Cluster headache and the hypothalamus: causal relationship or epiphenomenon?

  title={Cluster headache and the hypothalamus: causal relationship or epiphenomenon?},
  author={Dagny Holle and Mark Obermann},
  journal={Expert Review of Neurotherapeutics},
  pages={1255 - 1263}
  • D. Holle, M. Obermann
  • Published 1 September 2011
  • Psychology, Biology, Medicine
  • Expert Review of Neurotherapeutics
Typical clinical features of cluster headache (CH) include circadian/circannual rhythmicity and ipisilateral cranial autonomic features. This presentation has led to the assumption that the hypothalamus plays a pivotal role in this primary headache disorder. Several studies using neuroimaging techniques or measuring hormone levels supported the hypothesis of a hypothalamic involvement in the underlying pathophysiology of CH. Animal studies added further evidence to this hypothesis. Based on… 
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A Review of Hormonal Findings in Cluster Headache. Evidence for Hypothalamic Involvement
  • M. LeoneG. Bussone
  • Medicine, Psychology
    Cephalalgia : an international journal of headache
  • 1993
The hormonal abnormalities in cluster headache support disorders of hypothalamic function, which are known to cause cluster headache and to support the role of the hypothalamus in this illness.
Lessons From 8 Years' Experience of Hypothalamic Stimulation in Cluster Headache
Autonomic studies of patients undergoing posterior hypothalamic stimulation provide further evidence that long-term stimulation is safe, revealing that it can cause altered modulation of the mechanisms of orthostatic adaptation without affecting the baroreflex, cardiorespiratory interactions or efferent sympathetic and vagal functions.
Hypothalamic deep brain stimulation in the treatment of chronic cluster headache
Activation of the hypothalamus and of the trigeminal system are both necessary, but not sufficient to generate CH attacks, suggesting other unknown brain areas are likely to play a role in the pathophysiology of this illness.
Hypothalamic involvement in chronic migraine
Results support hypothalamic involvement in CM, shown by a chronobiologic dysregulation, and a possible hyperdopaminergic state in patients with CM, which might be an important variable in the study findings.
Local Field Potentials Reveal a Distinctive Neural Signature of Cluster Headache in the Hypothalamus
The findings reveal a potential locus in CH neurogenesis and a potential rationale for efficacious stimulator titration, and support and extend the current literature, which has long implicated hypothalamic activation as key to CH generation.
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Patients with cluster headache offer a population of primary headache patients with devastating acute attacks of pain and the syndrome is stereotyped with effective evidence-based treatments that are prescribed in only half of patients having cluster headache.
Hypothalamic Deep Brain Stimulation for the Treatment of Chronic Cluster Headaches: A Series Report
Preliminary results indicate that hypothalamic stimulation is safe and effective for the treatment of drug‐resistant, chronic CH and confirm the “central” pathogenesis for chronic CH.
Cerebrospinal fluid hypocretin-1 levels during the active period of cluster headache
CSF hypocretin-1 levels seem not to influence the clinical course of CH, but the results cannot completely exclude a functional involvement of the hypothalamic hypoc retinergic system in the pathogenesis of CH.
Central modulation in cluster headache patients treated with occipital nerve stimulation: an FDG-PET study
Metabolic normalization in the pain neuromatrix and lack of short-term changes induced by the stimulation might support the hypothesis that ONS acts in drCCH through slow neuromodulatory processes.