Clinical and Physiological Examination of Headache Disorders

Abstract

　Functional neuroimaging techniques, such as functional magnetic resonance imaging and voxel-based morphometry, are powerful tools in headache research and have greatly contributed to our understanding of pathophysiology of headache disorders. Over the past two decades, the brainstem and hypothalamus have been identified as target regions of interest in migraine and cluster headache pathophysiology. A number of functional neuroimaging studies have shown that migraine is associated with significant gray matter activation and/or reduction in several cortical areas involved in pain processing and modulation. Recent evidence suggests that the brainstem and hypothalamus activity periodically change during different stages of the migraine cycle. Additionally, the morphometric gray matter changes have been identified between ictal and interictal migraine phases.