza

doi:10.1007/s11916-009-0026-9

Cited by 11 publications

(2 citation statements)

References 40 publications

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“…The trigeminal system has been broadly implicated in generating pain in different headache disorders, but the causative factors that may sensitize and/or disinhibit the trigeminal pathway may differ across conditions. Several studies have demonstrated that there is an interaction between pain mediated by the trigeminal system and photophobia.…”

Section: Photophobia In Headache Disordersmentioning

confidence: 99%

Photophobia in Primary Headaches

Rossi

Recober

2015

Headache

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Background Photophobia is a debilitating feature of many headache disorders. Overview Clinical and preclinical research has identified several potential pathways involved in enhanced light sensitivity. Some of these structures include trigeminal afferents in the eye, second order neurons in the trigeminal nucleus caudalis, third order neurons in the posterior thalamus, modulatory neurons in the hypothalamus, and fourth order neurons in the visual and somatosensory cortices. It is unclear to what degree each site plays a role in establishing the different temporal patterns of photophobia across different disorders. Peptides such as calcitonin-gene related peptide and pituitary adenylate cyclase-activating polypeptide may play a role in photophobia at multiple levels of the visual and trigeminal pathways. Conclusion While our understanding of photophobia has greatly improved in the last decade, there are still unanswered questions. These answers will help us develop new therapies to provide relief to patients with primary headache disorders.

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Section: Photophobia In Headache Disordersmentioning

confidence: 99%

Photophobia in Primary Headaches

Rossi

Recober

2015

Headache

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“…In addition to having a significant impact on patients’ daily life due to pain and disability, the socioeconomic burden of headaches are considerable, with a cumulative burden of $14 billion per year (3). Although the pathophysiological mechanisms involved remain partially elusive, chronic headache is believed to have a neurogenic basis (4–11). For example, a recent fMRI study showed that areas within the hypothalamus and brainstem, including the trigeminal system, were involved in mediating migraine (12).…”

Section: Introductionmentioning

confidence: 99%

Vagus nerve stimulation for primary headache disorders: An anatomical review to explain a clinical phenomenon

et al. 2019

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Background Non-invasive stimulation of the vagus nerve has been proposed as a new neuromodulation therapy to treat primary headache disorders, as the vagus nerve is hypothesized to modulate the headache pain pathways in the brain. Vagus nerve stimulation can be performed by placing an electrode on the ear to stimulate the tragus nerve, which contains about 1% of the vagus fibers. Non-invasive vagus nerve stimulation (nVNS) conventionally refers to stimulation of the cervical branch of the vagus nerve, which is made up entirely of vagal nerve fibers. While used interchangeably, most of the research to date has been performed with nVNS or an implanted vagus nerve stimulation device. However, the exact mechanism of action of nVNS remains hypothetical and no clear overview of the effectiveness of nVNS in primary headache disorders is available. Methods In the present study, the clinical trials that investigated the effectiveness, tolerability and safety of nVNS in primary headache disorders were systematically reviewed. The second part of this study reviewed the central connections of the vagus nerve. Papers on the clinical use of nVNS and the anatomical investigations were included based on predefined criteria, evaluated, and results were reported in a narrative way. Results The first part of this review shows that nVNS in primary headache disorders is moderately effective, safe and well-tolerated. Regarding the anatomical review, it was reported that fibers from the vagus nerve intertwine with fibers from the trigeminal, facial, glossopharyngeal and hypoglossal nerves, mostly in the trigeminal spinal tract. Second, the four nuclei of the vagus nerve (nuclei of the solitary tract, nucleus ambiguus, spinal nucleus of the trigeminal nerve and dorsal motor nucleus (DMX)) show extensive interconnections. Third, the efferents from the vagal nuclei that receive sensory and visceral input (i.e. nuclei of the solitary tract and spinal nucleus of the trigeminal nerve) mainly course towards the main parts of the neural pain matrix directly or indirectly via other vagal nuclei. Conclusion The moderate effectiveness of nVNS in treating primary headache disorders can possibly be linked to the connections between the trigeminal and vagal systems as described in animals.

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Mechanisms of Cluster Headache and Other Trigeminal Autonomic Cephalalgias

Prakash¹,

Hansen²

2011

Handbook of Headache

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The electrophysiology of cluster headache

Cited by 11 publications

References 40 publications

Photophobia in Primary Headaches

Photophobia in Primary Headaches

Vagus nerve stimulation for primary headache disorders: An anatomical review to explain a clinical phenomenon

Mechanisms of Cluster Headache and Other Trigeminal Autonomic Cephalalgias

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