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Characteristics of pre-cluster symptoms in cluster headache: A cross-sectional multicentre study

 Soohyun Cho  ;  Soo-Jin Cho  ;  Mi Ji Lee  ;  Jeong Wook Park  ;  Min Kyung Chu  ;  Heui-Soo Moon  ;  Pil-Wook Chung  ;  Jong-Hee Sohn  ;  Byung-Su Kim  ;  Daeyoung Kim  ;  Jae-Moon Kim  ;  Jae Myun Chung  ;  Kyungmi Oh  ;  Jin-Young Ahn  ;  Young Eun Gil  ;  Chin-Sang Chung  ;  Byung-Kun Kim 
 CEPHALALGIA, Vol.42(7) : 570-578, 2022-06 
Journal Title
Issue Date
Cluster Headache* / complications ; Cluster Headache* / diagnosis ; Cluster Headache* / epidemiology ; Cross-Sectional Studies ; Female ; Humans ; Periodicity ; Prevalence ; Surveys and Questionnaires
Trigeminal autonomic cephalalgia ; cluster headache ; pre-cluster symptoms
Background: Contrary to pre-attack symptoms before an individual cluster headache attack, little is known about the pre-cluster symptoms before the onset of cluster bouts. We previously described pre-attack symptoms before cluster headache attacks. The aim of this study was to investigate characteristics of pre-cluster symptoms in patients with episodic cluster headache.

Methods: In this multicentre study, 184 patients with episodic cluster headache were recruited between October 2018 and December 2020. They were interviewed by investigators and completed a structured questionnaire. To investigate pre-cluster and pre-attack symptoms, we assessed 20 symptoms and signs using the questionnaire.

Results: The upcoming cluster bout was predictable in 35.3% (n = 65/184) of the patients. When present, pre-cluster symptoms occurred at a median duration of 7 days (interquartile range, 2.3-14 days) before the onset of the cluster bout. Patients with pre-cluster symptoms showed a higher proportion of women, prevalence of pre-attack symptoms and seasonal rhythmicity, frequency of cluster headache attacks per day, and total number of cluster bouts compared to patients without pre-cluster symptoms. In univariable and multivariable logistic regression analyses, female sex was associated with the predictability of pre-cluster symptoms (odds ratio = 2.297, p = 0.016).

Conclusions: The upcoming cluster bout was predicted in approximately 35% of patients with episodic cluster headache, which may allow for an earlier preventive treatment and help understand the pathophysiology.
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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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