Structural neuroimaging study in rare primary headache syndromes
Research type
Research Study
Full title
Structural neuroimaging in trigeminal autonomic cephalalgias and cranial neuralgias: a voxel-based morphometry and diffusion tensor imaging study.
IRAS ID
99881
Contact name
Manjit Matharu
Contact email
Sponsor organisation
UCL
Research summary
The trigeminal autonomic cephalalgias (TACs) are a group of rare primary headache disorders characterized by unilateral trigeminal distribution pain that occurs in association with ipsilateral cranial autonomic features, such as redness of the eye and runny nose. The TACs include cluster headache (CH), paroxysmal hemicrania (PH), short-lasting unilateral neuralgiform headache with conjunctival injection and tearing (SUNCT) and short-lasting unilateral neuralgiform headache with autonomic symptoms (SUNA). Trigeminal neuralgia (TN) is the most common amongst the cranial neuralgias. It is characterised by unilateral short-lived, painful attacks in one or more branches of the trigeminal nerve.
The pathophysiology of these conditions is poorly understood. The principal brain structure thought to have a role in pathogenesis of TACs is the posterior hypothalamus, an area that is linked with the trigeminal pain pathway and the autonomic system. TN is thought to be caused by a compression of the trigeminal nerve ipsilateral to the side of the pain by an abnormal vessel (neurovascular conflict),which would injury the nerve, rendering the axons hyperexcitable, thus resulting in paroxysmal painful discharges. SUNCT, SUNA and TN share various clinical (type of pain, duration and frequency of attacks, triggers) and therapeutic similarities (carbamazepine and lamotrigine work in both the conditions), raising the possibility that SUNCT and SUNA may be cranial neuralgias rather than TACs
This project aims to determine whether or not there are macro and micro-structural abnormalities in the grey and/or white matter of brain nociceptive processing pathways (regions responsible of perception of pain and its modulation) in patients with TACs and TN, compared to a non-headache control group, using voxel-based morphometry (VBM) and diffusion tensor imaging (DTI) magnetic resonance imaging (MRI) techniques.
REC name
London - Queen Square Research Ethics Committee
REC reference
12/LO/1982
Date of REC Opinion
30 Dec 2013
REC opinion
Further Information Favourable Opinion