Circadian functional changes of pain-processing brainstem nuclei and implications for cluster headache: A 7 Tesla imaging study.

Autor: Pohl H; Department of Neurology, University Hospital Zurich, Clinical Neuroscience Centre, Zurich, Switzerland., Neumeier MS; Department of Neurology, University Hospital Zurich, Clinical Neuroscience Centre, Zurich, Switzerland., Gantenbein AR; Department of Neurology, University Hospital Zurich, Clinical Neuroscience Centre, Zurich, Switzerland.; Department of Neurology and Neurorehabilitation, ZURZACH Care, Bad Zurzach, Switzerland., Wegener S; Department of Neurology, University Hospital Zurich, Clinical Neuroscience Centre, Zurich, Switzerland.; Department of Neurology, University of Zurich, Zurich, Switzerland., Rosio M; Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland., Hennel F; Institute for Biomedical Engineering, ETH Zurich and University of Zurich, Zurich, Switzerland., Sandor PS; Department of Neurology, University Hospital Zurich, Clinical Neuroscience Centre, Zurich, Switzerland.; Department of Neurology and Neurorehabilitation, ZURZACH Care, Bad Zurzach, Switzerland., Weller M; Department of Neurology, University Hospital Zurich, Clinical Neuroscience Centre, Zurich, Switzerland.; Department of Neurology, University of Zurich, Zurich, Switzerland., Michels L; Department of Neuroradiology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland.; Neuroscience Center Zurich, University of Zurich and Swiss Federal Institute of Technology Zurich, Zurich, Switzerland.
Jazyk: angličtina
Zdroj: Headache [Headache] 2024 Jul-Aug; Vol. 64 (7), pp. 729-737. Date of Electronic Publication: 2024 Jun 24.
DOI: 10.1111/head.14752
Abstrakt: Background: Pain thresholds and primary headaches, including cluster headache attacks, have circadian rhythmicity. Thus, they might share a common neuronal mechanism.
Objective: This study aimed to elucidate how the modulation of nociceptive input in the brainstem changes from noon to midnight. Insights into the mechanism of these fluctuations could allow for new hypotheses about the pathophysiology of cluster headache.
Methods: This repeated measure observational study was conducted at the University Hospital Zurich from December 2019 to November 2022. Healthy adults between 18 and 85 years of age were eligible. All participants were examined at noon and midnight. We tested the pain threshold on both sides of the foreheads with quantitative sensory testing, assessed tiredness levels, and obtained high-field (7 Tesla) and high-resolution functional magnetic resonance imaging (MRI) at each visit. Functional connectivity was assessed at the two visits by performing a region-of-interest analysis. We defined nuclei in the brainstem implicated in processing nociceptive input as well as the thalamus and suprachiasmatic nucleus as the region-of-interest.
Results: Ten people were enrolled, and seven participants were included. First, we did not find statistically significant differences between noon and midnight of A-delta-mediated pain thresholds (median mechanical pain threshold at noon: left 9.2, right 9.2; at night: left 6.5, right 6.1). Second, after correction for a false discovery rate, we found changes in the mechanical pain sensitivity to have a statistically significant effect on changes in the functional connectivity between the left parabrachial nucleus and the suprachiasmatic nucleus (T = -40.79).
Conclusion: The MRI data analysis suggested that brain stem nuclei and the hypothalamus modulate A-delta-mediated pain perception; however, these changes in pain perception did not lead to statistically significantly differing pain thresholds between noon and midnight. Hence, our findings shed doubt on our hypothesis that the physiologic circadian rhythmicity of pain thresholds could drive the circadian rhythmicity of cluster headache attacks.
(© 2024 The Author(s). Headache: The Journal of Head and Face Pain published by Wiley Periodicals LLC on behalf of American Headache Society.)
Databáze: MEDLINE
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