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This article addresses the anatomic placement of electrodes used for deep brain stimulation (DBS) of the hypothalamic gray in patients with chronic cluster headache. Previously, investigators have performed DBS of this general region, reporting excellent results in a majority of patients (Neurology 2006; 67:150). Functional imaging studies performed at the time of cluster headache attacks have revealed activation of the hypothalamic gray, and this region has been described as the “generator” of the attacks (Lancet Neurol 2002; 1:251). However, the authors of the current study question whether the anatomic localization for DBS in published coordinates actually localizes to the hypothalamus, as the other authors have claimed.
The researchers i…