Evidence map›Paper›PMID 37848331›Full record

Observational studyNeurology2023

Association of Clinical and Neuroanatomic Factors With Response to Ventral Tegmental Area DBS in Chronic Cluster Headache.

Sanjay Cheema, Francisca Ferreira, Olga Parras, Susie Lagrata, Salwa Kamourieh, Ashkan Pakzad, Ludvic Zrinzo, Manjit Matharu, Harith Akram

Open access · greenAbstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 17% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 1 institution in 2 countries.

Sanjay CheemaFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK. s.cheema@ucl.ac.uk.ORCID 0000-0002-5438-6549
Francisca FerreiraFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.ORCID 0000-0001-6406-0983
Olga ParrasFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.ORCID 0009-0006-7419-8162
Susie LagrataFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.ORCID 0000-0002-5672-5540
Salwa KamouriehFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.ORCID 0009-0009-3718-3772
Ashkan PakzadFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.
Ludvic ZrinzoFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.
Manjit MatharuFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.
Harith AkramFrom the Headache and Facial Pain Group (S.C., S.K., M.M.), UCL Queen Square Institute of Neurology; The National Hospital for Neurology and Neurosurgery (S.C., F.F., O.P., S.L., S.K., L.Z., M.M., H.A.); Functional Neurosurgery Unit (F.F., O.P., L.Z., H.A.), UCL Queen Square Institute of Neurology; Wellcome Centre for Human Neuroimaging (F.F.), 12 Queen Square; UCL EPSRC Centre for Doctoral Training in Intelligent Integrated Imaging in Healthcare (i4health) (F.F.); Centre for Medical Image Computing (A.P.), University College London; and Department of Medical Physics and Biomedical Engineering (A.P.), University College London, London, UK.
Engineering and Physical Sciences Research Council · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

objectivesDeep brain stimulation (DBS) of the ventral tegmental area (VTA) is a surgical treatment option for selected patients with refractory chronic cluster headache (CCH). We aimed to identify clinical and structural neuroimaging factors associated with response to VTA DBS in CCH.

methodsThis prospective observational cohort study examines consecutive patients with refractory CCH treated with VTA DBS by a multidisciplinary team in a single tertiary neuroscience center as part of usual care. Headache diaries and validated questionnaires were completed at baseline and regular follow-up intervals. All patients underwent T1-weighted structural MRI before surgery. We compared clinical features using multivariable logistic regression and neuroanatomic differences using voxel-based morphometry (VBM) between responders and nonresponders.

resultsOver a 10-year period, 43 patients (mean age 53 years, SD 11.9), including 29 male patients, with a mean duration of CCH 12 years (SD 7.4), were treated and followed up for at least 1 year (mean follow-up duration 5.6 years). Overall, there was a statistically significant improvement in median attack frequency from 140 to 56 per month (Z = -4.95, DISCUSSION: VTA DBS showed no serious adverse events, and, although there was no placebo control, was effective in approximately two-thirds of patients at long-term follow-up. This study did not reveal any reliable clinical predictors of response. However, nonresponders had increased neural density in brain regions linked to processing of pain and autonomic function, both of which are prominent in the pathophysiology of CCH.

Indexed as

Cluster HeadacheDeep Brain StimulationAdultFemaleHeadacheHumansMaleMiddle AgedPainProspective StudiesTreatment OutcomeVentral Tegmental Area

Identifiers

PMID37848331
PMCPMC10752645
OpenAlexW4387699007

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.