Pre-cluster symptoms in a Taiwanese cohort of cluster headache: symptom profiles and clinical predictions.

Autor: Wu JW; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi- Pai Rd, Taipei, 11217, Taiwan.; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chen ST; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan., Wang YF; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi- Pai Rd, Taipei, 11217, Taiwan.; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan., Chen SP; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi- Pai Rd, Taipei, 11217, Taiwan.; Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan., Tseng SY; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi- Pai Rd, Taipei, 11217, Taiwan., Kuo YS; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Department of Ophthalmology, Taipei Veterans General Hospital, Taipei, Taiwan., Chen WT; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi- Pai Rd, Taipei, 11217, Taiwan.; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.; Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan., Chiang CC; Department of Neurology, Mayo Clinic, Rochester, MN, USA., Wang SJ; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shi- Pai Rd, Taipei, 11217, Taiwan. sjwang@vghtpe.gov.tw.; College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. sjwang@vghtpe.gov.tw.; Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
Jazyk: angličtina
Zdroj: The journal of headache and pain [J Headache Pain] 2024 Oct 08; Vol. 25 (1), pp. 174. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1186/s10194-024-01862-8
Abstrakt: Background: Pre-cluster symptoms (PCSs) are symptoms preceding cluster bouts and might have implications for the treatment of cluster headache (CH). This study investigated the prevalence of PCSs, and their utility in predicting upcoming bouts as well as the associations with therapeutic efficacy.
Methods: We prospectively collected data from patients with CH. Each patient received a structured interview and completed questionnaire surveys during CH bouts. In sub-study 1, we cross-sectionally analyzed the prevalence, symptomatology, and predictability of upcoming bouts. Overall, 34 PCSs, divided into seven categories, were queried, including head and neck pain, cranial autonomic symptoms, restlessness, fatigue or mood changes, sleep alterations, constitutional symptoms, and generalized pain. In sub-study 2, we recorded the weekly frequency of CH attacks after the initiation of verapamil concurrently with a 14-day transitional therapy based on the patients' headache diary. A responder to verapamil was defined as a patient who have a reduction from baseline of at least 50% in the weekly frequency of CH attacks 4 weeks after the initiation of verapamil.
Results: A total of 168 CH patients (women/men: 39/129) completed the study. In sub-study 1, we found 149 (88.7%) experienced PCSs, with a median of 24 (IQR 18 to 72) hours before the bouts. Up to 57.7% of patients with PCS reported that they could predict upcoming bouts. Among the seven categories of PCSs, head and neck pain was the most common (81.0%) and was associated with a higher predictability of upcoming bouts (odds ratio [OR] = 4.0; 95% confidence interval [CI] 1.7-9.6). In sub-study 2, we found two categories of PCSs were associated with the response to verapamil: sleep alteration (OR = 2.5 [95% CI = 1.3-4.8], p = 0.004) and ≥ 1 cranial autonomic symptoms (OR = 2.7 [95% CI = 1.4-5.1], p = 0.003).
Conclusion: PCSs were very common in CH and could be used to predict upcoming bouts. Different symptom categories of PCSs may have different clinical implications.
(© 2024. The Author(s).)
Databáze: MEDLINE
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