Effect on sleep of posterior hypothalamus stimulation in cluster headache

Roberto Vetrugno, Giulia Pierangeli, Massimo Leone, Gennaro Bussone, Angelo Franzini, Giovanni Brogli, Roberto D'Angelo, Pietro Cortelli, Pasquale Montagna

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. - To evaluate the structure and quality of sleep and the circadian rhythm of body core temperature (BcT°) in patients with drug-resistant chronic cluster headache (CH) before and during deep brain stimulation (DBS) of the posterior hypothalamus. Background. - Chronic CH is a severe primary headache and frequently associated with disturbances in sleep. Posterior hypothalamus DBS is performed as an effective treatment of drug-resistant chronic CH. The effects of posterior hypothalamus DBS on sleep and the circadian rhythm of BcT° are unknown. Methods. - Three male patients with chronic drug-resistant CH underwent 48-hour consecutive polysomnography (PSG) by means of the VITAPORT® system with determination of BcT° by means of a rectal probe. Recordings were done before electrode implantation in the posterior hypothalamus and after optimized DBS of posterior hypothalamus. Results. - Before electrode implantation PSG showed nocturnal CH attacks, reduced sleep efficiency, fragmented sleep and increased periodic limb movements in sleep (PLMS). During DBS nocturnal CH attacks were abolished and sleep efficiency and PLMS improved. BcT° circadian rhythm was normal both before and during DBS. Conclusions. - Our data show that DBS of posterior hypothalamus in drug-resistant chronic CH is effective in curtailing nocturnal CH attacks, and is associated with improved sleep structure and quality. Chronic CH displays a normal circadian rhythm of BcT°, unchanged during hypothalamic DBS.

Original languageEnglish
Pages (from-to)1085-1090
Number of pages6
JournalHeadache
Volume47
Issue number7
DOIs
Publication statusPublished - Jul 2007

Keywords

  • Body core temperature
  • Circadian rhythm
  • Cluster headache
  • Hypothalamus
  • Periodic limb movements during sleep
  • Sleep

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)

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