Deep Brain Activity in Cluster Headache and Mood Disorder
Research type
Research Study
Full title
Ventral Tegmental Area Local Field Potentials and Brain Magnetoencephalography Measurement in Cluster Headache and Mood Disorder.
IRAS ID
184295
Contact name
Ludvic Zrinzo
Contact email
Sponsor organisation
University College London
Duration of Study in the UK
3 years, 0 months, 0 days
Research summary
Cluster headache is one of the most severe forms of headache. Brain scans identified abnormally increased activity in part of the brain called the ventral tegmental area (VTA). Deep brain stimulation (DBS) acts largely by inhibiting activity in the region stimulated. DBS to the VTA is a routine NHS treatment for otherwise intractable cluster headache. Whilst studies have reported abnormal brain electrical activity in cluster headache, the recordings may not have been from the VTA and characteristic abnormalities remain unclear.
The 2010 WHO Global Burden of Disease Study identified psychiatric disorders as the leading cause of years-of-life-lived-with-disability worldwide with mood disorder being the largest contributor by some margin. Approximately 50% of cluster headache patients also suffer from depressive illness. Neuroimaging studies have identified abnormal VTA activity in patients with depression and animal models of human depressive illness have reported therapeutic effects on depression-like symptoms from specific patterns of VTA DBS stimulation. However there have been no direct VTA recordings from humans with depression so characteristic features remain unclear.
The study aims to shed light on the above, with the immediate aim of improving understanding of cluster headache and depressive illness mechanisms, and the longer term aim of improving current therapies.
We will obtain recordings from VTA electrodes in patients who have undergone surgery for DBS for cluster headache whilst simultaneously recording electrical signals from the scalp surface using a magnetoencephalography (MEG) scanner. We will assess brain function both at rest and during a behavioral task which has been used previously in functional Magnetic Resonance Imaging (fMRI) scanners, including studies with patients with depression, as the type of task is known to highlight normal VTA activity, so helping identify abnormal function. If patients are able to participate in the recordings from the VTA but not with MEG recording, we will still make LFP recordings but without MEG scanning.
REC name
East Midlands - Derby Research Ethics Committee
REC reference
16/EM/0148
Date of REC Opinion
6 Apr 2016
REC opinion
Favourable Opinion