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The Journal of Headache and Pain

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Open Access 01-12-2020 | Cluster Headache | Research article

Phase dependent hypothalamic activation following trigeminal input in cluster headache

Authors: Laura H. Schulte, Ame Abdu Haji, Arne May

Published in: The Journal of Headache and Pain | Issue 1/2020

Abstract

Background

Task-free imaging approaches using PET have shown the posterior hypothalamus to be specifically activated during but not outside cluster headache attacks. Evidence from task related functional imaging approaches however is scarce.

Methods

Twenty-one inactive cluster headache patients (episodic cluster headache out of bout), 16 active cluster headache patients (10 episodic cluster headache in bout, 6 chronic cluster headache) and 18 control participants underwent high resolution brainstem functional magnetic resonance imaging of trigeminal nociception using gaseous ammonia as a painful stimulus.

Results

Following trigeminonociceptive stimulation with ammonia there was a significantly stronger activation within the posterior hypothalamus in episodic cluster headache patients out of bout when compared to controls. When contrasting estimates of the pain contrast, active cluster headache patients where in between the two other groups but did not differ significantly from either.

Conclusion

The posterior hypothalamus might thus be hyperexcitable in cluster headache patients outside the bout while excitability to external nociceptive stimuli decreases during in bout periods, probably due to frequent hypothalamic activation and possible neurotransmitter exhaustion during cluster attacks.

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Title: Phase dependent hypothalamic activation following trigeminal input in cluster headache
Authors: Laura H. Schulte
Ame Abdu Haji
Arne May
Publication date: 01-12-2020
Publisher: Springer Milan
Keywords: Cluster Headache
Verapamil
Published in: The Journal of Headache and Pain / Issue 1/2020
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-020-01098-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Phase dependent hypothalamic activation following trigeminal input in cluster headache

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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