Retino-hypothalamic-pineal hypothesis in the pathophysiology of primary headaches

Medical Hypotheses
Vinod D Deshmukh

Abstract

Primary headaches include migraine, tension, cluster headaches, paroxysmal hemicrania and miscellaneous headaches unassociated with structural lesions. A putative role of the retino-hypothalamic-pineal (RHP) axis in the pathophysiology of primary headaches is reviewed in terms of (1) retinal dysfunction, (2) hypothalamic dysfunction and human circadian desynchrony, (3) pineal melatonin dysfunction and (4) rostral limbic dysfunction mediating the human stress response. Unified RHP hypothesis is proposed, suggesting that an acute, periodic or chronic, circadian desynchrony and dysfunction of the whole or part of the RHP axis is implicated in the pathophysiology of primary headaches. Supportive evidence for the RHP hypothesis, including recent PET studies showing changes in dorsal pons, hypothalamus and rostral limbic structures, is presented.

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Citations

Sep 24, 2008·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Silvia MianoMaria Pia Villa
Feb 3, 2007·Visual Neuroscience·Per O LundmarkDaniel P Cardinali
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May 9, 2015·Disease-a-month : DM·Thomas Freedom
Feb 7, 2015·Cephalalgia : an International Journal of Headache·Carina EweringMartin Marziniak
May 21, 2013·Cephalalgia : an International Journal of Headache·Jeppe L PedersenRigmor H Jensen

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