Episodic and Chronic Cluster Headache: Differences in Family History, Traumatic Head Injury, and Chronorisk

Abstract

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.

Cluster headache in Asian populations: Similarities, disparities, and a narrative review of the mechanisms of the chronic subtype

“…Barloese et al. recruited 400 CH patients and 200 controls and showed a family history of CH was more prevalent in cCH vs. eCH (23% vs. 13%, p = 0.008) ( 45 ). A family history of CH is rare in Asian countries (3.6%) ( 9 , 12 , 13 ) compared to European and North American countries (4–18%) ( 17 , 20 , 21 , 27 ).…”

Real-life treatment of cluster headache in a tertiary headache center – results from the Danish Cluster Headache Survey

“…The study is a cross-sectional investigation (performed 2012–2017) based on data from the Danish Cluster Headache Survey. We applied the same methodology as in previous studies (8–13) and the primary analysis of the dataset has previously been published (8).…”

Current Understanding of the Chronobiology of Cluster Headache and the Role of Sleep in Its Management

“…A detailed description of the methodology behind this analysis is available in references. 30,36 submit your manuscript | www.dovepress.com…”

“…A genetic component in CH is supported epidemiologically and ties in with the strong chronobiological features. 35 , 36 Remarkably, it has been shown that in familial CH, relative nocturnal chronorisk is more than double that of sporadic CH. 36 Three possible culprit genes, which pertain to the topic of this review, have been identified.…”

“… 35 , 36 Remarkably, it has been shown that in familial CH, relative nocturnal chronorisk is more than double that of sporadic CH. 36 Three possible culprit genes, which pertain to the topic of this review, have been identified. 35 , 37 , 38 First, a genetic polymorphism of the CLOCK (Circadian Locomotor Output Cycles Kaput) was recently found to be associated with CH.…”