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Research paper
Altered hypothalamic functional connectivity in cluster headache: a longitudinal resting-state functional MRI study
  1. Fu-Chi Yang1,2,
  2. Kun-Hsien Chou3,4,
  3. Jong-Ling Fuh5,6,
  4. Pei-Lin Lee7,
  5. Jiing-Feng Lirng8,9,
  6. Yung-Yang Lin1,4,5,6,
  7. Ching-Po Lin1,3,4,7,
  8. Shuu-Jiun Wang1,4,5,6
  1. 1Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan
  2. 2Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
  3. 3Institute of Neuroscience, National Yang-Ming University, Taipei, Taiwan
  4. 4Brain Research Center, National Yang-Ming University, Taipei, Taiwan
  5. 5Department of Neurology, National Yang-Ming University, Taipei, Taiwan
  6. 6Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan
  7. 7Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan
  8. 8Department of Radiology, National Yang-Ming University, Taipei, Taiwan
  9. 9Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan
  1. Correspondence to Dr Shuu-Jiun Wang, Department of Neurology, Taipei Veterans General Hospital, No. 201, Section 2, Shipai Road, Beitou 112, Taipei, Taiwan; sjwang{at}vghtpe.gov.tw; Ching-Po Lin, Institute of Neuroscience, National Yang-Ming University, Taiwan No. 155, Section. 2, Li-Nong St. Beitou 112, Taipei, Taiwan; cplin@ym.edu.tw

Abstract

Background Neuroimaging studies implicate hypothalamic dysfunction in the pathogenesis of cluster headache (CH). Disruptions in non-traditional pain processing areas, including the cerebellum and visual cortex, have also been reported in CH. It is unknown whether the hypothalamus interacts significantly with these areas, and whether any such interactions vary between the ‘in-bout’ and ‘out-of-bout’ periods in CH. This study aimed to investigate the resting-state functional connectivity (FC) of the hypothalamus of patients with CH.

Methods Using 3-T functional MRI, we conducted a seed-based resting-state intrinsic FC analysis of the hypothalamus in 18 episodic CH patients during in-bout and out-of-bout periods, and in 19 healthy controls. Correlations between hypothalamic FC and clinical variables were also assessed.

Results Compared to controls, CH patients showed hypothalamic FC changes with the medial frontal gyrus and occipital cuneus during in-bout and out-of-bout periods. Compared to out-of-bout scans, in-bout scans revealed decreased hypothalamic FC with the medial frontal gyrus, precuneus, and cerebellar areas (tonsil, declive and culmen). Additionally, the annual bout frequency correlated significantly with the hypothalamic FC in the cerebellar culmen (r=−0.576, p=0.02) and cerebellar declive (r=−0.522, p=0.038).

Conclusions Our findings suggest that in CH, FC differences between the hypothalamus and its regional distribution extends beyond traditional pain processing areas, primarily to the cerebellar, frontal and occipital areas. These changes may be important and associated with CH pathophysiology.

  • HEADACHE
  • MRI
  • PAIN

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