title: The effect of posterior hypothalamus region deep brain stimulation on sleep.
abstract: BACKGROUND
  Early observations by von Economo showed that the posterior part of the hypothalamus (PH) plays a prominent role in sleep-wake regulation. The PH is a candidate area involved in cluster headaches and other trigeminal autonomic cephalalgias (TACs) and is targeted for deep brain stimulation (DBS).
  
  
  METHODS
  Sleep studies in two men, 69- and 39-years-old, with pre-existing sleep disorders, before and after PH-DBS for pharamacoresistant cluster headache and SUNCT syndrome showed that PH-DBS led to a dramatic alteration of the patients' sleep patterns. This coincided with an improvement of the predominantly diurnal TACs, suggesting a PH-DBS-induced change in sleep patterns. Hypnograms after DBS demonstrated disrupted sleep and a prolonged period of wakefulness after midnight in both patients, which was reproduced the second night.
  
  
  CONCLUSIONS
  PH-DBS, a promising treatment for severe refractory TACs, affects sleep quality and pre-existing sleep disorders. This needs to be considered when treating patients with PH-DBS.
authors.affiliation: Institute of Neurology, National Hospital for Neurology and Neurosurgery, London, UK.
authors.forename: Stjepana
authors.initials: S
authors.lastname: Kovac
authors.forename: Mary-Anne
authors.initials: MA
authors.lastname: Wright
authors.forename: Sofia H
authors.initials: SH
authors.lastname: Eriksson
authors.forename: Ludvic
authors.initials: L
authors.lastname: Zrinzo
authors.forename: Manjit
authors.initials: M
authors.lastname: Matharu
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Walker
mesh_terms: D000328:Adult; D000368:Aged; D003027:Cluster Headache / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D046690:Deep Brain Stimulation / Q000379:methods; D006801:Humans; D007031:Hypothalamus; D008297:Male; D050798:SUNCT Syndrome / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D012890:Sleep; D012893:Sleep Wake Disorders / Q000175:diagnosis / Q000503:physiopathology* / Q000517:prevention & control*; D016896:Treatment Outcome
keywords: DBS; Parasomnia; REM behavioural disorder; cluster headache; trigeminal autonomic cephalalgias