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Bob P

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Our messed up brains
Feb 8^th, 2012 at 6:59am

From "Headache:
Quote:

Diffusion Tensor Imaging in Episodic Cluster Headache
Michael Teepker MD, Katja Menzler MD, Marcus Belke MD, Johannes T. Heverhagen MD, Maximilian Voelker BA, Veit Mylius MD, Wolfgang H. Oertel MD, Felix Rosenow MD, Susanne Knake MD*Article first published online: 14 NOV 2011

Background.— Cluster headache (CH) is a rare headache disorder with severe unilateral headache bouts and autonomic symptoms. The pathophysiology of CH is not completely understood. Using a voxel-based morphometric paradigm or functional imaging, a key role of the hypothalamus and the pain matrix could be demonstrated during CH episodes. However, there are no diffusion tensor imaging (DTI) data investigating the white matter microstructure of the brain in patients with CH. Therefore, we used DTI to delineate microstructural changes in patients with CH in a headache-free state.

Methods.— Seven male patients with episodic CH and 7 healthy subjects were included and examined with a routine 1.5 T magnetic resonance imaging scanner. Whole-head DTI scans measuring fractional anisotropy were analyzed without a priori hypotheses using track-based spatial statistics.

Results.— We found significant microstructural brain tissue changes bilaterally in the white matter of the brainstem, the frontal lobe, the temporal lobe, the occipital lobe, the internal capsule, and on the right side of thalamus and cerebellum. There were further lesions in the basal frontal lobe that were part of the olfactory system. Alterations of fractional anisotropy in the brainstem might indicate changes of the medial lemniscus and central sympathetic pathways.

Conclusions.— Patients with episodic CH have microstructural brain changes in regions that belong to the pain matrix. Furthermore, we were able to detect structural changes suggesting an involvement of the olfactory system as well as lesions in the brainstem indicating an involvement of trigeminal and sympathetic systems.

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Mrs. Barlow, I never, and I repeat never, ever pissed in your steam iron. "SHUT UP HUB!"

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wimsey1 CH.com Alumnus Offline I Love CH.com! Posts: 2457 MA Gender:	Re: Our messed up brains Reply #1 - Feb 8^th, 2012 at 8:04am So what does this mean? lance
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Guiseppi CH.com Moderator CH.com Alumnus Offline San Diego to Florida 05-16-2011 Posts: 12063 SAN DIEGO, CALIFORNIA USA Gender:	Re: Our messed up brains Reply #2 - Feb 8^th, 2012 at 8:42am Who are these people? I don't recognize their names, but I'm tickled to death that a group is looking into CH from this angle. I'm with Lance, I don't understand most of it, but it's great people are still doing research. Great find Bob. Joe
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thebbz

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Re: Our messed up brains
Reply #3 - Feb 11^th, 2012 at 3:03pm

I think the indications presented, somewhat duplicate ome of the findings from the PET scans that Goadsby did. Abnormal grey matter growth on the side effected in the hypothalmus...like Bob said, our messed up brains.
Thanks Bob
the bb
Quote:

Patients with episodic CH have microstructural brain changes in regions that belong to the pain matrix. Furthermore, we were able to detect structural changes suggesting an involvement of the olfactory system as well as lesions in the brainstem indicating an involvement of trigeminal and sympathetic systems.

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coach_bill

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Re: Our messed up brains
Reply #4 - Feb 11^th, 2012 at 8:43pm

Just a thought, if that were it... wouldn't we all get it around the same time together? and Ive heard of people losing clusters in the older stages of life. What about those that don't get the clusters till much later in life like the 40+ age range?

I think its a link in our DNA, A splice of the migraine gene that went haywire. A Gene that goes all the way back to our cousin the cave man. Look at the timing, I think were going all the way back to migration. When Seasons change, Equinox and the like... Let me know.....

Extension!!!
Coach Bill

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« Last Edit: Feb 11^th, 2012 at 8:49pm by coach_bill »

boy i cant wait till it's my turn to give him a headache. paybacks a bitch

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Bob P CH.com Hall of Famer Offline Shut up Bob! Posts: 4573 Clio,California Gender:	Re: Our messed up brains Reply #5 - Feb 12^th, 2012 at 6:39am Quote: There were further lesions... I guess they found these small lesions in the parts of the brain listed (does that make us all swiss cheeseheads). My question is do they cause the pain or are they caused by the pain?
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Guiseppi CH.com Moderator CH.com Alumnus Offline San Diego to Florida 05-16-2011 Posts: 12063 SAN DIEGO, CALIFORNIA USA Gender:	Re: Our messed up brains Reply #6 - Feb 12^th, 2012 at 9:10am My question is do they cause the pain or are they caused by the pain? Mine too. Joe
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Brew CH.com Sponsor CH.com Alumnus Offline Posts: 14163	Re: Our messed up brains Reply #7 - Feb 12^th, 2012 at 10:10am Some of us are cheeseheads by birth.
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ttnolan

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Re: Our messed up brains
Reply #8 - Feb 12^th, 2012 at 4:27pm

Ya I read a similar study done where they talked about brain tissue atrophy due to the chronic severe pain. So is this pain matrix something we really have different, or something well developed by the effects of CH? I know Goadsby identified extra matter in the hypothalamus which demonstrated increased activity in that area of the brain during an attack. I am wondering how much of the other findings... "lesions", are normal brain atrophy/reconstruction due to the disease?
Just some thoughts.

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« Last Edit: Feb 12^th, 2012 at 4:30pm by ttnolan »

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Bob P CH.com Hall of Famer Offline Shut up Bob! Posts: 4573 Clio,California Gender:	Re: Our messed up brains Reply #9 - Feb 13^th, 2012 at 7:53am Quote: Some of us are cheeseheads by birth. Myself included. Born at Milwaukee County Hospital to a good beer family (Dad was GM of a Schlitz Brewery).
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Callico

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Re: Our messed up brains
Reply #10 - Feb 15^th, 2012 at 4:52pm

ttnolan wrote on Feb 12^th, 2012 at 4:27pm:

Ya I read a similar study done where they talked about brain tissue atrophy due to the chronic severe pain. So is this pain matrix something we really have different, or something well developed by the effects of CH? I know Goadsby identified extra matter in the hypothalamus which demonstrated increased activity in that area of the brain during an attack. I am wondering how much of the other findings... "lesions", are normal brain atrophy/reconstruction due to the disease?
Just some thoughts.

This study was of Episodic Clusterheads, I wonder where we Chronics fit in? I was episodic for the first 20+ years before going chronic now for the last 10+. I was struck by the "brain tissue atrophy" comment. Would that cause loss of cognitive ability? I know I'm not nearly as sharp as I was 10 years ago. Part of it is probably due to sleep deprivation and some of the meds I was on, but I can't lay it all to that. I know my memory, especially short term, is shot. If I don't write down details from meeting with clients I won't have any idea what was decided the next day.

Jerry

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« Last Edit: Feb 15^th, 2012 at 4:53pm by Callico »

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wimsey1 CH.com Alumnus Offline I Love CH.com! Posts: 2457 MA Gender:	Re: Our messed up brains Reply #11 - Feb 16^th, 2012 at 8:23am I wouldn't let that "brain atrophy" stuff get around too much. I have enough trouble counting my fingers and toes as it is. I don't need others nodding knowingly and sayin, "it's OK, his brain is shrunk."
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AubanBird

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Re: Our messed up brains
Reply #12 - Feb 17^th, 2012 at 1:29am

this raises a lot of questions for me.

"measuring fractional anisotropy" is pretty much just a fancy way of saying they were watching the direction that neural tracts and signals were moving througout the brain. they were basicaly watching the organizational pattern of the brain activity.

anisotropy is the property of something being aligned by an axis. for instance, wood has a high degree of anisotropy because the fibers line up along the grain. paper would be just the opposite, isotropy, showing no directional organization.

the part that has me interested is the results. the "statistics" they used for comparison indicated that there were changes in the sympathetic pathways.

its the sympathetic pathway part that makes it extremely interesting to me. i understand the pain matrix being different, as cluster headaches give those areas plenty of "workouts". the trigeminal nerve, well duh.

however, the sympathetic nervous system is usually in control of fight or flight responses as well as maintaining homeostasis, but can also cause severe pain if something goes wrong.

just ask anyone with fibromyalgia or RSDS (like my wife).

the medical community knows nearly as little about sympathetic nervous system disorders as they do about cluster headaches, even though they are MUCH more common.

im going to have to stew on this for a while and look into it. i just wish i knew the progression of these abnormalities. what is the cause and what is the affect?

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pattik

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Re: Our messed up brains
Reply #13 - Feb 24^th, 2012 at 12:27pm

Bob P wrote on Feb 12^th, 2012 at 6:39am:

Quote:

There were further lesions...

I guess they found these small lesions in the parts of the brain listed (does that make us all swiss cheeseheads). My question is do they cause the pain or are they caused by the pain?

Bob~Thanks for posting this new study. I am most interested in the autonomic aspects that go along with or without the headaches. The mention of the sympathetic system in the study just reinforces my belief that the old "cluster headache syndrome" label is still appropriate. Those pesky autonomic issues never seem to be too far away for me, even during remissions. I still like to refer back to OUCH's page on the wacky hypothalamus and autonomic system: Multimedia File Viewing and Clickable Links are available for Registered Members only!! You need to

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Again..thanks for posting from a fellow Cheesehead Wink

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Kristie

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Re: Our messed up brains
Reply #14 - Feb 27^th, 2012 at 10:03pm

On this note, has anyone ever had their opthamologist do an optic nerve imaging test? I have my optho do it every few years and guess what? My right optic nerve has damage and it has continued to deteriorate over the years. Same side of the head where the CHs attack. Coincidence? I think not. But not sure if the chicken or the egg came first. Having optic nerve damage is not all that rare in most adults, but he thought mine pretty severe given the lack of trauma and all other signs being healthy. Just curious to know if anyone else has had similar tests run with similar results? It doesn't surprise me in the least that there would be damage given the crushing pain that ocurs during a CH.

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Mike Bernardo

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Re: Our messed up brains
Reply #15 - Mar 5^th, 2012 at 12:02pm

THis fits in with the testing I had done for years when they thought I had MS. The one thing that didn't fit was the increasing severity of the headaches. I had the gray matter changes in the MRI, the optic changes and the hearing issues in the left ear, as well as issues with evoked potentials results on the opposing side of the of the body. Curious. More studies will result in more findings, I'm sure.

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Purple (head404)

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Re: Our messed up brains
Reply #16 - Mar 6^th, 2012 at 11:30am

A study with similar findings was discussed at Clusterbusters, or is it the same? Hmmm I guess no.
I don't know if Dr Filippi's study was discussed here at all?

Seems to me Dr Filippi's study demonstrate the abnormalities in grey and white matter are a result of the many years of pain, not the source, as I commented on a clusterbusters thread (the last link).
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