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Temporal Changes of Circadian Rhythmicity in Cluster Headache

 Mi Ji Lee  ;  Soo-Jin Cho  ;  Jeong Wook Park  ;  Min Kyung Chu  ;  Heui-Soo Moon  ;  Pil-Wook Chung  ;  Jae-Myun Chung  ;  Jong-Hee Sohn  ;  Byung-Kun Kim  ;  Byung-Su Kim  ;  Soo-Kyoung Kim  ;  Tae-Jin Song  ;  Yun-Ju Choi  ;  Kwang-Yeol Park  ;  Kyungmi Oh  ;  Jin-Young Ahn  ;  Sook-Young Woo  ;  Seonwoo Kim  ;  Kwang-Soo Lee  ;  Chin-Sang Chung 
 CEPHALALGIA, Vol.40(3) : 278-287, 2020-03 
Journal Title
Issue Date
Trigeminal autonomic cephalalgia ; circadian periodicity ; disease course ; hypothalamus
Objective: To investigate the temporal changes of circadian rhythmicity in relation to the disease course in patients with cluster headache. Methods: In this multicenter study, patients with cluster headache were recruited between September 2016 and July 2018. We evaluated the patients for circadian rhythmicity and time of cluster headache attacks in the current bout and any experience of bout-to-bout change in circadian rhythmicity. We analyzed the patterns of circadian rhythmicity in relation to the disease progression (the number of total lifetime bouts, grouped into deciles). Results: Of the 175 patients in their active, within-bout period, 86 (49.1%) had circadian rhythmicity in the current bout. The prevalence of circadian rhythmicity in the active period was overall similar regardless of disease progression. Sixty-three (46.3%) out of 136 patients with ≥2 bouts reported bout-to-bout changes in circadian rhythmicity. The most frequent time of cluster headache attacks was distributed evenly throughout the day earlier in the disease course and dichotomized into hypnic and midday as the number of lifetime bouts increased (p = 0.037 for the homogeneity of variance). When grouped into nighttime and daytime, nighttime attacks were predominant early in the disease course, while daytime attacks increased with disease progression (up to 7th deciles of total lifetime bouts, p = 0.001) and decreased in patients with the most advanced disease course (p = 0.013 for the non-linear association). Conclusions: Circadian rhythmicity is not a fixed factor, and changes according to the disease course. Our findings will be valuable in providing a new insight into the stability of functional involvement of the suprachiasmatic nucleus in the pathophysiology of cluster headache.
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1. College of Medicine (의과대학) > Dept. of Neurology (신경과학교실) > 1. Journal Papers
Yonsei Authors
Chu, Min Kyung(주민경) ORCID logo https://orcid.org/0000-0001-6221-1346
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