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Effect on Sleep of Posterior Hypothalamus Stimulation in Cluster Headache
Author(s) -
Vetrugno Roberto,
Pierangeli Giulia,
Leone Massimo,
Bussone Gennaro,
Franzini Angelo,
Brogli Giovanni,
D'Angelo Roberto,
Cortelli Pietro,
Montagna Pasquale
Publication year - 2007
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/j.1526-4610.2007.00864.x
Subject(s) - cluster headache , circadian rhythm , polysomnography , medicine , hypothalamus , deep brain stimulation , sleep (system call) , nocturnal , anesthesia , migraine , parkinson's disease , apnea , disease , computer science , operating system
Objective.—To evaluate the structure and quality of sleep and the circadian rhythm of body core temperature (BcT°) in patients with drug‐resistant chronic cluster headache (CH) before and during deep brain stimulation (DBS) of the posterior hypothalamus. Background.—Chronic CH is a severe primary headache and frequently associated with disturbances in sleep. Posterior hypothalamus DBS is performed as an effective treatment of drug‐resistant chronic CH. The effects of posterior hypothalamus DBS on sleep and the circadian rhythm of BcT° are unknown. Methods.—Three male patients with chronic drug‐resistant CH underwent 48‐hour consecutive polysomnography (PSG) by means of the VITAPORT ® system with determination of BcT° by means of a rectal probe. Recordings were done before electrode implantation in the posterior hypothalamus and after optimized DBS of posterior hypothalamus. Results.—Before electrode implantation PSG showed nocturnal CH attacks, reduced sleep efficiency, fragmented sleep and increased periodic limb movements in sleep (PLMS). During DBS nocturnal CH attacks were abolished and sleep efficiency and PLMS improved. BcT° circadian rhythm was normal both before and during DBS. Conclusions.—Our data show that DBS of posterior hypothalamus in drug‐resistant chronic CH is effective in curtailing nocturnal CH attacks, and is associated with improved sleep structure and quality. Chronic CH displays a normal circadian rhythm of BcT°, unchanged during hypothalamic DBS.