Cluster headache and the hypothalamus: causal relationship or epiphenomenon?

@article{Holle2011ClusterHA,
  title={Cluster headache and the hypothalamus: causal relationship or epiphenomenon?},
  author={Dagny Holle and Mark Obermann},
  journal={Expert Review of Neurotherapeutics},
  year={2011},
  volume={11},
  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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References

SHOWING 1-10 OF 103 REFERENCES

A Review of Hormonal Findings in Cluster Headache. Evidence for Hypothalamic Involvement

  • M. LeoneG. Bussone
  • Medicine, Psychology
    Cephalalgia : an international journal of headache
  • 1993
TLDR
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

TLDR
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.

Specific hypothalamic activation during a spontaneous cluster headache attack

TLDR
Results of voxel-based morphometry support the role of the posterior hypothalamus in the pathogenesis of cluster headache because an increased gray matter density has been shown in this structure, but clinical and experimental data show NTG-provoked and spontaneous cluster attacks to be comparable.

Hypothalamic deep brain stimulation in the treatment of chronic cluster headache

TLDR
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

TLDR
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

TLDR
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.

Cluster headache: A prospective clinical study with diagnostic implications

TLDR
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

TLDR
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

TLDR
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.
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