Deep Brain Stimulation in Cluster Headache: Hypothalamus or Midbrain Tegmentum?

2010 ◽  
Vol 14 (2) ◽  
pp. 151-159 ◽  
Author(s):  
Manjit S. Matharu ◽  
Ludvic Zrinzo
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Midbrain Tegmentum ◽  
Deep Brain

scholarly journals Common cerebral networks associated with distinct deep brain stimulation targets for cluster headache

Cephalalgia ◽  
2013 ◽  
Vol 34 (3) ◽  
pp. 224-230 ◽  
Author(s):  
Claire D Clelland ◽  
Zhong Zheng ◽  
Won Kim ◽  
Ausaf Bari ◽  
Nader Pouratian
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Diffusion Tensor ◽  
Normal Subjects ◽  
Patient Specific ◽  
Hypothalamic Region ◽  
Midbrain Tegmentum ◽  
The Common ◽  
Deep Brain

Background Several centers have reported efficacious cluster headache suppression with deep brain stimulation (DBS) of the hypothalamic region using a variety of targets. While the connectivity of some of these targets has individually been studied, commonalities across these targets, especially with respect to network-level connectivity, have not previously been explored. Methods We examined the anatomic connectivity of the four distinct DBS targets reported in the literature using probabilistic diffusion tensor tractography in normal subjects. Results Despite being described as hypothalamic, the DBS targets localized in the midbrain tegmentum posterior to the hypothalamus. Common tracts across DBS targets and subjects included projections to the ipsilateral hypothalamus, reticular formation, and cerebellum. Discussion Although DBS target coordinates are not located within the hypothalamus, a strong connection between DBS targets and the hypothalamus likely exists. Moreover, a common projection to the medial ipsilateral cerebellum was identified. Understanding the common connectivity of DBS-targeted regions may elucidate anatomic pathways that are involved in modulating cluster headache attacks and facilitate more precise patient-specific targeting of DBS.

Deep brain stimulation modulates hypothalamic-brainstem fibers in cluster headache: case report

2020 ◽  
Vol 132 (3) ◽  
pp. 717-720 ◽  
Author(s):  
Sérgio A. F. Dantas ◽  
Eduardo J. L. Alho ◽  
Juliano J. da Silva ◽  
Nilson N. Mendes Neto ◽  
Erich Talamoni Fonoff ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Clinical Effects ◽  
Chronic Stimulation ◽  
Mammillary Bodies ◽  
Fiber Tracts ◽  
White Matter Region ◽  
Deep Brain ◽  
Stimulation Of

Hypothalamic deep brain stimulation (DBS) has been used for more than a decade to treat cluster headache (CH) but its mechanisms remain poorly understood. The authors have successfully treated a patient with CH using hypothalamic DBS and found that the contact used for chronic stimulation was located in a white matter region posterior to the mammillary bodies. Fiber tracts crossing that region were the medial forebrain bundle and those interconnecting the hypothalamus and brainstem, including the dorsal longitudinal fasciculus. Because the stimulation of axons is an important mechanism of DBS, some of its clinical effects in CH may be related to the stimulation of fibers interconnecting the hypothalamus and brainstem.

Deep Brain Stimulation for Intractable Chronic Cluster Headache: Results of Neuroimaging and Neurovegetative Assessment

2003 ◽  
Vol 6 (3) ◽  
pp. 206-206
Author(s):  
Angelo Franzini ◽  
Giovanni Broggi ◽  
Gennaro Bussone ◽  
Paolo Ferroli ◽  
Massimo Leone ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Deep Brain

scholarly journals 200 The Treatment of Chronic Cluster Headache With Deep Brain Stimulation of the Posterior Hypothalamus

Neurosurgery ◽  
2018 ◽  
Vol 65 (CN_suppl_1) ◽  
pp. 115-115
Author(s):  
Nilson N. Mendes Neto ◽  
Jessika Thais da Silva Maia ◽  
Juliano Jose da Silva ◽  
Sergio Adrian Fernandes Dantas ◽  
Marcelo Rodrigues Zacarkim ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Posterior Hypothalamus ◽  
Deep Brain ◽  
Stimulation Of

Deep Brain Stimulation for Chronic Cluster Headache: A Review

2018 ◽  
Vol 22 (4) ◽  
pp. 388-397 ◽  
Author(s):  
Daivik B. Vyas ◽  
Allen L. Ho ◽  
David Y. Dadey ◽  
Arjun V. Pendharkar ◽  
Eric S. Sussman ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Deep Brain

Hypothalamic Deep Brain Stimulation for Cluster Headache: Experience From a New Multicase Series

Cephalalgia ◽  
2008 ◽  
Vol 28 (3) ◽  
pp. 285-295 ◽  
Author(s):  
T Bartsch ◽  
MO Pinsker ◽  
D Rasche ◽  
T Kinfe ◽  
F Hertel ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Discharge Rate ◽  
Therapeutic Option ◽  
Case Series ◽  
Chronic Cluster Headache ◽  
Posterior Hypothalamus ◽  
Attack Frequency ◽  
Deep Brain

Deep brain stimulation (DBS) of the posterior hypothalamus was found to be effective in the treatment of drug-resistant chronic cluster headache. We report the results of a multicentre case series of six patients with chronic cluster headache in whom a DBS in the posterior hypothalamus was performed. Electrodes were implanted stereotactically in the ipsilateral posterior hypothalamus according to published coordinates 2 mm lateral, 3 mm posterior and 5 mm inferior referenced to the mid-AC-PC line. Microelectrode recordings at the target revealed single unit activity with a mean discharge rate of 17 Hz (range 13-35 Hz, n = 4). Out of six patients, four showed a profound decrease of their attack frequency and pain intensity on the visual analogue scale during the first 6 months. Of these, one patient was attack free for 6 months under neurostimulation before returning to the baseline which led to abortion of the DBS. Two patients had experienced only a marginal, non-significant decrease within the first weeks under neurostimulation before returning to their former attack frequency. After a mean follow-up of 17 months, three patients are almost completely attack free, whereas three patients can be considered as treatment failures. The stimulation was well tolerated and stimulation-related side-effects were not observed on long term. DBS of the posterior inferior hypothalamus is an effective therapeutic option in a subset of patients. Future controlled multi-centre trials will need to confirm this open-label experience and should help to better define predictive factors for non-responders.

Secondary chronic cluster headache treated by posterior hypothalamic deep brain stimulation: First reported case

Cephalalgia ◽  
2012 ◽  
Vol 33 (2) ◽  
pp. 136-138 ◽  
Author(s):  
Giuseppe Messina ◽  
Michele Rizzi ◽  
Roberto Cordella ◽  
Augusto Caraceni ◽  
Ernesto Zecca ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Soft Tissues ◽  
Chronic Cluster Headache ◽  
Successful Outcome ◽  
The Right ◽  
Fondazione Irccs ◽  
Deep Brain

Introduction Deep brain stimulation (DBS) of the posterior hypothalamus (pHyp) has been reported as an effective treatment for primary, drug-refractory and chronic cluster headache (CCH). We here describe the use of such a procedure for the treatment of secondary CCH due to a neoplasm affecting the soft tissues of the right hemiface. Methods A 27-year-old man affected by infiltrating angiomyolipoma of the right hemiface who subsequently developed drug refractory homolateral CCH underwent DBS of the right pHyp region at the Fondazione IRCCS Istituto Nazionale Neurologico Carlo Besta. Results After surgery, the patient presented a significant reduction in frequency of pain bouts. However, because of a subsequent infection, the entire system was removed. After re-implantation of the system, successful outcome was observed at 2 years follow-up. Discussion This brief report shows the feasibility of pHyp DBS in secondary drug-refractory CCH syndromes; future reports are needed in order to confirm our positive result.

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