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Transition of cluster headache phenotype: An interview-based study.

Marie-Louise Kulas Søborg1, Anja Sofie Petersen1, Nunu Lund1

  • 1The Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark.

Cephalalgia : an International Journal of Headache
|January 1, 2023
PubMed
Summary
This summary is machine-generated.

Cluster headache is a fluctuating disorder, with 20.7% of patients changing between episodic and chronic forms. Attack side shifts may predict these phenotype changes in cluster headache patients.

Keywords:
Natural historychronic cluster headacheepisodic cluster headachepredictors

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Area of Science:

  • Neurology
  • Headache Medicine
  • Clinical Neuroscience

Background:

  • Cluster headache presents as episodic and chronic variants, with documented patient transitions between these phenotypes.
  • Understanding the dynamics of cluster headache phenotype conversion and associated clinical features is crucial for patient management.

Purpose of the Study:

  • To quantify the incidence of phenotype changes in cluster headache patients.
  • To identify potential predictors associated with cluster headache phenotype transitions.
  • To compare clinical characteristics between primary and secondary cluster headache subtypes.

Main Methods:

  • A cross-sectional study involving 540 well-defined cluster headache patients.
  • Data collection utilized semi-structured interviews adhering to current International Classification of Headache Disorders (ICHD) criteria.

Main Results:

  • A total of 20.7% of patients experienced a phenotype change, with 14.4% converting from episodic to chronic and 6.3% from chronic to episodic.
  • Attack side shift was identified as a potential predictor for phenotype transition (p=0.007).
  • Secondary chronic cluster headache patients reported more frequent but shorter attacks compared to primary chronic patients. Secondary episodic patients had shorter remission periods than primary episodic patients.

Conclusions:

  • Cluster headache is a dynamic disorder with a significant proportion of patients exhibiting phenotype fluctuations.
  • While attack side shifts may indicate transition, other predictors remain elusive. Distinct clinical differences exist between primary and secondary subtypes.
  • There is a critical need for enhanced understanding and improved treatment strategies for cluster headache.