Characteristics of pre-cluster symptoms in cluster headache

초록

Background: In this study, we investigated characteristics of pre-cluster symptoms in patients with cluster headache. Methods: In this multi-center study, 190 patients with cluster headache patients (184 episodic and 6 chronic cluster headache) were recruited between October 2018 and December 2020. Patients were asked about the prediction of upcoming cluster bout. For the characteristics of precluster symptoms, we selected the 20 relevant symptoms and signs. If patients have had other symptoms which were not included in the list, they could describe them in their own words. Results: Pre-cluster symptoms were predictable in 36.8%. When present, pre-cluster symptoms occurred at a median of 7 days (IQR 2.3 to 14) before the onset of cluster bout. The most frequent symptom in the precluster symptoms was painful symptom (25.8%). Patients with pre-cluster symptoms had higher female proportion, prevalence of pre-attack symptom and seasonal rhythmicity, frequency of cluster headache attack per day, and total number of cluster bouts than patients without pre-cluster symptoms. In univariable and multivariable logistic regression analysis, being female was associated with the predictability of pre-cluster symptoms (OR ¼ 2.026, p ¼ 0.039). Conclusions: Pre-cluster symptoms were predictable in about two-fifth of patients with cluster headache, which may allow earlier preventive treatment and help understanding pathophysiology.