Short‐Lasting Unilateral Neuralgiform Headache With Conjunctival Injection and Tearing (SUNCT) Improves With Bilateral Ventral Tegmental Area Deep Brain Stimulation

2020 ◽  
Vol 60 (10) ◽  
pp. 2548-2554
Author(s):  
Virgilio Gerald H. Evidente ◽  
Francisco A. Ponce ◽  
Maris H. Evidente ◽  
Robin Garrett ◽  
Margaret Lambert
Keyword(s):  
Deep Brain Stimulation ◽  
Ventral Tegmental Area ◽  
Brain Stimulation ◽  
Conjunctival Injection ◽  
Ventral Tegmental ◽  
Deep Brain

scholarly journals Ventral tegmental area deep brain stimulation in refractory short-lasting unilateral neuralgiform headache attacks

Brain ◽  
2016 ◽  
Vol 139 (10) ◽  
pp. 2631-2640 ◽  
Author(s):  
Sarah Miller ◽  
Harith Akram ◽  
Susie Lagrata ◽  
Marwan Hariz ◽  
Ludvic Zrinzo ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Ventral Tegmental Area ◽  
Brain Stimulation ◽  
Ventral Tegmental ◽  
Deep Brain

scholarly journals Deep brain stimulation for aggressiveness: long-term follow-up and tractography study of the stimulated brain areas

2020 ◽  
pp. 1-10 ◽  
Author(s):  
Cristina V. Torres ◽  
Guillermo Blasco ◽  
Marta Navas García ◽  
Elena Ezquiaga ◽  
Jesús Pastor ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Ventral Tegmental Area ◽  
Therapeutic Effect ◽  
Brain Stimulation ◽  
Medial Forebrain Bundle ◽  
Diffusion Tensor ◽  
Long Term Outcome ◽  
Ventral Tegmental ◽  
Deep Brain

OBJECTIVEInitial studies applying deep brain stimulation (DBS) of the posteromedial hypothalamus (PMH) to patients with pathological aggressiveness have yielded encouraging results. However, the anatomical structures involved in its therapeutic effect have not been precisely identified. The authors’ objective was to describe the long-term outcome in their 7-patient series, and the tractography analysis of the volumes of tissue activated in 2 of the responders.METHODSThis was a retrospective study of 7 subjects with pathological aggressiveness. The findings on MRI with diffusion tensor imaging (DTI) in 2 of the responders were analyzed. The authors generated volumes of tissue activated according to the parameters used, and selected those volumes as regions of interest to delineate the tracts affected by stimulation.RESULTSThe series consisted of 5 men and 2 women. Of the 7 patients, 5 significantly improved with stimulation. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be involved in the stimulation field.CONCLUSIONSIn this series, 5 of 7 medication-resistant patients with severe aggressiveness who were treated with bilateral PMH DBS showed a significant long-lasting improvement. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be in the stimulation field and might be responsible for the therapeutic effect of DBS.

Increased number of TH-immunoreactive cells in the ventral tegmental area after deep brain stimulation of the anterior nucleus of the thalamus

2014 ◽  
Vol 220 (5) ◽  
pp. 3061-3066 ◽  
Author(s):  
J. A. D. Dela Cruz ◽  
S. Hescham ◽  
B. Adriaanse ◽  
F. L. Campos ◽  
H. W. M. Steinbusch ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Ventral Tegmental Area ◽  
Brain Stimulation ◽  
Anterior Nucleus ◽  
Ventral Tegmental ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Ventral tegmental area deep brain stimulation for refractory chronic cluster headache

Neurology ◽  
2016 ◽  
Vol 86 (18) ◽  
pp. 1676-1682 ◽  
Author(s):  
Harith Akram ◽  
Sarah Miller ◽  
Susie Lagrata ◽  
Jonathan Hyam ◽  
Marjan Jahanshahi ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Ventral Tegmental Area ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Ventral Tegmental ◽  
Deep Brain

scholarly journals Deep brain stimulation of the brainstem

Brain ◽  
2020 ◽  
Author(s):  
Gavin J B Elias ◽  
Aaron Loh ◽  
Dave Gwun ◽  
Aditya Pancholi ◽  
Alexandre Boutet ◽  
...  
Keyword(s):  
Neuropathic Pain ◽  
Deep Brain Stimulation ◽  
Ventral Tegmental Area ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Red Nucleus ◽  
Pedunculopontine Nucleus ◽  
Central Neuropathic Pain ◽  
Ventral Tegmental ◽  
Deep Brain

Abstract Deep brain stimulation (DBS) of the subthalamic nucleus, pallidum, and thalamus is an established therapy for various movement disorders. Limbic targets have also been increasingly explored for their application to neuropsychiatric and cognitive disorders. The brainstem constitutes another DBS substrate, although the existing literature on the indications for and the effects of brainstem stimulation remains comparatively sparse. The objective of this review was to provide a comprehensive overview of the pertinent anatomy, indications, and reported stimulation-induced acute and long-term effects of existing white and grey matter brainstem DBS targets. We systematically searched the published literature, reviewing clinical trial articles pertaining to DBS brainstem targets. Overall, 164 studies describing brainstem DBS were identified. These studies encompassed 10 discrete structures: periaqueductal/periventricular grey (n = 63), pedunculopontine nucleus (n = 48), ventral tegmental area (n = 22), substantia nigra (n = 9), mesencephalic reticular formation (n = 7), medial forebrain bundle (n = 8), superior cerebellar peduncles (n = 3), red nucleus (n = 3), parabrachial complex (n = 2), and locus coeruleus (n = 1). Indications for brainstem DBS varied widely and included central neuropathic pain, axial symptoms of movement disorders, headache, depression, and vegetative state. The most promising results for brainstem DBS have come from targeting the pedunculopontine nucleus for relief of axial motor deficits, periaqueductal/periventricular grey for the management of central neuropathic pain, and ventral tegmental area for treatment of cluster headaches. Brainstem DBS has also acutely elicited numerous motor, limbic, and autonomic effects. Further work involving larger, controlled trials is necessary to better establish the therapeutic potential of DBS in this complex area.

scholarly journals Ventral tegmental area deep brain stimulation for chronic cluster headache: Effects on cognition, mood, pain report behaviour and quality of life

Cephalalgia ◽  
2019 ◽  
Vol 39 (9) ◽  
pp. 1099-1110 ◽  
Author(s):  
Davide Cappon ◽  
Agata Ryterska ◽  
Susie Lagrata ◽  
Sarah Miller ◽  
Harith Akram ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Ventral Tegmental Area ◽  
Brain Stimulation ◽  
Rating Scale ◽  
Chronic Cluster Headache ◽  
Headache Frequency ◽  
Deep Brain

Background Deep brain stimulation in the ventral tegmental area (VTA-DBS) has provided remarkable therapeutic benefits in decreasing headache frequency and severity in patients with medically refractory chronic cluster headache (CH). However, to date the effects of VTA-DBS on cognition, mood and quality of life have not been examined in detail. Methods The aim of the present study was to do so in a case series of 18 consecutive patients with cluster headache who underwent implantation of deep brain stimulation electrodes in the ventral tegmental area. The patients were evaluated preoperatively and after a mean of 14 months of VTA-DBS on tests of global cognition (Mini Mental State Examination), intelligence (Wechsler Abbreviated Scale of Intelligence), verbal memory (California Verbal Learning Test-II), executive function (Delis–Kaplan Executive Function System), and attention (Paced Auditory Serial Addition Test). Depression (Beck Depression Inventory and Hospital Anxiety and Depression Rating Scale-D), anxiety (Hospital Anxiety and Depression Rating Scale-A), apathy (Starkstein Apathy Scale), and hopelessness (Beck Hopelessness Scale) were also assessed. Subjective pain experience (McGill Pain Questionnaire), behaviour (Pain Behaviour Checklist) and quality of life (Short Form-36) were also evaluated at the same time points. Results VTA-DBS resulted in significant improvement of headache frequency (from a mean of five to two attacks daily, p < .001) and severity (from mean Verbal Rating Scale [VRS] of 10 to 7, p < .001) which was associated with significant reduction of anxiety (from mean HADS-A of 11.94 to 8.00, p < .001) and help-seeking behaviours (from mean PBC of 4.00 to 2.61, p < .001). VTA-DBS did not produce any significant change to any tests of cognitive function and any other outcome measures (BDI, HADS-D, SAS, BHS, McGill Pain Questionnaire, Short Form-36). Conclusion We confirm the efficacy of VTA-DBS in the treatment of medically refractory chronic cluster headache. The reduction of headache frequency and severity was associated with a significant reduction of anxiety. Furthermore, the result suggests that VTA-DBS for chronic cluster headache improves pain-related help-seeking behaviours and does not produce any change in cognition.

Responsiveness of short-lasting unilateral neuralgiform headache with conjunctival injection and tearing to hypothalamic deep brain stimulation

2009 ◽  
Vol 110 (2) ◽  
pp. 279-281 ◽  
Author(s):  
Mark K. Lyons ◽  
David W. Dodick ◽  
Virgilio Gerald H. Evidente
Keyword(s):  
Deep Brain Stimulation ◽  
Functional Imaging ◽  
Brain Stimulation ◽  
Primary Headache ◽  
Headache Disorder ◽  
Trigeminal Autonomic Cephalalgias ◽  
Conjunctival Injection ◽  
Imaging Studies ◽  
Primary Headache Disorder ◽  
Deep Brain

Short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) is a severe primary headache disorder that is often refractory to medical therapy. Although the pathogenesis of this and other trigeminal autonomic cephalalgias is not completely understood, ipsilateral activation of the posterior and inferior hypothalamus has been identified on functional imaging studies during attacks. The authors report on a case of SUNCT syndrome successfully treated with hypothalamic deep brain stimulation and discuss the current literature.

Deep brain stimulation of the posterior hypothalamic area in intractable short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT)

Cephalalgia ◽  
2011 ◽  
Vol 31 (13) ◽  
pp. 1405-1408 ◽  
Author(s):  
T Bartsch ◽  
D Falk ◽  
K Knudsen ◽  
R Reese ◽  
J Raethjen ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Sudden Onset ◽  
Conjunctival Injection ◽  
Hypothalamic Area ◽  
Hypothalamic Region ◽  
Central Origin ◽  
Deep Brain ◽  
Stimulation Of

Background: SUNCT (short-lasting unilateral neuralgiform headache with conjunctival injection and tearing) is a rare syndrome characterized by the sudden onset of excruciating unilateral periorbital pain that is accompanied by conjunctival injection and lacrimation or further autonomic signs. Similar to patients with chronic cluster headache, Leone and Lyons showed a beneficial effect of deep brain stimulation of the posterior hypothalamic region in two patients with a chronic SUNCT. Case: Here, we present the case of a man with a chronic SUNCT responding to deep brain stimulation of the posterior hypothalamic area. Conclusion: This case supports the idea of a central origin of SUNCT and shows that deep brain stimulation of the hypothalamic region can be effective in the treatment of the chronic form of this rare disorder.

Sign in / Sign up

Export Citation Format

Share Document