Download PDF
J Neurol Surg A Cent Eur Neurosurg 2020; 81(04): 368-371
DOI: 10.1055/s-0039-1685508
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Headache Perception in an Epilepsy Patient with Neuromodulation by Anterior Thalamic Nuclei Deep Brain Stimulation: A Case Report

Bogdan Pintea
1   Neurochriurgie, Berufsgenossenschaftliches Universitatsklinikum Bergmannsheil, Bochum, Germany
4   Department of Neurosurgery, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
,
Rainer Surges
2   Department of Epileptology, Universitatsklinikum Bonn Zentrum fur Nervenheilkunde, Bonn, Nordrhein-Westfalen, Germany
3   Section of Epileptology, Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany
,
Jan Boström
4   Department of Neurosurgery, Universitatsklinikum Bonn, Bonn, Nordrhein-Westfalen, Germany
› Author Affiliations
Further Information

Publication History

03 October 2018

11 January 2019

Publication Date:
16 March 2020 (online)

Also available at
    Permissions and Reprints

Abstract

Objective Headache disorders are frequently associated with epilepsy. Some neuromodulation techniques for refractory epilepsy have been reported to positively influence the associated chronic headache. However, the exact mechanism of action of vagus nerve stimulation (VNS) and anterior thalamic nuclei-deep brain stimulation (ANT-DBS) on pain perception is unclear.

Method We report a structured assessment of pain perception in a patient who experienced headache relief after ANT-DBS for refractory focal epilepsy and compare it with pain perception of epilepsy patients with chronic headache who were treated with and without VNS.

Results The pain-associated symptoms in the ANT-DBS case were on the Pain Anxiety Symptoms Scale (PASS-40) subscore “physiological anxiety” closer to the control collective, whereas in patients with VNS, this was more likely for the PASS-40 subscores “cognitive anxiety” or “escape and avoidance.”

Conclusion ANT-DBS and VNS may influence epilepsy-associated chronic headache in different ways.

Keywords

ANT-DBS - migraine - pain perception - VNS - epilepsy
 

  • References

  • 1 Brodtkorb E, Bakken IJ, Sjaastad O. Comorbidity of migraine and epilepsy in a Norwegian community. Eur J Neurol 2008; 15 (12) 1421-1423
    CrossrefPubMedGoogle Scholar
  • 2 Yuan H, Silberstein SD. Vagus nerve stimulation and headache. Headache 2017; 57 (Suppl. 01) 29-33
    CrossrefPubMedGoogle Scholar
  • 3 Altinay M, Estemalik E, Malone Jr DA. A comprehensive review of the use of deep brain stimulation (DBS) in treatment of psychiatric and headache disorders. Headache 2015; 55 (02) 345-350
    CrossrefPubMedGoogle Scholar
  • 4 Andreou AP, Goadsby PJ. Topiramate in the treatment of migraine: a kainate (glutamate) receptor antagonist within the trigeminothalamic pathway. Cephalalgia 2011; 31 (13) 1343-1358
    CrossrefPubMedGoogle Scholar
  • 5 Hebestreit JM, May A. Topiramate modulates trigeminal pain processing in thalamo-cortical networks in humans after single dose administration. PLoS One 2017; 12 (10) e0184406
    CrossrefPubMedGoogle Scholar
  • 6 Pintea B, Hampel K, Boström J. , et al. Extended long-term effects of cervical vagal nerve stimulation on headache intensity/frequency and affective/cognitive headache perception in drug resistant complex-partial seizure patients. Neuromodulation 2017; 20 (04) 375-382
    CrossrefPubMedGoogle Scholar
  • 7 Salanova V, Witt T, Worth R. , et al; SANTE Study Group. Long-term efficacy and safety of thalamic stimulation for drug-resistant partial epilepsy. Neurology 2015; 84 (10) 1017-1025
    CrossrefPubMedGoogle Scholar
  • 8 Lendvai IS, Kinfe TM. Migraine improvement after anterior thalamic deep brain stimulation for drug-resistant idiopathic generalized seizure: a case report. Headache 2017; 57 (06) 964-966
    CrossrefPubMedGoogle Scholar
  • 9 McCracken LM, Zayfert C, Gross RT. The Pain Anxiety Symptoms Scale: development and validation of a scale to measure fear of pain. Pain 1992; 50 (01) 67-73
    CrossrefPubMedGoogle Scholar
  • 10 Ambrosini PJ, Metz C, Bianchi MD, Rabinovich H, Undie A. Concurrent validity and psychometric properties of the Beck Depression Inventory in outpatient adolescents. J Am Acad Child Adolesc Psychiatry 1991; 30 (01) 51-57
    CrossrefPubMedGoogle Scholar
  • 11 Robbins MS, Lipton RB. Transcutaneous and percutaneous neurostimulation for headache disorders. Headache 2017; 57 (Suppl. 01) 4-13
    CrossrefPubMedGoogle Scholar
  • 12 Michels L, Christidi F, Steiger VR. , et al. Pain modulation is affected differently in medication-overuse headache and chronic myofascial pain—a multimodal MRI study. Cephalalgia 2017; 37 (08) 764-779
    CrossrefPubMedGoogle Scholar
  • 13 Wu D, Zhou Y, Xiang J. , et al. Multi-frequency analysis of brain connectivity networks in migraineurs: a magnetoencephalography study. J Headache Pain 2016; 17: 38
    CrossrefPubMedGoogle Scholar
  • 14 Chiapparini L, Ferraro S, Nigri A, Proietti A, Bruzzone MG, Leone M. Resting state fMRI in cluster headache: which role?. Neurol Sci 2015; 36 (Suppl. 01) 47-50
    PubMedGoogle Scholar
  • 15 Franzini A, Messina G, Leone M, Cecchini AP, Broggi G, Bussone G. Feasibility of simultaneous vagal nerve and deep brain stimulation in chronic cluster headache: case report and considerations. Neurol Sci 2009; 30 (Suppl. 01) S137-S139
    PubMedGoogle Scholar
  • 16 De Ridder D, Vanneste S. Burst and tonic spinal cord stimulation: different and common brain mechanisms. Neuromodulation 2016; 19 (01) 47-59
    CrossrefPubMedGoogle Scholar
  • 17 Yakunina N, Kim SS, Nam EC. Optimization of transcutaneous vagus nerve stimulation using functional MRI. Neuromodulation 2017; 20 (03) 290-300
    CrossrefPubMedGoogle Scholar
  • 18 Wang K, Chai Q, Qiao H, Zhang J, Liu T, Meng F. Vagus nerve stimulation balanced disrupted default-mode network and salience network in a postsurgical epileptic patient. Neuropsychiatr Dis Treat 2016; 12: 2561-2571
    CrossrefPubMedGoogle Scholar
  • 19 Muto V, Shaffii-le Bourdiec A, Matarazzo L. , et al. Influence of acute sleep loss on the neural correlates of alerting, orientating and executive attention components. J Sleep Res 2012; 21 (06) 648-658
    CrossrefPubMedGoogle Scholar