Effect of deep brain stimulation of the posterior hypothalamic area on the cardiovascular system in chronic cluster headache patients
P. Cortelli
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorP. Guaraldi
Department of Neurosciences, University of Modena and Reggio Emilia, Modena, Italy;
Search for more papers by this authorM. Leone
Headache Unit, Carlo Besta Neurological Institute, Milan, Italy
Search for more papers by this authorG. Pierangeli
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorG. Barletta
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorD. Grimaldi
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorS. Cevoli
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorG. Bussone
Headache Unit, Carlo Besta Neurological Institute, Milan, Italy
Search for more papers by this authorA. Baruzzi
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorP. Montagna
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorP. Cortelli
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorP. Guaraldi
Department of Neurosciences, University of Modena and Reggio Emilia, Modena, Italy;
Search for more papers by this authorM. Leone
Headache Unit, Carlo Besta Neurological Institute, Milan, Italy
Search for more papers by this authorG. Pierangeli
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorG. Barletta
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorD. Grimaldi
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorS. Cevoli
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorG. Bussone
Headache Unit, Carlo Besta Neurological Institute, Milan, Italy
Search for more papers by this authorA. Baruzzi
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorP. Montagna
Department of Neurological Sciences, University of Bologna, Bologna, Italy
Search for more papers by this authorAbstract
The objective of this study was to determine the cardiovascular effects of chronic stimulation of the posterior hypothalamic area (PHA) in cluster headache (CH) patients. Systolic and diastolic blood pressure (SBP, DBP), cardiac output, total peripheral resistance (TPR), heart rate (HR) and breathing were monitored at supine rest and during head-up tilt test (HUTT), Valsalva manoeuvre, deep breathing, cold face test and isometric handgrip in eight drug-resistant chronic CH patients who underwent monolateral electrode implantation in the PHA for therapeutic purposes. Autoregressive power spectral analysis (PSA) of HR variability (HRV) was calculated at rest and during HUTT. Each subject was studied before surgery (condition A) and after chronic deep brain stimulation (DBS) of PHA (condition B). Baseline SBP, DBP, HR and cardiovascular reflexes were normal and similar in both conditions. With respect to condition A, DBP, TPR and the LF/HF obtained from the PSA of HRV were significantly (P < 0.05) increased during HUTT in condition B. In conclusion, chronic DBS of the PHA in chronic CH patients is associated with an enhanced sympathoexcitatory drive on the cardiovascular system during HUTT.
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