Long-Term Results of Deep Brain Stimulation of the Mamillotegmental Fasciculus in Chronic Cluster Headache
| Autor: | Fernando Seijo-Fernandez, Elisa Seijo, Lydia Nader, Juan A. Barcia, Elena Santamarta, Beatriz Lozano, Antonio Saiz, Marco Antonio Alvarez-Vega |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Deep brain stimulation Deep Brain Stimulation medicine.medical_treatment Cluster Headache 03 medical and health sciences 0302 clinical medicine Cephalalgia Neuromodulation Fasciculus medicine Humans 030212 general & internal medicine book book.periodical biology business.industry Cluster headache Ventricular wall Long term results Middle Aged biology.organism_classification medicine.disease Intensity (physics) Diffusion Tensor Imaging Treatment Outcome medicine.anatomical_structure Subthalamus Female Surgery Neurology (clinical) Nuclear medicine business 030217 neurology & neurosurgery |
| Zdroj: | Stereotactic and Functional Neurosurgery. 96:215-222 |
| ISSN: | 1423-0372 1011-6125 |
| DOI: | 10.1159/000489937 |
| Popis: | Background: Deep brain stimulation (DBS) and the proper target for chronic cluster headache (CCH) are still subjects of controversy. Objectives: We present our long-term results of analysis of the target and its structural connectivity. Methods: Fifteen patients with drug-resistant CCH underwent DBS in coordinates 4 mm lateral to the III ventricular wall and 2 mm behind and 5 mm below the intercommissural point. The clinical parameters recorded were the number of weekly attacks, pain intensity, and duration of the headache. Structural connectivity was studied using 3-T MR diffusion tensor imaging (DTI). Results: All of our patients improved from a mean of 39 attacks/week to 2; pain intensity decreased from 9 to 3 out of 10, and the mean cephalalgia duration decreased from 53 to 8 min. The mean stereotactic coordinates of the effective contact location were 6.1 mm lateral to the midcommissural point and 1.2 mm behind and 4.0 mm below the intercommissural point. DTI analysis showed that this target was connected to tracts and nuclei of the posterior mesencephalic tegmentum, specifically the dorsal longitudinal and mamillotegmental fasciculi. Conclusions: Our data showed DBS to be a safe and useful procedure for the treatment of drug-resistant CCH; the rate of improvement was higher than those found in other series. Although these are promising results, larger series targeting those fasciculi with a longer follow-up are needed. |
| Databáze: | OpenAIRE |
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