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High-Tech MRI Reveals Brain Atrophy From CH

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http://www.painmedicinenews.com/ViewArticle.aspx?d=Pain+&+The+Brain&d_id=374&i=July+2011&i_id=744&a_id=17470

High-Tech MRI Reveals Brain Atrophy From Cluster Headache

by Andrew Wilner

Honolulu—Voxel-based morphometry (VBM) of magnetic resonance imaging data revealed multiple areas of gray matter brain atrophy in subjects with cluster headache, according to research presented at the recent 2011 annual meeting of the American Academy of Neurology (P03.044).

“Our VBM findings agree with several morphometric studies that have suggested reduced gray matter density in pain-transmitting areas in patients with chronic pain,” said Massimo Filippi, MD, from the Scientific Institute and University Osperdale San Raffaele, Milan, Italy. “At present, however, these findings do not have immediate consequences for treating cluster headache.”

Cluster headache is a relatively rare neurologic disease, affecting only 0.01% of the population, but it is the most severe of all headache disorders and, as of yet, has no cure. To determine how the brain is affected by cluster headache, Dr. Filippi and colleagues compared 15 right-handed patients (13 men, two women, mean age 44) with episodic cluster headache to 19 right-handed healthy volunteers (12 men, seven women, mean age 42) using VBM.

VBM showed that patients with cluster headache (vs. those without) had significantly more gray matter atrophy in several areas of the pain matrix network, including the right thalamus, bilateral posterior cingulate cortex, bilateral middle frontal gyrus, right middle temporal gyrus and right precentral gyrus (P<0.001). Additionally, the extent of atrophy in the left middle frontal gyrus correlated with disease duration (P<0.001). The researchers found no significant differences between subjects and controls in mean diffusivity or fractional anisotropy of the brainÂ’s white matter.

Although prior research with VBM and positron emission tomography found patients with cluster headache had abnormalities in the hypothalamus—proposed as a key component in the pathophysiology of cluster headache—the current study showed no such abnormalities.

“Dr. Filippi’s poster muddies the waters a little bit, because his group didn’t find the same abnormalities in the hypothalamus that had previously been reported,” said Stewart Tepper, MD, professor of neurology, Cleveland Clinic, Lerner College of Medicine, Ohio, who was not involved in the study. “The increasing sophistication of brain imaging, however, will allow us to continue to gradually work out the entire anatomy of the efferent outflow of cluster headache and learn how best to treat it.”

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I know, especially since the amount of atrophy seems to correlate to the length of time having CH. I started getting them at age 16-17  :(

Interesting about their results not showing the same abnormalities in the hypothalamus that were previously thought to be associated with cluster headaches

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Thanks for putting this up Kyle.

Amazing technology and interesting findings from the study.

"VBM showed that patients with cluster headache (vs. those without) had significantly more gray matter atrophy in several areas of the pain matrix network, including the right thalamus, bilateral posterior cingulate cortex, bilateral middle frontal gyrus, right middle temporal gyrus and right precentral gyrus (P<0.001)."

--yep.  Can someone explain what all these areas do?

"Additionally, the extent of atrophy in the left middle frontal gyrus correlated with disease duration (P<0.001)."

--this seems to agree with a thought I've always had:  living with this sort of recurring pain for this many years can't be good for us in the long run.   

"Although prior research with VBM and positron emission tomography found patients with cluster headache had abnormalities in the hypothalamus—proposed as a key component in the pathophysiology of cluster headache—the current study showed no such abnormalities."

-- this is something to watch.  When the early PET scans showed hypothalamus activity it was hoped this might lead to more targeted treatment possibilities.  (hypothalamic deep brain stimulation).   Maybe not???

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Hello,

That is really interesting.  What is the difference between our normal mri and this vbm mentioned?  Do they not use it for the general public yet, is it just being used for research purposes?  I ask because I've never heard of it, I find it interesting.

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Wow so the whole defective hypothalamus theory is just flying right out the window?

The atrophying hunks and chunks of brain do correspond to my feeling of having been left with a damaging brain burn after a whopper CH has ripped through.

I use terms like 'hunks and chunks' because the parts of my brain that would've come up with the correct terms have atrophied.  :D

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The hypothalamus theory is NOT yet proven incorrect. 

This is only one study, one more piece in the puzzle.

So hold on to your hunks and chunks Bejeebers.  ;-)

The good news of all this, there is some research  going on into something about cluster headache.

FG

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I was at The OUCH conference last month with a bunch of CH'ers, many of them middle aged and older, and they were such a sharp bunch that I practically felt  like I was at a Mensa convention (but without the the egotistical nerdliness I imagine you'd find amongst the Mensa rank and file :D), and that eases my mind about lasting damage from CH. :)

So I will go ahead and hang onto my hunks'n chunks. Good thinkin', Fun Guy. ;D

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So I wonder...

Is the atrophy the cause of our CH?

Or is the CH the cause of the atrophy?

If the latter then preventing CH from occurring such as through busting takes on a new urgency.

For years we thought CH was a cruel annoyance without any long term effects.  This might indicate otherwise. 

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HONOLULU -- An MRI study of young, otherwise healthy individuals with type 1 diabetes has revealed significant cerebral atrophy that may underlie cognitive deficits, Dr. Richard K.T. Chan reported at the annual meeting of the American Academy of Neurology.

Nearly 90% of individuals with type 1 diabetes in the study had brain-volume scores lower than the 50th percentile of nondiabetic subjects, according to interim results from 26 diabetic and 24 nondiabetic subjects. Despite the relatively small number of subjects, the brain-volume difference proved to be highly statistically significant.

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This study belies the impression given to me by virtually every Clusterhead (except Dan) that I've had the pleasure to meet here. The level of intelligence exhibited by posters to this forum (except Dan) never ceases to amaze. The "lost" gray matter must not be too important.

Ron

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violinmaker,

Interesting information!  I have to say that since getting my CH pain under control with busting, I feel smarter...  8-)  Maybe my grey matter didn't turn into black water (anyone with a large boat or camper should get that one. :)  .. ha...

Jeff

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