Hypothalamic Activation in Spontaneous Migraine Attacks

Marie Denuelle, MD; Nelly Fabre, MD; Pierre Payoux, MD; Francois Chollet, MD; Gilles Geraud, MD

Disclosures

Headache. 2007;47(10):1418-1426. 

In This Article

Conclusion

In conclusion, our data replicate activation of midbrain and pons nuclei during spontaneous migraine attacks and, for the first time, demonstrate activation of the hypothalamus. It has long been hypothesized that the prodromal phase of migraine attacks are initiated by a functional disturbance of the hypothalamus, and that either an episodic disturbance of hypothalamic activity or a labile activation threshold could account for the periodicity of the migraine attack.[35,36,37] Indeed, as early as 1989, Lance hypothesized that internal biological rhythms and/or external triggers such as stressful events and excessive afferent stimulation may initiate a migraine attack via activation of the hypothalamus and its down-stream connections with brainstem nuclei.[36] If the hypothalamus really is the integrator and trigger of migraine attacks, this must be confirmed by the sequential neuroimaging of spontaneous attacks from the prodromal phase onward.

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