Mesocorticolimbic system abnormalities in chronic cluster headache patients: a neural signature?

BACKGROUND: Converging evidence suggests that anatomical and functional mesocorticolimbic abnormalities support the chronicization of pain disorders. METHODS: We mapped structural and functional alterations of the mesocorticolimbic system in a sample of chronic cluster headache (cCH) patients (n = 28) in comparison to age and sex-matched healthy individuals (n=28) employing structural MRI and resting-state functional MRI (rs-fMRI). RESULTS: Univariate logistic regression models showed that several of the examined structures/areas (i.e., the bilateral nucleus accumbens, ventral diencephalon, hippocampus, and frontal pole, and the right amygdala) differentiated cCH patients from healthy individuals (p<0.05, uncorrected). Specifically, all the significant structures/areas had increased volumes in cCH patients compared to healthy individuals. The examination of the groups suffering from left and right-sided cranial attacks showed a lateralization effect: ipsilateral to the pain ventral diencephalic regions and contralateral to the pain nucleus accumbens discriminated cCH patients from healthy individuals. The rs-fMRI data analyses showed that cCH patients compared to CTRL individuals present robust reduced functional connectivity in the right frontal pole-right amygdala pathway (p<0.05, FDR-corrected). CONCLUSION: Our results showed that cCH patients present anatomical and functional maladaptation of the mesocorticolimbic system, with functional data indicating a possible prefrontal areas' failure to modulate the mesolimbic structures. These results were opposite to what we hypothesized based on the previous literature on chronic pain conditions. Future studies should assess whether the observed mesocorticolimbic abnormalities are due to the neuroprotective effects of the assumed medications, or to the frequent comorbidity of CH with neuropsychiatric disorders or if they are a genuine neural signature of CH and/or cCH condition.

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

Cephalalgia ◽

10.1177/0333102412468675 ◽

2012 ◽

Vol 33 (2) ◽

pp. 136-138 ◽

Cited By ~ 15

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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Chronic cluster headache: a study of the telencephalic and cerebellar cortical thickness

10.1101/2021.03.01.21252083 ◽

2021 ◽

Author(s):

Greta Demichelis ◽

Chiara Pinardi ◽

Luca Giani ◽

Jean Paul Medina ◽

Ruben Gianeri ◽

...

Keyword(s):

Cluster Headache ◽

Functional Characterization ◽

Chronic Cluster Headache ◽

Cross Sectional ◽

Morphological Alterations ◽

Cortical Thinning ◽

Left Posterior ◽

Posterior Insula ◽

The Right ◽

Headache Patients

AbstractPrevious studies on brain morphological alterations in chronic cluster headache revealed inconsistent findings. The present cross-sectional explorative study determined telencephalic and cerebellar cortex thickness alterations in a relatively wide sample of chronic cluster headache patients (n=28) in relation to matched healthy individuals. The combination of two highly robust state-of-the-art approaches for thickness estimation (Freesurfer and CERES) with an unbiased functional characterization of the abnormal regions, revealed two main results. First, chronic cluster headache patients show cortical thinning in the right middle cingulate cortex and the left posterior insula. This indicates abnormalities in key-regions of pain processing areas, in particular in regions belonging to the spino-thalamic-cortical tract and primarily involved in the sensory-motor aspects of nociception. Second, chronic cluster headache patients present cortical thinning in the left anterior superior temporal sulcus and the left collateral/lingual sulcus, suggesting neuroplastic maladaptations in areas possibly involved in social cognition, which may promote psychiatric comorbidity, frequently observed in these patients.

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Comparison of the Aditus ad Antrum Diameter on CT between Patients with Chronic Otitis Media and Healthy Individuals

Current Medical Imaging Formerly Current Medical Imaging Reviews ◽

10.2174/1573405615666190327110216 ◽

2019 ◽

Vol 15 (10) ◽

pp. 990-993 ◽

Cited By ~ 1

Author(s):

Elif Gündoğdu ◽

Uğur Toprak

Keyword(s):

Computed Tomography ◽

Otitis Media ◽

Middle Ear ◽

Healthy Subjects ◽

Normal Values ◽

Chronic Otitis Media ◽

Healthy Individuals ◽

Inner Diameter ◽

Male Patients ◽

The Right

Background: The middle ear cavity is ventilated through the aditus ad antrum. Aditus blockage contributes to the pathology of otitis media. Objective: To determine the normal values of the aditus ad antrum diameter on computed tomography and to investigate its relationship with chronic otitis media and related pathologies (tympanosclerosis and myringosclerosis). Methods: The temporal CT images of 162 individuals were evaluated retrospectively. In the axial sections, the inner diameter of the aditus was measured at the narrowest point at the cortex. The differences in diameter were compared between diseased and healthy ears. Results: In healthy individuals, the diameter was narrower in women. There was no difference between the right and left ears in healthy subjects. No correlation was found between age and diameter. In male patients with myringosclerosis, the diameter was slightly narrower on both sides but more marked on the left. In female patients with myringosclerosis, the diameter in both ears was slightly narrower. In cases of otitis media and tympanosclerosis, the diameter was less than that of healthy individuals, despite the lack of statistically significant result in all cases. Conclusion: The aditus ad antrum was narrower in diseased ears, indicating that a blocked aditus may contribute to the development of otitis media, as well as mucosal diseases.

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Força dos Músculos Rotadores do Ombro em Indivíduos Saudáveis/ Rotator Cuff Muscle Strength in Healthy Individuals

REVISTA CIÊNCIAS EM SAÚDE ◽

10.21876/rcsfmit.v1i1.19 ◽

1970 ◽

Vol 1 (1) ◽

pp. 78-82

Author(s):

Paulo José Oliveira Cortez ◽

José Elias Tomazini ◽

Mauro Gonçalves

Keyword(s):

Rotator Cuff ◽

Muscle Strength ◽

Internal Rotation ◽

Upper Limb ◽

Statistical Difference ◽

External Rotation ◽

Healthy Individuals ◽

Average Strength ◽

Strength Tests ◽

The Right

Introdução: A diminuição da capacidade de exercer esforços por parte dos músculos rotadores pode criar uma variedade de problemas. O conhecimento preciso do nível de força muscular de um indivíduo é importante, tanto para a avaliação da capacidade funcional ocupacional, como para uma apropriada prescrição de exercícios atléticos e de reabilitação. Percebe-se escassez de informação sobre as articulações do ombro, bem como os fatores envolvidos na força muscular dessa região. O objetivo deste estudo foi comparar a força gerada pelos músculos do manguito rotador entre o membro superior direito e o membro superior esquerdo em indivíduos saudáveis. Métodos: Participaram do estudo 22 sujeitos do sexo masculino, com idade de 18 e 19 anos, militares, saudáveis e sem história clínica de patologia ortopédica ou qualquer tipo de lesão no sistema musculoesquelético. Foram aplicados dois testes de força: Rotação Interna e Rotação Externa. Resultado : A força média de rotação interna no membro superior direito (MSD) foi maior que a força média de rotação interna no membro superior esquerdo (MSE) (p=0,723) e a força de rotação externa no MSD foi menor que a força média de rotação externa no MSE (p=0,788). Não houve diferença estatística na comparação dos valores de força de todos os testes de força isométrica. Conclusão: Para amostra estudada e metodologia utilizada na avaliação da força muscular, não houve diferença estatística na comparação da força gerada pelos músculos do manguito rotador do membro superior direito e do membro superior esquerdo.Rotator Cuff Muscle Strength in Healthy Individuals Introduction: Decreased ability to exert efforts by the rotator muscles can create a variety of problems. The precise knowledge of the level of muscular strength of an individual is important for both the functional capacity evaluation for occupational as an appropriate exercise prescription and rehabilitation of athletic. It is perceived scarcity of information on the shoulder joints as well as factors involved in muscle strength in this region. Objective: Develop a device for measuring the strength generated by the muscles of the upper limbs and the verification of efficiency and adaptability of this device through a comparative study of muscle strength in healthy subjects. Methods: The study included 22 male subjects, aged 18 and 19 years, military personnel, body mass between 57.7 and 93 kg (71.8 ± 9.45 kg) and height between 1.67 and 1.90 m (1.75 ± 0.06 m), healthy and without a history of orthopaedic disease or any kind of damage to the musculoskeletal system. Three strength tests were applied: Internal Rotation and External Rotation. For each type of effort three maximum voluntary contractions were required for 10 seconds, with an interval of 30 seconds between each contraction. Results: Internal rotation in the right upper limb (RUL) was higher than the average strength of internal rotation in the left upper limb (LUL) (p = 0, 723) and the external rotation strength in RUL was lower than the average strength of external rotation in the LUL (p=0,788). No statistical difference in comparing the strength values of all isometric strength tests. Conclusion: For sample and methodology used to assess muscle strength, there was no statistical difference in comparing the force generated by the muscles of the rotator cuff of the right and left upper limb.

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Occipital Nerve Stimulation for Refractory Chronic Cluster Headache: A Cost‐Effectiveness Study

Neuromodulation Technology at the Neural Interface ◽

10.1111/ner.13394 ◽

2021 ◽

Author(s):

Julie Bulsei ◽

Aurélie Leplus ◽

Anne Donnet ◽

Jean Regis ◽

Christian Lucas ◽

...

Keyword(s):

Cost Effectiveness ◽

Cluster Headache ◽

Nerve Stimulation ◽

Chronic Cluster Headache ◽

Effectiveness Study ◽

Occipital Nerve Stimulation ◽

Occipital Nerve ◽

Cost Effectiveness Study

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A Connectome-Wide Functional Signature of Trait Anger

Clinical Psychological Science ◽

10.1177/21677026211030240 ◽

2021 ◽

pp. 216770262110302

Author(s):

M. Justin Kim ◽

Maxwell L. Elliott ◽

Annchen R. Knodt ◽

Ahmad R. Hariri

Keyword(s):

Functional Connectivity ◽

Visual Information ◽

Past Research ◽

Brain Regions ◽

Small Sample ◽

Trait Anger ◽

Frontal Pole ◽

Brain Correlates ◽

Small Sample Sizes ◽

The Right

Past research on the brain correlates of trait anger has been limited by small sample sizes, a focus on relatively few regions of interest, and poor test–retest reliability of functional brain measures. To address these limitations, we conducted a data-driven analysis of variability in connectome-wide functional connectivity in a sample of 1,048 young adult volunteers. Multidimensional matrix regression analysis showed that self-reported trait anger maps onto variability in the whole-brain functional connectivity patterns of three brain regions that serve action-related functions: bilateral supplementary motor areas and the right lateral frontal pole. We then demonstrate that trait anger modulates the functional connectivity of these regions with canonical brain networks supporting somatomotor, affective, self-referential, and visual information processes. Our findings offer novel neuroimaging evidence for interpreting trait anger as a greater propensity to provoked action, which supports ongoing efforts to understand its utility as a potential transdiagnostic marker for disordered states characterized by aggressive behavior.

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Long-term use of daily sumatriptan injections in severe drug-resistant chronic cluster headache: Table

Neurology ◽

10.1212/wnl.0000000000002117 ◽

2015 ◽

Vol 86 (2) ◽

pp. 194-195 ◽

Cited By ~ 11

Author(s):

Massimo Leone ◽

Alberto Proietti Cecchini

Keyword(s):

Cluster Headache ◽

Chronic Cluster Headache ◽

Drug Resistant

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TRIGEMINAL NERVE RADIOSURGICAL TREATMENT IN INTRACTABLE CHRONIC CLUSTER HEADACHE

Neurosurgery ◽

10.1227/01.neu.0000245612.86484.7 ◽

2006 ◽

Vol 59 (6) ◽

pp. 1252-1257 ◽

Cited By ~ 22

Author(s):

Anne Donnet ◽

Manabu Tamura ◽

Dominique Valade ◽

Jean Régis

Keyword(s):

Trigeminal Neuralgia ◽

Cluster Headache ◽

Trigeminal Nerve ◽

Chronic Cluster Headache ◽

High Rate ◽

Long Term Results ◽

Complete Relief ◽

Term Evaluation ◽

The One

Abstract OBJECTIVE We have previously reported short-term results of a prospective open trial designed to evaluate trigeminal nerve radiosurgical treatment in intractable chronic cluster headache (CCH). Medium- and long-term results have not yet been reported. METHODS Ten patients presenting with a severe and drug-resistant CCH were enrolled (nine men, one woman). The radiosurgical treatment was performed according to the technique usually used for trigeminal neuralgia in our department. A single 4-mm shot was positioned at the level of the cisternal portion of the trigeminal nerve. The median distance between the center of the shot and the emergence of the nerve was 9.35 mm (range, 7.5–13.3 mm). The median of this maximum dose to the brainstem was 8.0 Gy (range, 4.0–11.1 Gy). Mean age was 49.8 years (range, 32–77 yr). Mean duration of the CCH was 9 years (range, 2–33 yr). The mean follow-up period was 36.3 months (range, 24–48 mo). RESULTS Two patients had complete relief of CCH. One patient had a good result with evolution in an episodic form. Seven patients had no improvement. Nine patients developed a new trigeminal nerve disturbance: three developed paresthesia with no hypoesthesia and six developed hypoesthesia, including two patients with deafferentation pain. Only one patient had neither paresthesia nor hypoesthesia. CONCLUSION We confirmed, with medium- and long-term evaluation, the high rate of toxicity and failure of the technique. The high toxicity, despite a methodology identical to the one used in trigeminal neuralgia, leads us to suspect an underlying specificity of the nerve in CCH. We do not recommend radiosurgery for treatment of intractable CCH.

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