title: Impaired thermal perception in cluster headache.
abstract: Cluster headache is characterized by attacks of severe periorbital pain. Repetitive burst activity in afferent fibers may induce plastic alterations in somatosensory synaptic processing as a prerequisite for recurring and chronic pain. This psychophysical study addressed hypothesized dysfunctions in craniofacial somatosensory processing in cluster headache disease. Thermal and mechanical sensory functions in the periorbital region were assessed by quantitative sensory testing (QST) in 25 cluster headache patients and 60 healthy volunteers. Perception of warmth (p<0.01), cold (p<0.000001), and pressure pain (p<0.05) was reduced on the cluster side as compared with the contralateral asymptomatic side. In contrast to healthy volunteers, warm detection threshold (WDT) and thermal sensory limen (TSL) on one side did not positively correlate with the other side. WDT and TSL negatively correlated with the elapsed time since last attack. All patients showed QST abnormalities on the headache side in comparison to healthy controls. Loss of sensory functions strongly preponderated gain. Several lines of evidence indicate a pivotal role of the hypothalamus in cluster headache pathophysiology. The impairment of warm and cold perception in patients may be based upon a dysfunction of the hypothalamus which is strongly involved in thermosensory control.
authors.affiliation: Department of Neurosurgery, Experimental Neurosurgery Section, Medical Faculty, RWTH Aachen University, Pauwelsstrasse 30, 52074, Aachen, Germany. jellrich@ukaachen.de
authors.forename: Jens
authors.initials: J
authors.lastname: Ellrich
authors.forename: Dejan
authors.initials: D
authors.lastname: Ristic
authors.forename: Sareh Said
authors.initials: SS
authors.lastname: Yekta
mesh_terms: D000328:Adult; D003027:Cluster Headache / Q000523:psychology*; D003080:Cold Temperature; D005260:Female; D006358:Hot Temperature; D006801:Humans; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold / Q000502:physiology; D010812:Physical Stimulation; D013697:Thermosensing / Q000502:physiology*; D014732:Vibration