This study attempts to evaluate the potential morphological changes of hypothalamus and hypothalamic networks in patients with Cluster Headache (CH). Clinical features, especially the circadian rhythmicity, of cluster headaches are suggestive of hypothalamic involvement in cluster headache pathophysiology. This suggestion has been further supported in multiple functional and structural imaging studies, yet morphological changes consistent enough to be used as clinical or research criteria have been elusive.

In this study we will evaluate the volume of hypothalamus, along with hypothalamic networks with surrounding structures. To this aim, we will use three-dimensional T1, T2 and Diffusion Tensor Imaging (DTI) sequences obtained from cluster headache patients, migraine patients and controls. The measurements to be obtained will include separate volumetric measurements of hypothalamus, anterior hypothalamus, and posterior hypothalamus; along with quantitative analysis of hypothalamic connectome on DTI sequences. We will also study the T1 and T2 signal intensity of hypothalamus by normalizing its mean value to that of the entire axial cut of Sternocleidomastoid muscle at C4 level. Finally, as a secondary aim, we will also explore a DTI derivative sequence developed in UCLA aimed at highlighting structures with neural cell bodies, in hypothalamic imaging.

A brief oral presentation of the accepted Frontiers in Headache Research Scholarship on the project "A retrospective cross-sectional study on the onset of continuous headache in children" conducted at the Children's Hospital of Philadelphia (CHOP).

There are currently no published studies that investigate the characteristics of migraine attacks in patients with advanced cognitive decline. However, anecdotal patient encounters as well as online caregiver resources highlight the difficulty that caregivers for advanced dementia patients can face in identifying when a patient is experiencing a migraine attack. It follows that, it may be difficult to administer abortive medication in a timely manner in these cases. It is also plausible that behavioral dysregulation in dementia patients may be a manifestation of the premonitory phase of migraine, or the headache phase itself. This session will present a research proposal to investigate these areas of concern.