The contribution of functional neuroimaging to primary headaches

Functional imaging techniques have begun to provide considerable insight into the pathophysiology of primary headache syndromes. PET and f-MRI have allowed to to monitor the physiological cortical reaction and nociceptor transmission of head-pain, but more importantly have identified pathophysiological abnormalities and even the "motor" in migraine and cluster headache attacks. This has even prompted new treatment options such as DBS in cluster headache and will undoubtly change the way we see headache. Innovative techniques such as voxel- and deformation-based morphometry have just started to unravel the structural consequences of chronic pain. Functional imaging will undoubtedly provide further opportunities to study and compare metabolic, haemodynamic and structural parameters in headache sufferers' brains.