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Updated: Aug 11, 2026
Quantitative Autonomic Testing
Published on: July 19, 2011
Cardiovascular autonomic function tests in cluster headache
J A van Vliet1, A A Vein, M D Ferrari
1Department of Neurology and Clinical Neurophysiology, Leiden University Medical Centre, Leiden, the Netherlands.
Insights
Cluster headache (CH) patients show no significant cardiovascular autonomic function changes during a cluster period, outside of active attacks. This suggests systemic cardiovascular control remains stable between CH attacks.
Area of Science:
- Neurology
- Autonomic Neuroscience
Background:
- Facial autonomic symptoms are common in cluster headache (CH) attacks.
- Cardiovascular autonomic function in CH patients requires further investigation, particularly during different disease stages.
Purpose of the Study:
- To evaluate changes in general autonomic function in CH patients during a cluster period, specifically outside of active attacks.
- To determine if cardiovascular autonomic function differs between periods with and without active cluster headaches.
Main Methods:
- Conducted autonomic function tests (AFT) on 18 CH patients during and outside of a cluster period, but not during an attack.
- Assessed heart rate variability (HRV) through deep breathing, standing, and Valsalva maneuver.
- Measured blood pressure (BP) changes during rest, standing, and sustained handgrip.
Main Results:
- No significant differences were found in most AFT measurements between the cluster and non-cluster periods.
- A statistically significant increase in diastolic blood pressure (BP) at rest was observed during the cluster period (P = 0.04).
Conclusions:
- Systemic cardiovascular autonomic control does not appear to be significantly impaired in CH patients during a cluster period when not experiencing an active attack.
- The observed increase in resting diastolic BP warrants further investigation in the context of cluster headache pathophysiology.
Abstract:
While facial autonomic signs are prominent during cluster headache (CH) attacks, cardiovascular autonomic changes have been described in few CH patients. Cardiovascular autonomic function tests (AFT) can be used to assess general autonomic function in CH patients in different stages of the disease. We aimed to assess whether general autonomic function is changed in CH patients during a cluster period. AFT was performed both during a cluster period, but outside an actual attack, and outside a cluster period in 18 patients. Heart rate variability was studied at rest, during deep breathing, after standing up and during a Valsalva manoeuvre. Blood pressure (BP) changes were recorded at rest, during standing up and during sustained handgrip. Measurements during and outside the cluster period were compared using the paired t-test. AFT measurements revealed no significant differences between the two measurements, except for diastolic BP in rest, which was higher during the cluster period [80.3 (SD 12.2) vs. 74.8 (SD 9.0), P = 0.04]. Autonomic dysfunction during a cluster period, but outside an attack, does not include systemic cardiovascular control.
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