RT Journal Article
SR Electronic
T1 Hypothalamus as a mediator of chronic migraine
JF Neurology
JO Neurology
FD Lippincott Williams & Wilkins
SP 2011
OP 2016
DO 10.1212/WNL.0000000000003963
VO 88
IS 21
A1 Laura H. Schulte
A1 Angie Allers
A1 Arne May
YR 2017
UL http://n.neurology.org/content/88/21/2011.abstract
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.CM=chronic migraineur; EM=episodic migraineur; HC=healthy control