Enrico
Arkink1, Nicole Schmitz1,2, Guus Schoonman3,
Jorien van Vliet3,4, Gisela Terwindt3, Mark van Buchem1,
Michel Ferrari3, Mark Kruit1
1Radiology, Leiden University Medical
Center, Leiden, Netherlands; 2Psychiatry, Amsterdam Medical
Center, Amsterdam, Netherlands; 3Neurology, Leiden University
Medical Center, Leiden, Netherlands; 4Neurology, Medisch Centrum
Haaglanden, Den Haag, Netherlands
Trigeminal
autonomic cephalalgias include cluster headache, paroxysmal hemicrania and
SUNCT. An earlier voxel-based morphometry (VBM) study pointed at the
posterior inferior hypothalamus to be involved in CH, but results were never
reproduced. In the current study we used state of the art whole-brain and
regional VBM, and manual segmentation of the hypothalamus, in analyzing the
brains of 151 subjects with TACs (n=70), migraine patients (n=33) and
controls (n=48). We found the anterior part (but not the posterior part) of
the hypothalamus, including the suprachiasmatic nucleus (the biological
clock), to be larger in TACs compared to migraineurs and controls. Our
results seem to be specific for TACs, and question the validity and/or
relevance of the earlier finding, including its role in deep brain
stimulation as treatment for intractable cluster headaches.