Abnormal coactivation of the hypothalamus and salience network in patients with cluster headache.
OBJECTIVE
The purpose of this study was to investigate whether the resting-state coactivation of the hypothalamus, both ipsilateral and contralateral to the headache side, and the salience network (SN) was altered in patients with cluster headache (CH) in the headache attack remission state in the cluster period, and to reveal possible pathogenesis of CH attacks and gain further insight into the pathophysiology of CH.


METHODS
Resting-state fMRI scans of 21 patients with CH were obtained (13 with right-sided headache and 8 with left-sided headache) and 21 age- and sex-matched normal controls. The resting-state fMRI data were analyzed using independent component analysis to identify the group differences of hypothalamic-SN coactivation between the patients with CH and healthy controls.


RESULTS
Decreased functional coactivation was detected between the hypothalamus, both ipsilateral and contralateral to the headache side, and the SN both in patients with right-sided CH and in those with left-sided CH.


CONCLUSIONS
Our findings suggest that the decreased hypothalamus-SN coactivation may have a role in CH attacks by the defective central pathway of pain control and autonomic nervous system dysregulation. This helps to gain additional insight into the pathophysiologic basis of CH and the nature of the brain dysfunction in CH.
From the Department of Neurology, The First Affiliated Hospital (E.Q.), and Department of Radiology (Y.W., L.M.), Chinese PLA General Hospital, Beijing; and Department of Biomedical Engineering (L.T.), School of Computer and Information Technology, Beijing Jiaotong University, China.
Enchao
E
Qiu
From the Department of Neurology, The First Affiliated Hospital (E.Q.), and Department of Radiology (Y.W., L.M.), Chinese PLA General Hospital, Beijing; and Department of Biomedical Engineering (L.T.), School of Computer and Information Technology, Beijing Jiaotong University, China.
Lixia
L
Tian
From the Department of Neurology, The First Affiliated Hospital (E.Q.), and Department of Radiology (Y.W., L.M.), Chinese PLA General Hospital, Beijing; and Department of Biomedical Engineering (L.T.), School of Computer and Information Technology, Beijing Jiaotong University, China.
Yan
Y
Wang
From the Department of Neurology, The First Affiliated Hospital (E.Q.), and Department of Radiology (Y.W., L.M.), Chinese PLA General Hospital, Beijing; and Department of Biomedical Engineering (L.T.), School of Computer and Information Technology, Beijing Jiaotong University, China.
Lin
L
Ma
From the Department of Neurology, The First Affiliated Hospital (E.Q.), and Department of Radiology (Y.W., L.M.), Chinese PLA General Hospital, Beijing; and Department of Biomedical Engineering (L.T.), School of Computer and Information Technology, Beijing Jiaotong University, China. yusy1963@126.com.
Shengyuan
S
Yu
D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D003027:Cluster Headache / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D007031:Hypothalamus / Q000503:physiopathology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009415:Nerve Net / Q000503:physiopathology*; D055815:Young Adult