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Altered white matter microstructural connectivity in cluster headaches: a longitudinal diffusion tensor imaging

Kun-Hsien Chou1, Fu-Chi Yang2, Jong-Ling Fuh3

  • 1Institute of Neuroscience, National Yang-Ming University, Taiwan Brain Research Center, National Yang-Ming University, Taiwan.

Cephalalgia : an International Journal of Headache
|March 27, 2014
PubMed
Summary
This summary is machine-generated.

Cluster headache (CH) involves distinct white matter (WM) changes in brain regions connected to the hypothalamus. These WM alterations in the pain matrix may play a role in cluster headache pathophysiology.

Keywords:
Cluster headachediffusion tensor imagingdiffusivity indicespain matrixprobabilistic tractography

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Area of Science:

  • Neuroimaging
  • Neurology
  • Neuroscience

Background:

  • Cluster headache (CH) pathophysiology may involve disruptions in white matter (WM) pathways connecting the pain-processing system and hypothalamus.
  • Previous research on WM changes in CH has yielded inconclusive results.
  • WM variations during active (in-bout) and inactive (out-of-bout) periods of CH require further investigation.

Purpose of the Study:

  • To investigate white matter (WM) integrity in cluster headache (CH) patients.
  • To compare WM variations between in-bout and out-of-bout periods in CH.
  • To elucidate the role of WM pathways connecting the pain matrix and hypothalamus in CH pathophysiology.

Main Methods:

  • Diffusion tensor imaging (DTI) was employed to acquire multiple diffusivity indices.
  • Post-hoc probabilistic tractography was utilized to analyze WM pathways.
  • WM integrity was assessed in CH patients during in-bout and out-of-bout periods, and compared to healthy controls.

Main Results:

  • In-bout CH patients exhibited higher radial and mean diffusivities in the left medial frontal gyrus and frontal sub-gyrus compared to controls.
  • Lower axial, radial, and mean diffusivities were observed in the right parahippocampal gyrus of the limbic lobe in in-bout CH patients.
  • WM changes generally persisted in the out-of-bout period, with an exception in the left cerebellar tonsil. Tractography confirmed connections between altered areas and the hypothalamus.

Conclusions:

  • Episodic cluster headache (CH) is associated with distinct white matter (WM) alterations.
  • The identified WM changes suggest that connections between pain-modulation areas and the hypothalamus are implicated in CH pathophysiology.