Deep brain stimulation for trigeminal autonomic cephalalgias

Giuseppe Messina, Giovanni Broggi, Vincenzo Levi, Angelo Franzini

Research output: Contribution to journalReview article

Abstract

Introduction: Deep brain stimulation (DBS) of the posterior hypothalamic region (pHyr) has been shown to be efficacious for more than a half of patients suffering from trigeminal autonomic cephalalgias (TACs); nonetheless, controversies about the mechanisms of action and the actual site of stimulation have arisen in recent years. Areas covered: Firstly, a review of the most recent literature on the subject is presented, stressing the critical points that could, in the future, make a difference for optimal management of patients afflicted by these life-threating diseases. Hypothalamic functional anatomy, experimental data and pathophysiological hypotheses are reported. Expert commentary: About 32% of patients who underwent DBS for TACs are pain-free. The determination of the pHyr region seems to be crucial for the generation of pain attack in these pathologies, although other structures are involved in complex mechanisms and circuits that interact with each other. Neurophysiological data, combined with more advanced experimental models, are of primary importance regarding our understanding of what the real target is, and how to overcome the issue of refractory patients.

Original languageEnglish
Pages (from-to)421-426
Number of pages6
JournalExpert Review of Neurotherapeutics
Volume18
Issue number5
DOIs
Publication statusPublished - May 4 2018

Keywords

  • deep brain stimulation
  • headache
  • Hypothalamus
  • neurophysiology
  • trigeminal autonomic cephalalgias

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Neurology
  • Pharmacology (medical)

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