Functional neuroimaging of headaches

Functional neuroimaging, mainly PET and functional MRI, is the main tool that allows the capturing of neurovascular events during a headache attack. In migraine, functional imaging has clarified the underlying pathophysiology of the visual aura, whereas in migraine without aura, brainstem findings suggest a dysfunctional pain system. In cluster headache, the activation and morphological changes seen in a region posterior and inferior to the hypothalamus has provided a useful therapeutic target using deep-brain stimulation. We will discuss the main neuroimaging findings pertaining to the pathophysiology of these two common headache disorders, migraine and cluster headache.