TY - JOUR

T1 - Episodic and Chronic Cluster Headache

T2 - Differences in Family History, Traumatic Head Injury, and Chronorisk

AU - Barloese, Mads C.J.

AU - Beske, Rasmus P.

AU - Petersen, Anja S.

AU - Haddock, Bryan

AU - Lund, Nunu

AU - Jensen, Rigmor H.

PY - 2020

Y1 - 2020

N2 - Objective and Background: The diagnostic criteria of episodic and chronic cluster headache (cCH) were recently modified, yet pathophysiological differences between the two are still unclear. The aim of this cross-sectional study is to identify and characterize other differences between episodic and cCH. Methods: Data from a retrospective, questionnaire- and interview-based study were analyzed with a focus on associated factors including traumatic head injury (THI), familial history, and change of phenotype. Attack patterns were analyzed using Gaussian and spectral modeling. Results: 400 patients and 200 controls participated. A positive family history was more prevalent in chronic than episodic cluster headache (eCH) (34/146 (23%) vs 33/253 (13%), respectively, P =.008). A history of THI was more common in patients than controls (173/400 (43%) vs 51/200 (26%), respectively, P <.0001) and in chronic compared to eCH (77/146 (53%) vs 96/253 (37%), respectively, P =.004). Patients with a positive family history had a unique diurnal attack pattern with twice the risk of nocturnal attacks as patients who did not report family history. Patients reporting phenotype change had a chronobiological fingerprint similar to the phenotype they had experienced a transition into. A higher attack frequency in chronic patients was the only difference in symptom manifestation across all analyzed subgroups of patients. Conclusions: cCH is associated with a positive family history and THI. In familial CH, a peak in nocturnal chronorisk may implicate genes involved in diurnal-, sleep- and homeostatic regulation. The stereotypical nature of the CH attacks themselves is confirmed and differences between subgroups should be sought in other characteristics.

AB - Objective and Background: The diagnostic criteria of episodic and chronic cluster headache (cCH) were recently modified, yet pathophysiological differences between the two are still unclear. The aim of this cross-sectional study is to identify and characterize other differences between episodic and cCH. Methods: Data from a retrospective, questionnaire- and interview-based study were analyzed with a focus on associated factors including traumatic head injury (THI), familial history, and change of phenotype. Attack patterns were analyzed using Gaussian and spectral modeling. Results: 400 patients and 200 controls participated. A positive family history was more prevalent in chronic than episodic cluster headache (eCH) (34/146 (23%) vs 33/253 (13%), respectively, P =.008). A history of THI was more common in patients than controls (173/400 (43%) vs 51/200 (26%), respectively, P <.0001) and in chronic compared to eCH (77/146 (53%) vs 96/253 (37%), respectively, P =.004). Patients with a positive family history had a unique diurnal attack pattern with twice the risk of nocturnal attacks as patients who did not report family history. Patients reporting phenotype change had a chronobiological fingerprint similar to the phenotype they had experienced a transition into. A higher attack frequency in chronic patients was the only difference in symptom manifestation across all analyzed subgroups of patients. Conclusions: cCH is associated with a positive family history and THI. In familial CH, a peak in nocturnal chronorisk may implicate genes involved in diurnal-, sleep- and homeostatic regulation. The stereotypical nature of the CH attacks themselves is confirmed and differences between subgroups should be sought in other characteristics.

KW - biological rhythm disorders

KW - cluster headache

KW - traumatic brain injuries

U2 - 10.1111/head.13730

DO - 10.1111/head.13730

M3 - Journal article

C2 - 31868233

AN - SCOPUS:85077168182

VL - 60

SP - 515

EP - 525

JO - Headache

JF - Headache

SN - 0017-8748

IS - 3

ER -