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Ipsilateral Alteration of Resting State Activity Suggests That Cortical Dysfunction Contributes to the Pathogenesis of Cluster Headache


The pathomechanism of cluster headache (CH) is not entirely understood, but central and peripheral components were suggested. A recent report showed that transcranial magnetic stimulation measured cortical excitability was increased in the hemisphere ipsilalteral to the pain. In the current study we set out to investigate the amplitude of resting brain fMRI activity to find signatures of the increased excitability. High resolution T1 weighted and resting state functional MRI images were acquired from seventeen patients with CH in pain free period and from twenty-six healthy volunteers. Patients’ data were normalized (e.g. inverted along the midsagittal axis) according to the headache side. Independent component analysis and a modified dual regression approach were used to reveal the differences between the resting state networks. Furthermore, the timecourses were decomposed into five frequency bands by discrete wavelet decomposition and were also re-regressed to the original data to reveal frequency specific resting activity maps. Two of the identified resting state networks showed alterations in CH. When the data were inverted to have patients’ headaches on the left, the ipsilateral attention network showed increased connectivity in 0.08–0.04 Hz frequency band in the in CH group. In the same dataset, cerebellar network showed higher functional connectivity in 0.02–0.01 Hz range in the ipsilateral cerebellum. When the data of patients having headache on the left were inverted to the right, similar increased signal was found in the ipsilateral attention network in 0.08–0.04 Hz band. The cerebellar network showed increased connectivity in the cerebellum in 0.02–0.01 Hz band in patients. The Fourier analysis of these area revealed increased power in CH at all cases. Our results showed alterations of brain functional networks in CH. The alterations of resting state activity were found in the hemisphere ipsilateral to the pain, signifying the altered cortical processing in the pathomechanism of CH.

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The study was supported by the “Neuroscience Research Group of the Hungarian Academy of Sciences and University of Szeged”, project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123) from the European Regional Development Fund, the National Brain Research Program (Grant No. KTIA_13_NAP-A-II/20.) and an OTKA [PD 104715] Grant. Dr. Szabó and Dr. Kincses were supported by European Regional Development Fund—Project FNUSA-ICRC (No. CZ.1.05/1.1.00/02.0123) and by European Union—Project ICRC-ERA-HumanBridge (No. 316345). Dr. Párdutz was supported by the Bolyai Scholarship Program of the Hungarian Academy of Sciences.

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Correspondence to Zsigmond Tamás Kincses.

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Faragó, P., Szabó, N., Tóth, E. et al. Ipsilateral Alteration of Resting State Activity Suggests That Cortical Dysfunction Contributes to the Pathogenesis of Cluster Headache. Brain Topogr 30, 281–289 (2017).

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  • Cluster headache
  • MRI
  • Resting state networks
  • Dual regression
  • Frequency analysis