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The purpose of this study was to look at the connectivity of the posterior inferior hypothalamus in a patient implanted with a deep brain stimulating electrode using probabilistic tractography in conjunction with postoperative MRI scans. In a patient with chronic cluster headache we implanted a deep brain stimulating electrode into the ipsilateral postero-medial hypothalamus to successfully control his pain. To explore the connectivity, we used the surgical target from the postoperative MRI scan as a seed for probabilistic tractography, which was then linked to diffusion weighted imaging data acquired in a group of healthy control subjects. We found highly consistent connections with the reticular nucleus and cerebellum. In some subjects, connections were also seen with the parietal cortices, and the inferior medial frontal gyrus. Our results illustrate important anatomical connections that may explain the functional changes associated with cluster headaches and elucidate possible mechanisms responsible for triggering attacks.

Original publication




Journal article


J Clin Neurosci

Publication Date





955 - 960


Autonomic Nervous System, Biological Clocks, Brain Mapping, Brain Stem, Cerebellum, Cerebral Cortex, Cluster Headache, Deep Brain Stimulation, Diffusion Magnetic Resonance Imaging, Efferent Pathways, Electrodes, Implanted, Humans, Hypothalamic Diseases, Hypothalamus, Posterior, Image Processing, Computer-Assisted, Imaging, Three-Dimensional, Male, Middle Aged, Models, Statistical, Nerve Net, Reticular Formation, Sensitivity and Specificity, Tomography, X-Ray Computed