title: Deep brain stimulation for cluster headache.
abstract: Cluster headache is a severely debilitating disorder that can remain unrelieved by current pharmacotherapy. Alongside ablative neurosurgical procedures, neuromodulatory treatments of deep brain stimulation (DBS) and occipital nerve simulation have emerged in the last few years as effective treatments for medically refractory cluster headaches. Pioneers in the field have sought to publish guidelines for neurosurgical treatment; however, only small case series with limited long-term follow-up have been published. Controversy remains over which surgical treatments are best and in which circumstances to intervene. Here we review current data on neurosurgical interventions for chronic cluster headache focusing upon DBS and occipital nerve stimulation, and discuss the indications for and putative mechanisms of DBS including translational insights from functional neuroimaging, diffusion weighted tractography, magnetoencephalography and invasive neurophysiology.
authors.affiliation: Nuffield Department of Surgery, University of Oxford and Oxford Functional Neurosurgery, Department of Neurological Surgery, The West Wing, John Radcliffe Hospital, Headley Way, Headington, Oxford, OX3 9DU, UK.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Grover
authors.forename: Erlick A C
authors.initials: EA
authors.lastname: Pereira
authors.forename: Alexander L
authors.initials: AL
authors.lastname: Green
authors.forename: John-Stuart
authors.initials: JS
authors.lastname: Brittain
authors.forename: Sarah L F
authors.initials: SL
authors.lastname: Owen
authors.forename: Patrick
authors.initials: P
authors.lastname: Schweder
authors.forename: Morten L
authors.initials: ML
authors.lastname: Kringelbach
authors.forename: Paul T G
authors.initials: PT
authors.lastname: Davies
authors.forename: Tipu Z
authors.initials: TZ
authors.lastname: Aziz
mesh_terms: D003027:Cluster Headache / Q000191:economics / Q000473:pathology / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000191:economics / Q000379:methods*; D006801:Humans; D016896:Treatment Outcome