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The anterior hypothalamus in cluster headache
Enrico B Arkink1, Nicole Schmitz1, Guus G Schoonman2,3
11 Department of Radiology, Leiden University Medical Center, Leiden, The Netherlands.
Cephalalgia : an International Journal of Headache
|August 18, 2016
Summary
Enlarged anterior hypothalamus observed in cluster headache patients, distinguishing it from migraine. This finding highlights potential structural differences in the hypothalamus for cluster headache and related disorders.
Area of Science:
- Neurology
- Neuroimaging
- Headache Medicine
Background:
- Cluster headache and chronic paroxysmal hemicrania (CPH) are distinct headache disorders.
- Previous research suggests potential structural brain abnormalities in headache disorders, but hypothalamic involvement remains unclear.
Purpose of the Study:
- To investigate structural changes in the hypothalamus and whole brain in cluster headache and CPH.
- To differentiate these changes from those observed in migraine and healthy controls.
Main Methods:
- Comparison of T1-weighted MRI scans using voxel-based morphometry (VBM) and manual hypothalamic segmentation.
- Analysis included patients with episodic, chronic, and probable cluster headache, CPH, migraine (with and without aura), and healthy controls.
Main Results:
- Enlargement of the anterior hypothalamic gray matter was found in chronic cluster headache patients compared to controls.
- Both episodic and chronic cluster headache patients showed significantly larger hypothalamic volumes compared to controls and migraineurs.
- Exploratory VBM revealed widespread changes in pain-modulating areas across all headache groups.
Conclusions:
- The anterior hypothalamus is structurally enlarged in episodic and chronic cluster headache.
- This hypothalamic enlargement may be a specific biomarker for cluster headache, differentiating it from migraine.
- Further research is warranted to explore potential similar trends in probable cluster headache and CPH.
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