Effect of deep brain stimulation of the posterior hypothalamic area on the cardiovascular system in chronic cluster headache patients

P. Cortelli, P. Guaraldi, M. Leone, G. Pierangeli, G. Barletta, D. Grimaldi, S. Cevoli, G. Bussone, A. Baruzzi, P. Montagna

Research output: Contribution to journalArticlepeer-review

Abstract

The objective of this study was to determine the cardiovascular effects of chronic stimulation of the posterior hypothalamic area (PHA) in cluster headache (CH) patients. Systolic and diastolic blood pressure (SBP, DBP), cardiac output, total peripheral resistance (TPR), heart rate (HR) and breathing were monitored at supine rest and during head-up tilt test (HUTT), Valsalva manoeuvre, deep breathing, cold face test and isometric handgrip in eight drug-resistant chronic CH patients who underwent monolateral electrode implantation in the PHA for therapeutic purposes. Autoregressive power spectral analysis (PSA) of HR variability (HRV) was calculated at rest and during HUTT. Each subject was studied before surgery (condition A) and after chronic deep brain stimulation (DBS) of PHA (condition B). Baseline SBP, DBP, HR and cardiovascular reflexes were normal and similar in both conditions. With respect to condition A, DBP, TPR and the LF/HF obtained from the PSA of HRV were significantly (P <0.05) increased during HUTT in condition B. In conclusion, chronic DBS of the PHA in chronic CH patients is associated with an enhanced sympathoexcitatory drive on the cardiovascular system during HUTT.

Original languageEnglish
Pages (from-to)1008-1015
Number of pages8
JournalEuropean Journal of Neurology
Volume14
Issue number9
DOIs
Publication statusPublished - Sep 2007

Keywords

  • Cardiovascular physiology
  • Chronic cluster headache
  • Deep brain stimulation
  • Hypothalamus
  • Posterior

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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