Hypothalamic regulation of headache and migraine
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Hypothalamic regulation of headache and migraine. / May, Arne; Burstein, Rami.
in: CEPHALALGIA, Jahrgang 39, Nr. 13, 11.2019, S. 1710-1719.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Review › Forschung
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TY - JOUR
T1 - Hypothalamic regulation of headache and migraine
AU - May, Arne
AU - Burstein, Rami
PY - 2019/11
Y1 - 2019/11
N2 - BACKGROUND: The clinical picture, but also neuroimaging findings, suggested the brainstem and midbrain structures as possible driving or generating structures in migraine.FINDINGS: This has been intensely discussed in the last decades and the advent of modern imaging studies refined the involvement of rostral parts of the pons in acute migraine attacks, but more importantly suggested a predominant role of the hypothalamus and alterations in hypothalamic functional connectivity shortly before the beginning of migraine headaches. This was shown in the NO-triggered and also in the preictal stage of native human migraine attacks. Another headache type that is clinically even more suggestive of hypothalamic involvement is cluster headache, and indeed a structure in close proximity to the hypothalamus has been identified to play a crucial role in attack generation.CONCLUSION: It is very likely that spontaneous oscillations of complex networks involving the hypothalamus, brainstem, and dopaminergic networks lead to changes in susceptibility thresholds that ultimately start but also terminate headache attacks. We will review clinical and neuroscience evidence that puts the hypothalamus in the center of scientific attention when attack generation is discussed.
AB - BACKGROUND: The clinical picture, but also neuroimaging findings, suggested the brainstem and midbrain structures as possible driving or generating structures in migraine.FINDINGS: This has been intensely discussed in the last decades and the advent of modern imaging studies refined the involvement of rostral parts of the pons in acute migraine attacks, but more importantly suggested a predominant role of the hypothalamus and alterations in hypothalamic functional connectivity shortly before the beginning of migraine headaches. This was shown in the NO-triggered and also in the preictal stage of native human migraine attacks. Another headache type that is clinically even more suggestive of hypothalamic involvement is cluster headache, and indeed a structure in close proximity to the hypothalamus has been identified to play a crucial role in attack generation.CONCLUSION: It is very likely that spontaneous oscillations of complex networks involving the hypothalamus, brainstem, and dopaminergic networks lead to changes in susceptibility thresholds that ultimately start but also terminate headache attacks. We will review clinical and neuroscience evidence that puts the hypothalamus in the center of scientific attention when attack generation is discussed.
KW - Autonomic Nervous System/physiopathology
KW - Brain Stem/physiopathology
KW - Craving/physiology
KW - Dopamine/physiology
KW - Emotions
KW - Endocrine System/physiopathology
KW - Headache/physiopathology
KW - Humans
KW - Hypothalamus/physiopathology
KW - Migraine Disorders/diagnostic imaging
KW - Nitric Oxide/physiology
KW - Nociception/physiology
KW - Pain Perception/physiology
KW - Photophobia/physiopathology
KW - Prodromal Symptoms
U2 - 10.1177/0333102419867280
DO - 10.1177/0333102419867280
M3 - SCORING: Review article
C2 - 31466456
VL - 39
SP - 1710
EP - 1719
JO - CEPHALALGIA
JF - CEPHALALGIA
SN - 0333-1024
IS - 13
ER -