Diffusion tensor imaging in episodic cluster headache

Headache: The Journal of Head and Face PainTeepker M et al. | November 30, 2011

Patients with episodic cluster headache (CH) have microstructural brain changes in regions that belong to the pain matrix. Furthermore, authors were able to detect structural changes suggesting an involvement of the olfactory system as well as lesions in the brainstem indicating an involvement of trigeminal and sympathetic systems.


  • Seven male patients with episodic CH and 7 healthy subjects were included and examined with a routine 1.5 T magnetic resonance imaging scanner.
  • Whole–head DTI scans measuring fractional anisotropy were analyzed without a priori hypotheses using track–based spatial statistics.


  • Authors found significant microstructural brain tissue changes bilaterally in the white matter of the brainstem, the frontal lobe, the temporal lobe, the occipital lobe, the internal capsule, and on the right side of thalamus and cerebellum.
  • There were further lesions in the basal frontal lobe that were part of the olfactory system.
  • Alterations of fractional anisotropy in the brainstem might indicate changes of the medial lemniscus and central sympathetic pathways.

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