Please use this identifier to cite or link to this item: http://bura.brunel.ac.uk/handle/2438/30085
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dc.contributor.authorMedina, S-
dc.contributor.authorBakar, NA-
dc.contributor.authorO’Daly, O-
dc.contributor.authorMiller, S-
dc.contributor.authorMakovac, E-
dc.contributor.authorRenton, T-
dc.contributor.authorWilliams, SCR-
dc.contributor.authorMatharu, M-
dc.contributor.authorHoward, MA-
dc.date.accessioned2024-11-10T16:57:14Z-
dc.date.available2024-11-10T16:57:14Z-
dc.date.issued2021-08-12-
dc.identifierORCiD: Sonia Medina https://orcid.org/0000-0001-8883-6520-
dc.identifierORCiD: Elena Makovac-
dc.identifier91-
dc.identifier.citationMedina, S. et al. (2024) 'Regional cerebral blood flow as predictor of response to occipital nerve block in cluster headache', Journal of Headache and Pain, 22 (1), 91, pp. 1 - 14. doi: 10.1186/s10194-021-01304-9.en_US
dc.identifier.issn1129-2369-
dc.identifier.urihttps://bura.brunel.ac.uk/handle/2438/30085-
dc.descriptionAvailability of data and materials: All data were acquired at the Centre for Neuroimaging Sciences at King’s College London. Composite groupwise statistical maps derived study analyses are available from the corresponding author SM on reasonable request.en_US
dc.description.abstractBackground: Cluster headache is an excruciating disorder with no cure. Greater occipital nerve blockades can transiently suppress attacks in approximately 50% of patients, however, its mechanism of action remains uncertain, and there are no reliable predictors of treatment response. To address this, we investigated the effect of occipital nerve blockade on regional cerebral blood flow (rCBF), an index of brain activity, and differences between treatment responders and non-responders. Finally, we compared baseline perfusion maps from patients to a matched group of healthy controls. Methods: 21 male, treatment-naive patients were recruited while in a cluster headache bout. During a pain-free phase between headaches, patients underwent pseudo-continuous arterial spin labelled MRI assessments to provide quantitative indices of rCBF. MRIs were performed prior to and 7-to-21 days following treatment. Patients also recorded the frequency of their headache attacks in a daily paper diary. Neuropsychological assessment including anxiety, depression and quality of life measures was performed in a first, scanning free session for each patient. Results: Following treatment, patients demonstrated relative rCBF reductions in posterior temporal gyrus, cerebellum and caudate, and rCBF increases in occipital cortex. Responders demonstrated relative rCBF increases, compared to non-responders, in medial prefrontal cortex and lateral occipital cortex at baseline, but relative reductions in cingulate and middle temporal cortices. rCBF was increased in patients compared to healthy controls in cerebellum and hippocampus, but reduced in orbitofrontal cortex, insula and middle temporal gyrus. Conclusions: We provide new mechanistic insights regarding the aetiology of cluster headache, the mechanisms of action of occipital nerve blockades and potential predictors of treatment response. Future investigation should determine whether observed effects are reproducible and extend to other headache disorders.en_US
dc.description.sponsorshipThe present study was funded by an In-Service Training Scholarship Scheme from the Government of His Majesty The Sultan and Yang Di-Pertuan of Brunei Darussalam. SM, MAH, OOD and SCW are supported by the NIHR Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Trust. SM, MAH, TFR and SCW are also supported by a Medical Research Council EMCG grant (MR/N026969/1).en_US
dc.format.extent1 - 14-
dc.format.mediumPrint-Electronic-
dc.languageEnglish-
dc.language.isoenen_US
dc.publisherBioMed Central (part of Springer Nature)en_US
dc.rightsAttribution 4.0 International-
dc.rights.urihttps://creativecommons.org/licenses/by/4.0/-
dc.subjectcluster headacheen_US
dc.subjectgreater occipital nerve blocken_US
dc.subjectregional cerebral blood flowen_US
dc.subjectarterial spin labellingen_US
dc.subjecttrigeminal cephalgiaen_US
dc.titleRegional cerebral blood flow as predictor of response to occipital nerve block in cluster headacheen_US
dc.typeArticleen_US
dc.date.dateAccepted2021-07-30-
dc.identifier.doihttps://doi.org/10.1186/s10194-021-01304-9-
dc.relation.isPartOfJournal of Headache and Pain-
pubs.issue1-
pubs.publication-statusPublished-
pubs.volume22-
dc.identifier.eissn1129-2377-
dc.rights.licensehttps://creativecommons.org/licenses/by/4.0/legalcode.en-
dc.rights.holderThe Author(s)-
Appears in Collections:Dept of Life Sciences Research Papers

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