UTHealth Houston researchers uncover new findings about cluster headaches

Debilitating cluster headaches commonly begin in childhood, but patients are not typically diagnosed until they are adults, according to research from The University of Texas Health Science Center at Houston (UTHealth Houston）。

一组研究人员beplay苹果手机能用吗Mark Burish, MD, PhD,assistant professor in the Vivian L. Smith Department of Neurosurgery with McGovern Medical School at UTHealth Houston, conducted the Cluster Headache Questionnaire, an international, internet-based survey of 1,604 participants with cluster headache. Results from the survey were recently published inHeadache: The Journal of Head and Face Pain.

Cluster headache is a rare headache disorder, occurring in about one in every 1,000 individuals. They are extremely painful and occur in cyclical patterns known as cluster periods, with most attacks taking place at the same time each day. Cluster headache is diagnosed as “episodic” when the attacks occur in periods lasting between seven days and one year and are separated by pain-free periods lasting three months or longer. Meanwhile, in “chronic” cluster headache, attacks occur for more than one year without remission or with remissions lasting less than three months.

The headaches are similar to migraines, but there are some key differences. Unlike migraines, which can last an entire day or potentially several days if left untreated, cluster headaches typically last anywhere from 15 to 180 minutes. While it’s uncommon to have more than one migraine a day, it is possible for someone to have up to eight cluster headaches over a 24-hour period. Moreover, migraine pain can vary in location; by contrast, cluster headaches involve only one side of the head, typically at the temple or around the eye. Lastly, people who have migraines tend to rest in a quiet, dark room, whereas people who have cluster headaches tend to become restless and often pace around the room.

关于聚类头痛的几种特征，即小儿发作的簇头痛以及簇头痛治疗的比较有效性，有极有限的信息。

“I hope that this study will change the traditional thinking that cluster headache only affects adult men,” said Burish, who is also with The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences. “Our study shows that it commonly starts in childhood, and that many children go years without the correct diagnosis, presumably suffering the entire time because they don’t have the correct treatments.”

值得注意的是，在27.5％的调查参与者中发现了小儿发作，但只有15.2％的小儿发作参与者在18岁之前被诊断出。

尽管这种趋势背后的原因尚不清楚，但根据与儿科神经科医生，患者及其父母的对话，Burish提出了几种理论。家庭成员和医生没有意识到这一点，因为它很少见，并且患者没有被转介给适当的专家。此外，考虑到儿童和成年人在偏头痛等其他头痛的儿童和成人之间存在很小的差异，因此儿童簇头痛的特征可能与成年人不同。

Burish说，这项研究还表明，患有簇头痛的女性报告说，疼痛强度更高，恶心和抑郁得分更高。

其他关键调查结果包括：

• While previous studies have shown that women are more likely to have migraines between ages 10 and 50, the inverse is true for cluster headaches: Men were more likely to have episodic cluster headache between ages 10 and 50. The sex ratio was approximately equal for other ages.
• An overwhelming majority of respondents had at least one symptom featuring a reaction of the autonomic nervous system, like red eye or nasal congestion (99.0%) and had restlessness (96.6%), but many also had prototypical migraine features, including sensitivity to light and sound (50.1%), pain aggravated by physical activity (31.4%), or nausea and vomiting (27.5%).
• Interestingly, the first-line medications for acute treatment (oxygen) and preventive treatment (calcium channel blockers) were perceived as significantly less effective in chronic cluster headache compared with episodic cluster headache.

In addition to this epidemiological data, Burish said the study unearthed some smaller tidbits of information worthy of future research.

“Cluster headache seems to start at a younger age in patients with a family history of cluster headache, compared to an older age in patients without a family history,” Burish said. “In genetics, this is called ‘anticipation,’ which suggests there may be a gene or genes involved. Identifying those genes could be a huge breakthrough for cluster headache.”

其他研究人员beplay苹果手机能用吗包括宏宇苗博士协会iate professor in the Department of Biostatistics and Data Science at UTHealth School of Public Health; co-first authors Larry I. Schor, PhD, and Stuart M. Pearson, MA, with the University of West Georgia; and Robert E. Shapiro, MD, PhD, with the University of Vermont. Wei Zhang, PhD, formerly an assistant professor in the Department of Biostatistics and Data Science at UTHealth School of Public Health, was also part of the research team.

The study received funding support from Autonomic Technologies, Inc. and Clusterbusters.