Overview

The trigeminal nerve is responsible for the conduction of painful stimuli from the face and meningeal blood vessels. The so-called trigeminovascular system - consisting of the trigeminal nerve and the blood vessels it innervates - plays a key role in the pathophysiology of various headache disorders such as migraine or cluster headache. A major side of trigeminal pain processing and modulation is the brainstem which has been discussed as the location of headache generating processes and thus is a preferred target when investigating headache pathophysiology. Functional magnetic resonance imaging of the brainstem however is challenging as this part of the brain is surrounded by large blood vessels and cerebrospinal fluid that predisposes it for the presence of cardiac and respiratory noise. We developed a viable model for high resolution echoplanar brainstem imaging using a special noise correction technique and sequence. We are currently investigating headache specific alterations of brainstem pain processing mechanisms.