Chiffi Davide, Di Renzo Antonio, Giuliani Giada, Abagnale Chiara, Altieri Marta, Sebastianelli Gabriele, Casillo Francesco, Di Piero Vittorio, Coppola Gianluca, Caramia Francesca
Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy.
IRCCS - Fondazione Bietti, Rome, Italy.
Radiol Med. 2025 Jun 27. doi: 10.1007/s11547-025-02041-8.
The functional involvement of the hypothalamus in the pathophysiology of episodic cluster headache (eCH) is well known, but its macrostructural involvement remains unclear. In this study, we investigated differences in the volumetry of the entire hypothalamus and its subunits in patients with in-bout eCH during headache-free periods.
We examined hypothalamic volumes in 26 eCH patients (scanned during bout periods but outside of active attacks and off prophylactic medications) and 20 age- and sex-matched healthy controls (HCs). Magnetic resonance imaging (MRI) with T1-weighted sequences was used to perform volumetric segmentation of hypothalamic subunits (anterior-inferior, anterior-superior, posterior, tubular inferior, and tubular superior) and total hypothalamic volume. General linear models were used to assess volumetric differences, adjusting for age, sex, and total intracranial volume.
No statistically significant differences were found in either hypothalamic subunit volumes or total hypothalamic volumes between eCH patients and HCs (p > 0.05). Additionally, no correlations emerged between the hypothalamic volumes and CH clinical features.
These findings align with previous studies, suggesting that CH pathophysiology may involve network-level functional alterations rather than macrostructural hypothalamic changes.
下丘脑在发作性丛集性头痛（eCH）病理生理学中的功能参与已广为人知，但其宏观结构参与情况仍不清楚。在本研究中，我们调查了无头痛期内发作期eCH患者下丘脑整体及其亚单位体积的差异。
我们检查了26例eCH患者（在发作期扫描，但不在发作期内且未服用预防性药物）和20名年龄和性别匹配的健康对照者（HCs）的下丘脑体积。使用T1加权序列的磁共振成像（MRI）对下丘脑亚单位（前下、前上、后、管状下和管状上）和下丘脑总体积进行体积分割。使用一般线性模型评估体积差异，并对年龄、性别和颅内总体积进行校正。
eCH患者与HCs之间在下丘脑亚单位体积或下丘脑总体积方面均未发现统计学上的显著差异（p>0.05）。此外，下丘脑体积与CH临床特征之间也未发现相关性。
这些发现与先前的研究一致，表明CH病理生理学可能涉及网络水平的功能改变，而非下丘脑的宏观结构变化。
