Sex-related differences in cluster headache: A hospital-based study in Taiwan

Liaw, Yi-Chia; Wang, Yen-Feng; Chen, Wei–Ta; Wu, Jr-Wei; Chen, Shu-Ting; Lai, Kuan‐Lin; Fuh, Jong‐Ling

doi:10.1177/03331024221120054

Cited by 13 publications

(31 citation statements)

References 45 publications

(133 reference statements)

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“…An Italian study reported a decline in the M:F ratios from 6.2:1 to 2.1:1 according to onset (before 1960 vs. the 1990s) (53,54). A large cohort study in Taiwan also reported a decline in the M:F ratio from 5.2:1 to 4.3:1 according to the time of enrolment (1997–2020 vs. 2011–2021) (35). The M:F ratios reported in studies in Germany decreased from 4.3:1 in 1988 to 2.1:1 in 2021 (39,57,58) and, in France, decreased from 4.7:1 in 2002 to 1.7:1 in 2008 (56,59).…”

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

“…alcohol consumption or smoking) have been suggested as the cause of changes in the M:F ratios, as a recent genome-wide association study revealed smoking as a causal risk factor of CH (33). However, a Taiwanese study showed that the M:F ratio of current smokers increased from 14.9:1 to 21.6:1 in patients diagnosed before and after 2010, respectively (35). Another explanation is that CH could have been more frequently misdiagnosed in women in the earlier days.…”

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

“…In most studies comparing sex or sex-related differences in CH phenotypes, the core clinical manifestations of CH were similar in both women and men (73,74). However, nausea, osmophobia, ptosis, miosis, eyelid oedema, nasal congestion, and comorbid conditions such as thyroid diseases and psychiatric disorders have been reported more frequently in women than in men (34,35,66,75), whereas men seem to experience lacrimation and facial sweating more often than women (55,75). Women tend to present with longer attack duration, greater severity and migraine symptoms (35,66,76).…”

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

“…Aura in CH has not been as well studied as pre-attack symptoms, with the first mention dating back to 1972 in a study by Graham (93). The reported frequencies of aura in CH range from 0% to 35%, with significant variations across different studies and regions (25,35,43,56,67,72,73,81,94–100). Studies conducted in Asia, including China, Taiwan and India, reported a low prevalence of 0–1% (25,35,72,95,98), while studies in European/North American countries reported aura in 3.5–35% of patients with CH (43,56,67,73,81,94,96,97,99,100).…”

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

“…However, even within the same country, the reported rates varied widely, as evidenced by German reports, from 3.5% to 23% (96,100). Visual symptoms are the most frequent, while sensory, language/speech, motor and brainstem symptoms have also been reported (35,43,56,67,72,73,81,93,95–97,100). Similar to the migraine aura, the CH aura can occur either before or during an attack (67).…”

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

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Epidemiology, burden and clinical spectrum of cluster headache: a global update

Kim,

Choi,

Youn

et al. 2023

Cephalalgia

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Background This narrative review aims to broaden our understanding of the epidemiology, burden and clinical spectrum of cluster headache based on updated findings with a global perspective. Methods We conducted a literature search on the following topics: (a) epidemiology; (b) burden: quality of life, disability, economic burden, job-related burden and suicidality; and (c) clinical spectrum: male predominance and its changes, age, pre-cluster and pre-attack symptoms, aura, post-drome, attack characteristics (location, severity, duration and associated symptoms), bout characteristics (attack frequency, bout duration and bout frequency), circadian and seasonal rhythmicity and disease course. Results New large-scale population-based reports have suggested a lower prevalence than previous estimations. The impact of cluster headache creates a significant burden in terms of the quality of life, disability, economic and job-related burdens and suicidality. Several studies have reported decreasing male-to-female ratios and a wide age range at disease onset. The non-headache phases of cluster headache, including pre-cluster, pre-attack and postictal symptoms, have recently been revisited. The latest data regarding attack characteristics, bout characteristics, and circadian and seasonal rhythmicity from different countries have shown variability among bouts, attacks, individuals and ethnicities. Studies on the disease course of cluster headache have shown typical characteristics of attacks or bouts that decrease with time. Conclusions Cluster headache may be more than a “trigeminal autonomic headache” because it involves complex central nervous system phenomena. The spectrum of attacks and bouts is wider than previously recognised. Cluster headache is a dynamic disorder that evolves or regresses over time.

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Section: Clinical Spectrum Of Chmentioning

confidence: 99%

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

Section: Clinical Spectrum Of Chmentioning

confidence: 99%

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Epidemiology, burden and clinical spectrum of cluster headache: a global update

Kim,

Choi,

Youn

et al. 2023

Cephalalgia

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The Prevalence and Clinical Phenotypes of Cluster Headache in Relation with Latitude

Liaw,

Chen,

Wang

2024

Curr Pain Headache Rep

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Purpose of Review Previous studies have indicated a possible link between the prevalence of cluster headache (CH) and sunlight exposure. However, this theory has yet to be tested systemically. In this article, we aim to examine how latitude affects the prevalence and phenotypes of CH. Recent Findings To our knowledge, there is by far no article describing the effect of latitude on disease phenotype; thus, we performed a literature review. We noted positive effects of latitude on 1-year prevalence, the proportion of chronic CH, and the proportion of miosis and/or ptosis. Summary Latitude may affect the phenotypic presentations of cluster headache, probably partially mediated via temperature and sunlight variations. Still, other factors, such as environmental exposure to smoking and the genetic difference between the Eastern and Western populations, may participate in the pathogenesis and clinical manifestations of CH.

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