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Positron emission tomography studies in headache

H C Diener1

  • 1Department of Neurology, University of Essen, Germany.

Headache
|January 24, 1998
PubMed
Summary
This summary is machine-generated.

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Positron emission tomography (PET) reveals unchanged hemispheric blood flow in migraine without aura. However, PET detected increased brain stem activity during migraine headaches, even after treatment.

Area of Science:

  • Neuroscience
  • Medical Imaging

Background:

  • Positron emission tomography (PET) enables quantitative measurement of regional cerebral blood flow (rCBF).
  • rCBF variations are linked to vessel diameter and synaptic activity, making PET suitable for monitoring migraine-related blood flow changes.

Observation:

  • PET was employed to study rCBF during migraine aura and headache phases.
  • Researchers investigated focal areas of altered blood flow, specifically in the brain stem and midbrain.
  • Hemispheric rCBF remained stable in migraine attacks without aura, irrespective of the headache side.

Findings:

  • Sumatriptan demonstrated no impact on overall cerebral blood flow.
  • A significant increase in rCBF was observed in midline brain stem structures during the headache phase, persisting even after sumatriptan treatment.

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  • These brain stem changes appear specific to migraine attacks, differentiating them from cluster headaches.
  • Early migraine phase imaging suggested occipital cortex flow reductions spreading anteriorly, consistent with cortical spreading depression.

    • Implications:

    • The persistent brain stem hyperactivity may indicate the presence of a central migraine generator.
    • PET imaging offers valuable insights into the neurovascular mechanisms underlying migraine pathophysiology.
    • Further research is needed to elucidate the role of the brain stem in migraine and to study the aura phase more effectively.