Hypothalamus as a mediator of chronic migraine
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Hypothalamus as a mediator of chronic migraine : Evidence from high-resolution fMRI. / Schulte, Laura H; Allers, Angie; May, Arne.
In: NEUROLOGY, Vol. 88, No. 21, 23.05.2017, p. 2011-2016.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Hypothalamus as a mediator of chronic migraine
T2 - Evidence from high-resolution fMRI
AU - Schulte, Laura H
AU - Allers, Angie
AU - May, Arne
N1 - © 2017 American Academy of Neurology.
PY - 2017/5/23
Y1 - 2017/5/23
N2 - OBJECTIVE: To identify pathophysiologic mechanisms of migraine chronification using a recently standardized protocol for high-resolution brainstem imaging of trigeminal nociceptive stimulation.METHODS: Eighteen episodic migraineurs (EMs), 17 chronic migraineurs (CMs), and 19 healthy controls (HCs) underwent painful ammonia stimulation of the left nostril in a 3T MRI scanner. Functional images were acquired with a brainstem-optimized protocol for high-resolution echo-planar imaging.RESULTS: We detected a significantly stronger activation of the anterior right hypothalamus in CMs compared to HCs. To exclude the headache as a prime mediator of the hypothalamic activations, we compared all migraineurs with headaches (EMs and CMs) with all migraineurs without headaches (EMs and CMs) and HCs in a second analysis and found a more posterior region of the hypothalamus to be more activated bilaterally during headaches.CONCLUSIONS: Our data corroborate the fact that the hypothalamus plays a crucial role in the pathophysiology of migraine chronification and acute pain stage of migraineurs. While the more posterior part of the hypothalamus seems to be important for the acute pain stage, the more anterior part seems to play an important role in attack generation and migraine chronification.
AB - OBJECTIVE: To identify pathophysiologic mechanisms of migraine chronification using a recently standardized protocol for high-resolution brainstem imaging of trigeminal nociceptive stimulation.METHODS: Eighteen episodic migraineurs (EMs), 17 chronic migraineurs (CMs), and 19 healthy controls (HCs) underwent painful ammonia stimulation of the left nostril in a 3T MRI scanner. Functional images were acquired with a brainstem-optimized protocol for high-resolution echo-planar imaging.RESULTS: We detected a significantly stronger activation of the anterior right hypothalamus in CMs compared to HCs. To exclude the headache as a prime mediator of the hypothalamic activations, we compared all migraineurs with headaches (EMs and CMs) with all migraineurs without headaches (EMs and CMs) and HCs in a second analysis and found a more posterior region of the hypothalamus to be more activated bilaterally during headaches.CONCLUSIONS: Our data corroborate the fact that the hypothalamus plays a crucial role in the pathophysiology of migraine chronification and acute pain stage of migraineurs. While the more posterior part of the hypothalamus seems to be important for the acute pain stage, the more anterior part seems to play an important role in attack generation and migraine chronification.
KW - Adult
KW - Brain Mapping
KW - Female
KW - Functional Laterality
KW - Humans
KW - Hypothalamus
KW - Linear Models
KW - Magnetic Resonance Imaging
KW - Male
KW - Migraine Disorders
KW - Nociception
KW - Physical Stimulation
KW - Trigeminal Nerve
KW - Journal Article
U2 - 10.1212/WNL.0000000000003963
DO - 10.1212/WNL.0000000000003963
M3 - SCORING: Journal article
C2 - 28446645
VL - 88
SP - 2011
EP - 2016
JO - NEUROLOGY
JF - NEUROLOGY
SN - 0028-3878
IS - 21
ER -
