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Related Experiment Videos

Posterior hypothalamic and brainstem activation in hemicrania continua.

Manjit S Matharu1, Anna S Cohen, David J McGonigle

  • 1Institute of Neurology, Headache Group, London, United Kingdom.

Headache
|August 28, 2004
PubMed
Summary

Positron emission tomography revealed that hemicrania continua headache involves activation of the posterior hypothalamus and dorsal rostral pons. These brain regions are implicated in trigeminal autonomic headaches and migraine.

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Area of Science:

  • Neuroimaging
  • Neurology
  • Headache Medicine

Background:

  • Hemicrania continua is a continuous, unilateral headache with superimposed severe exacerbations.
  • It shares clinical features with trigeminal autonomic headaches and migraine.
  • The hypothalamus and brainstem are implicated in related headache disorders.

Purpose of the Study:

  • To identify brain structures involved in hemicrania continua pain using positron emission tomography (PET).
  • To test the hypothesis that hypothalamic or dorsal rostral pons activation underlies hemicrania continua.

Main Methods:

  • Seven patients with hemicrania continua underwent PET scans during baseline pain and pain-free states (after indomethacin) or during placebo.
  • Scans were compared to those of seven age- and sex-matched healthy controls.

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  • Image analysis utilized SPM99 software.

    • Main Results:

    • Significant activation was observed in the contralateral posterior hypothalamus and ipsilateral dorsal rostral pons during hemicrania continua pain.
    • Additional activations included the ipsilateral ventrolateral midbrain and bilateral pontomedullary junction.
    • No intracranial vessel dilation was evident.

    Conclusions:

    • Hemicrania continua is associated with activations in subcortical structures, notably the posterior hypothalamus and dorsal rostral pons.
    • The observed activation pattern aligns with the headache's clinical overlap with trigeminal autonomic headaches and migraine.
    • Hypothalamic and brainstem activations may serve as markers for these headache types.