Posterior hypothalamic activation in paroxysmal hemicrania.

Details

Serval ID
serval:BIB_EA2C73635443
Type
Article: article from journal or magazin.
Collection
Publications
Title
Posterior hypothalamic activation in paroxysmal hemicrania.
Journal
Annals of Neurology
Author(s)
Matharu M.S., Cohen A.S., Frackowiak R.S., Goadsby P.J.
ISSN
0364-5134 (Print)
ISSN-L
0364-5134
Publication state
Published
Issued date
2006
Volume
59
Number
3
Pages
535-545
Language
english
Notes
Publication types: Clinical Trial ; Comparative Study ; Journal Article ; Research Support, Non-U.S. Gov'tPublication Status: ppublish
Abstract
Paroxysmal hemicrania (PH) is a severe, strictly unilateral headache that lasts 2 to 30 minutes, occurs more than five times daily, is associated with trigeminal autonomic symptoms, and is exquisitely responsive to indomethacin. The purpose of the study was to determine the brain structures active in PH. Methods: Seven PH patients were studied using positron emission tomography (PET). Each patient was scanned in three states: (1) acute PH attack-off indomethacin; (2) pain-free-off indomethacin; and (3) pain-free after administration of intramuscular indomethacin 100mg. The scan images were processed and analyzed using SPM99. Results: The study showed no significant activations during state 1 compared with state 2, but there was relative activation of the pain neuromatrix in both states 1 and 2 compared with state 3. This suggests that there is persistent activation of the pain neuromatrix during acute PH attacks and during interictal pain-free states off indomethacin that is deactivated by the administration of indomethacin. In addition, the untreated PH state was associated with significant activation of the contralateral posterior hypothalamus and contralateral ventral midbrain, which extended over the red nucleus and the substantia nigra. Interpretation These activated subcortical structures may play a pivotal role in the pathophysiology of this syndrome.
Keywords
Adult, Anti-Inflammatory Agents, Non-Steroidal/therapeutic use, Biophysical Phenomena, Biophysics, Brain Mapping, Female, Functional Laterality, Humans, Hypothalamus, Posterior/drug effects, Hypothalamus, Posterior/physiopathology, Image Processing, Computer-Assisted/methods, Indomethacin/therapeutic use, Male, Middle Aged, Paroxysmal Hemicrania/drug therapy, Paroxysmal Hemicrania/pathology, Positron-Emission Tomography/methods, Regional Blood Flow/drug effects, Regional Blood Flow/physiology, Time Factors
Pubmed
Web of science
Create date
11/09/2011 18:13
Last modification date
20/08/2019 16:12
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