Cluster analysis to determine headache types

Promote Biomarker Discovery by Identifying Homogenous Primary Headache Subgroups

“…Subgroup identification (eg, based on genetic, clinical feature, comorbidity, and trigger profiles across headache categories) would capture if patients diagnosed with different disorders have overlapping profiles (eg, in regards to clinical features) . Construction of subgroups based on these data levels across headache categories would also be useful to account for the following: Clustering of headache patients based on clinical features supported the diagnostic criteria in adults, in contrast to findings in young adults and children . Subsequently, biochemical profiles can be investigated across clusters.…”

“…[10][11][12] Construction of subgroups based on these data levels across headache categories would also be useful to account for the following: Clustering of headache patients based on clinical features supported the diagnostic criteria in adults, in contrast to findings in young adults and children. [13][14][15][16][17] Subsequently, biochemical profiles can be investigated across clusters. However, as neuropeptide infusion can induce migraine-like attacks in migraine patients 18,19 (biochemical compound as exposure instead of outcome and subgroup identification, eg, based on trigger and biochemical profiles over time).…”

From Hemicrania Lunaris to Hemicrania Continua: An Overview of the Revised International Classification of Headache Disorders

“…The glaring disadvantage of the Ad Hoc Committee's Classification was that it required subjective interpretation—terms such as “often,”“usually,”“sometimes,” and “commonly” led to confusion and poor diagnostic precision. A 1982 editorial in Lancet succinctly summarized the prevailing problem by observing that existing criteria “are vague and unsatisfactory and are really descriptions of typical cases rather than clean‐cut methods of classification.” Furthermore, “evidence from clinical trials is at present difficult to interpret because of uncertainties about the basis for selection and classification.” 30 Epidemiologic studies confirmed the existing confusion classifying primary headaches and highlighted that widely varying treatments were being prescribed as a consequence 31 . In 1985, Rose moved the classification of headache forward by creating a comprehensive classification scheme divided into primary headaches (migraine, muscle contraction/ tension headache, and cluster headache) and secondary headaches (extracranial, cranial nerve, referred, intracranial, and toxic).…”

“…30 Epidemiologic studies confirmed the existing confusion classifying primary headaches and highlighted that widely varying treatments were being prescribed as a consequence. 31 In 1985, Rose moved the classification of headache forward by creating a comprehensive classification scheme divided into primary headaches (migraine, muscle contraction/ tension headache, and cluster headache) and secondary headaches (extracranial, cranial nerve, referred, intracranial, and toxic). A total of 82 different headache types and subtypes were delineated in his classification.…”

Epidemiology of disabling neurological disease: how and why does disability occur?

“…Headache and the disability and handicap associated with headache may well be the commonest example of an illness without a specific underlying pathology. Population based studies have generally failed to substantiate any specific types of headache75 76 and it is possible that any reported biochemical or other changes at the level of pathology associated with “migraine” are simply epiphenomena, occurring as a result of the impairment. The development of frozen shoulder after myocardial infarct is another example of a “secondary pathology”.…”