Chronic Cluster Headache Update and East–West Comparisons: Focusing on Clinical Features, Pathophysiology, and Management

Tsai, Chia Lin; Lin, Guan Yu; Wu, Sheng Kai; Yang, Fu‐Chi; Wang, Shuu Jiun

doi:10.1007/s11916-020-00902-7

Cited by 8 publications

(6 citation statements)

References 92 publications

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“…Nonetheless, male predominance remains stronger in China than North America and Europe (17,18), possibly due to ethnic and genetic differences responsible for a more pronounced male predominance in China than in North America and Europe. Furthermore, some studies have reported that the proportion of cCH in Eastern countries varied between 0–7.5% (12), and our study found that only 2.33% of patients were diagnosed with cCH, which is lower than the proportion reported in North America and Europe (15,19). This prominent difference could be attributed to ethnic or cultural differences, and the larger sample in our study makes the results more reliable.…”

Section: Discussioncontrasting

confidence: 78%

Profile of Chinese Cluster Headache Register Individual Study (CHRIS): Clinical characteristics, diagnosis and treatment status data of 816 patients in China

Zhang,

Xu,

Chen

et al. 2024

Cephalalgia

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Background The clinical profile of cluster headache may differ among different regions of the world, warranting interest in the data obtained from the initial Chinese Cluster Headache Register Individual Study (CHRIS) for better understanding. Methods We conducted a multicenter, prospective, longitudinal cohort study on cluster headache across all 31 provinces of China, aiming to gather clinical characteristics, treatment approaches, imaging, electrophysiological and biological samples. Results In total 816 patients were enrolled with a male-to-female ratio of 4.33:1. The mean age at consultation was 34.98 ± 9.91 years, and 24.89 ± 9.77 years at onset. Only 2.33% were diagnosed with chronic cluster headache, and 6.99% had a family history of the condition. The most common bout was one to two times per year (45.96%), lasting two weeks to one month (44.00%), and occurring frequently in spring (76.23%) and winter (73.04%). Of these, 68.50% experienced one to two attacks per day, with the majority lasting one to two hours (45.59%). The most common time for attacks was between 9 am and 12 pm (75.86%), followed by 1 am and 3 am (43.48%). Lacrimation (78.80%) was the most predominant autonomic symptom reported. Furthermore, 39.22% of patients experienced a delay of 10 years or more in receiving a correct diagnosis. Only 35.67% and 24.26% of patients received common acute and preventive treatments, respectively. Conclusion Due to differences in ethnicity, genetics and lifestyle conditions, CHRIS has provided valuable baseline data from China. By establishing a dynamic cohort with comprehensive multidimensional data, it aims to advance the management system for cluster headache in China.

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Section: Discussioncontrasting

confidence: 78%

Profile of Chinese Cluster Headache Register Individual Study (CHRIS): Clinical characteristics, diagnosis and treatment status data of 816 patients in China

Zhang,

Xu,

Chen

et al. 2024

Cephalalgia

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“…In our hospital based cohort, the mean age at onset was 28.6 years, similar to the previous studies and maleto-female ratio was 5.3:1. The gender ratio was more compatible with Asian studies (5.1:1) compared to recent European/North American studies (2-3.1:1) [10,18,19,[21][22][23][25][26][27]. Research about the mean time from CH onset to correct diagnosis reported various times in different countries (in the UK: 2.6 years, in Flanders: 3.6 years, in Spain: 4.9 years, in Italy and East European countries: 5.3 6.4 years, in Denmark: 6.2-9 years, in the USA: 6.6-8.5 years, in Japan: 7.3 6.9 years) [20,[28][29][30][31][32][33][34][35].…”

Section: Demographicssupporting

confidence: 57%

Clinical Characteristics and Burden of a Large Series with Cluster Headache From Turkey: A Cross-Sectional Study From Headache Centers

Dikmen

Ari

Şahin

et al. 2021

Preprint

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Background: Our purpose was to investigate the demographics, diagnosis patterns, clinical characteristics, triggers, treatment experiences, and personal burden of patients with Cluster headache (CH) in Turkey, a country located between Europe and Asia.Methods: The study is a cross-sectional investigation based on data from eight headache centers in Turkey. All patients completed the semi-structured survey either face to face or by phone interview with a neurologist.Results: A total of 209 individuals with a mean age of 39.8 (11.3) completed the survey (176 males; 188 episodic, 21 chronic). The mean age at disease onset was 28.6 (10.2) years. The diagnostic delay was 4.9 years and misdiagnosis before CH was 57.9%. Of participants, 9.1% reported a positive family history for CH. Male patients with CH showed higher rates for being current smokers in comparison to females (59.7% vs. 24.2%; p<0.0001) and they also had significantly more past history of smoking at the time of first diagnosis (60.8% vs. 21.2%; p<0.0001). Females with CH had a previous diagnosis of migraine more frequently (57.6% vs. 27.3; p=0.001). Attack duration without treatment was significantly longer in female patients with CH compared to males (112 min vs. 87 min; p=0.029). Female participants had more migrainous features (57.6 % vs. 36.9%; p=0.033) and nausea/vomiting (48.5% vs. 30.1%; p=0.045) during their attacks. Only 42.1% of all participants reported satisfying treatment experiences. Of the participants, 85.9 % reported that oxygen was efficient for abortive treatment of CH; however, only 22 % of them had an oxygen tube at home. Female participants, as well as chronic CH patients, reported a higher likelihood of preventive treatment experiences. In this study, 49.3% of all participants appeared to be disabled by their headaches. Over one-quarter percent of our cohort reported that CH caused job-related burden.Conclusion: Remarkable diagnostic delay is an ongoing problem for CH and migraine was the most common misdiagnosis. Nearly half of the patients suffered from a burden of CH regardless of chronicity. Both past abortive and preventive treatment experiences of the participants highlight the insufficient efficacy of available choices and the necessity of more specific treatments for CH.

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“…Previous studies have shown the male to female ratio for CH ranged from 3.8-7:1 in Eastern populations, while between1.3-3.5:1 in Western populations [10]. By comparison, the male to female ratio for migraine was approximately 1:2-3 [9,11],while that for MO was further reduced to 1:2.2-1:4.9 [12][13][14][15].…”

Section: Differences In Gendermentioning

confidence: 76%

Are migraine and cluster headache one spectrum? Implications from cyclical migraine

Zhang,

Yin

et al. 2023

Preprint

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Background and Objectives: Cyclical migraines (C-M) are occasionally met in headache clinics, but not well studied. The aim of the study was to delineate the characteristics of C-M, and compared them with those of cluster headache (CH) and migraine without aura (MO). Methods: We collected patients with C-M from our headache center, and patients with CH and MO from our cross-sectional standardized survey between 2014 and 2020. Data including demographics, headache characteristics, triggers, and relieving factors were recorded. Results: Forty-seven patients with C-M were identified. Most of the characteristics of C-M were found to be intermediate between MO and CH, including gender, attack duration, headache degree, headache side, as well as both migraine-like and CH-like accompanying symptoms. C-M had a significant higher percentage of women, and less severe and lower percentages of most CH-like accompanying features compared to CH. On the other hand, C-M had a significant lower percentage of women, earlier onset, shorter duration of headache attacks, more severe, lower percentages of migraine-like accompanying features and higher percentages of CH-like accompanying features compared to MO. However, triggers and relieving factors in C-M were more similar to CH than MO. Discussion: The largest C-M series defines it as a transition stage between MO and CH. Fewer differences were found between C-M and CH, indicating that C-M may be more similar to CH.

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Chronic Cluster Headache Update and East–West Comparisons: Focusing on Clinical Features, Pathophysiology, and Management

Cited by 8 publications

References 92 publications

Profile of Chinese Cluster Headache Register Individual Study (CHRIS): Clinical characteristics, diagnosis and treatment status data of 816 patients in China

Profile of Chinese Cluster Headache Register Individual Study (CHRIS): Clinical characteristics, diagnosis and treatment status data of 816 patients in China

Clinical Characteristics and Burden of a Large Series with Cluster Headache From Turkey: A Cross-Sectional Study From Headache Centers

Are migraine and cluster headache one spectrum? Implications from cyclical migraine

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