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Network Analysis of the Default Mode Network Using Functional Connectivity MRI in Temporal Lobe Epilepsy
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Altered hypothalamic functional connectivity in cluster headache: a longitudinal resting-state functional MRI study.

Fu-Chi Yang1, Kun-Hsien Chou2, Jong-Ling Fuh3

  • 1Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.

Journal of Neurology, Neurosurgery, and Psychiatry
|July 2, 2014
PubMed
Summary

Cluster headache (CH) involves hypothalamic dysfunction and altered connectivity with frontal, occipital, and cerebellar areas. These functional connectivity changes, particularly in the cerebellum, are linked to CH bout frequency and may play a role in its pathophysiology.

Keywords:
HEADACHEMRIPAIN

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Area of Science:

  • Neuroimaging
  • Neurology
  • Pain Medicine

Background:

  • Hypothalamic dysfunction is implicated in cluster headache (CH) pathogenesis.
  • Previous studies noted disruptions in non-traditional pain areas like the cerebellum and visual cortex in CH.
  • The interaction between the hypothalamus and these areas, and its variation during CH attacks, remains unclear.

Purpose of the Study:

  • To investigate resting-state functional connectivity (FC) of the hypothalamus in patients with cluster headache (CH).
  • To explore differences in hypothalamic FC between CH patients and healthy controls.
  • To examine variations in hypothalamic FC during CH 'in-bout' and 'out-of-bout' periods.

Main Methods:

  • 3-T functional MRI was used for seed-based resting-state FC analysis.
  • The study included 18 episodic CH patients and 19 healthy controls.
  • FC was assessed during both in-bout and out-of-bout periods; correlations with clinical variables were analyzed.

Main Results:

  • CH patients exhibited altered hypothalamic FC with the medial frontal gyrus and occipital cuneus compared to controls.
  • During in-bout periods, decreased hypothalamic FC was observed with the medial frontal gyrus, precuneus, and cerebellar regions (tonsil, declive, culmen).
  • Annual bout frequency correlated with hypothalamic FC in the cerebellar culmen and declive.

Conclusions:

  • Hypothalamic functional connectivity alterations in CH extend to cerebellar, frontal, and occipital areas.
  • These widespread connectivity changes suggest a broader involvement beyond traditional pain pathways in CH pathophysiology.
  • The observed alterations may be significant contributors to the underlying mechanisms of cluster headache.