Clinical symptoms of androgen deficiency in men with migraine or cluster headache: a cross-sectional cohort study

Abstract Background To compare symptoms of clinical androgen deficiency between men with migraine, men with cluster headache and non-headache male controls. Methods We performed a cross-sectional study using two validated questionnaires to assess symptoms of androgen deficiency in males with migraine, cluster headache, and non-headache controls. Primary outcome was the mean difference in androgen deficiency scores. Generalized linear models were used adjusting for age, BMI, smoking and lifetime depression. As secondary outcome we assessed the percentage of patients reporting to score below average on four sexual symptoms (beard growth, morning erections, libido and sexual potency) as these items were previously shown to more specifically differentiate androgen deficiency symptoms from (comorbid) anxiety and depression. Results The questionnaires were completed by n = 534/853 (63%) men with migraine, n = 437/694 (63%) men with cluster headache and n = 152/209 (73%) controls. Responders were older compared to non-responders and more likely to suffer from lifetime depression. Patients reported more severe symptoms of clinical androgen deficiency compared with controls, with higher AMS scores (Aging Males Symptoms; mean difference ± SE: migraine 5.44 ± 0.90, p < 0.001; cluster headache 5.62 ± 0.99, p < 0.001) and lower qADAM scores (quantitative Androgen Deficiency in the Aging Male; migraine: − 3.16 ± 0.50, p < 0.001; cluster headache: − 5.25 ± 0.56, p < 0.001). Additionally, both patient groups more often reported to suffer from any of the specific sexual symptoms compared to controls (18.4% migraine, 20.6% cluster headache, 7.2% controls, p = 0.001). Conclusion Men with migraine and cluster headache more often suffer from symptoms consistent with clinical androgen deficiency than males without a primary headache disorder.

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Cluster Headache - Incidence and Its Association with Age, Gender and Triggers

Journal of Evolution of Medical and Dental Sciences ◽

10.14260/jemds/2021/130 ◽

2021 ◽

Vol 10 (9) ◽

pp. 604-607

Author(s):

Abinayaah Suresh ◽

Gitanjali Narendran ◽

Sambandhan Alandur Paramasivan ◽

Haribalan Lakshmanasamy

Keyword(s):

Cluster Headache ◽

Disease Process ◽

Rare Condition ◽

Primary Headache ◽

Headache Disorder ◽

Cross Sectional Study ◽

Research Centre ◽

College Hospital ◽

Cross Sectional ◽

Key Words Cluster Headache

BACKGROUND Cluster headache is an unusual but particularly painful and crippling primary headache disorder with a prevalence of 1 in 1000 making study of the disease process a difficult task to master. These headaches are always unilateral characterised by recurrent short-lasting attacks of 15 - 180 minutes associated with ipsilateral autonomic signs. The diagnosis is mainly clinical, and it continues to be managed sub optimally as the chance of coming across such a condition is few and far between. This study was conducted to determine the incidence of cluster headache in a hospital population and study its association with age, gender and triggers. METHODS This is a cross sectional study of a total of 100 patients attending our Otorhinolaryngology department from June 2017 to June 2018 at Sri Muthukumaran Medical College Hospital & Research Centre with primary complaints of headache. Prior ethical committee clearance was obtained. Patients with chronic debilitating illness, chronic rhino sinusitis, headache following trauma or the presence of fever or any other acute illness were excluded from this study. The results were interpreted using Statistical Package for Social Sciences (SPSS) version 17. RESULTS Out of the total number of 100 patients with headache, only one patient, a 40-yearold male was diagnosed with cluster headache. CONCLUSIONS Hence, we conclude that the incidence of cluster headache in the total of 100 patients is only 1 % which makes it a quite rare condition. Diagnosis is clinical, hence effective history taking is mandatory. KEY WORDS Cluster Headache, Primary Headache, Trigeminal Autonomic Cephalgia, Cluster Attacks

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Correction to: Clinical symptoms of androgen deficiency in men with migraine or cluster headache: a cross-sectional cohort study

The Journal of Headache and Pain ◽

10.1186/s10194-021-01346-z ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Iris E. Verhagen ◽

Roemer B. Brandt ◽

Carlijn M. A. Kruitbosch ◽

Antoinette MaassenVanDenBrink ◽

Rolf Fronczek ◽

...

Keyword(s):

Cohort Study ◽

Cluster Headache ◽

Clinical Symptoms ◽

Androgen Deficiency ◽

Cross Sectional

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Stepwise web-based questionnaires for diagnosing cluster headache: LUCA and QATCH

Cephalalgia ◽

10.1177/0333102413479835 ◽

2013 ◽

Vol 33 (11) ◽

pp. 924-931 ◽

Cited By ~ 14

Author(s):

Leopoldine A Wilbrink ◽

Claudia M Weller ◽

Carlo Cheung ◽

Theo Stijnen ◽

Joost Haan ◽

...

Keyword(s):

Logistic Regression ◽

Cluster Headache ◽

Predictive Value ◽

Large Scale ◽

International Headache Society ◽

Primary Headache ◽

Headache Disorder ◽

Cross Sectional Study ◽

Cross Sectional ◽

Web Based

Background Cluster headache (CH) is a primary headache disorder that is diagnosed based on the patient's history. For large-scale epidemiologic and genetic studies, a web-based, preferably short, questionnaire can be a feasible alternative to replace time-consuming clinical interviews. Methods Self-reported CH patients were enrolled via our research website. Participants meeting screening criteria were directed to the Leiden University Cluster headache Analysis program (LUCA) questionnaire. Individual diagnoses were calculated using an algorithm based on International Headache Society criteria. Subsequently, semi-structured telephone interviews were carried out to validate the LUCA questionnaire. The shorter Quick Ascertainment of Cluster Headache (QATCH) questionnaire for diagnosing CH was constructed by using logistic regression to select the most predictive questions. Results Via our website 437 self-reported CH patients were recruited. Of these, 291 patients were included in this cross-sectional study. The LUCA questionnaire was valid and accurate. Using logistic regression, three questions (QATCH) provided similar sensitivity (53.8% vs. 57.2%), specificity (88.9% vs. 87.5%), positive predictive value (95.5% vs. 95.9%) and negative predictive value (30.8% vs. 28.8%) compared with the LUCA questionnaire. Conclusion The web-based LUCA questionnaire was accurate and reliable in diagnosing CH among self-reported patients. Males with headache attacks of short duration and long headache-free intervals (months to years) are very likely to have CH.

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Genetics of cluster headache

Cephalalgia ◽

10.1177/0333102418815503 ◽

2019 ◽

Vol 39 (10) ◽

pp. 1298-1312 ◽

Cited By ~ 8

Author(s):

Kate F Gibson ◽

Anita Dos Santos ◽

Nunu Lund ◽

Rigmor Jensen ◽

Ioannis M Stylianou

Keyword(s):

Cluster Headache ◽

Candidate Gene ◽

Gene Selection ◽

Association Studies ◽

Twin Studies ◽

Primary Headache ◽

Headache Disorder ◽

Genome Wide Association Studies ◽

Genetic Studies ◽

Primary Headache Disorder

Background Cluster headache is the most severe primary headache disorder. A genetic basis has long been suggested by family and twin studies; however, little is understood about the genetic variants that contribute to cluster headache susceptibility. Methods We conducted a literature search of the MEDLINE database using the PubMed search engine to identify all human genetic studies for cluster headache. In this article we provide a review of those genetic studies, along with an overview of the pathophysiology of cluster headache and a brief review of migraine genetics, which have both been significant drivers of cluster headache candidate gene selection. Results The investigation of cluster headache genetic etiology has been dominated by candidate gene studies. Candidate selection has largely been driven by the pathophysiology, such as the striking rhythmic nature of the attacks, which spurred close examination of the circadian rhythm genes CLOCK and HCRTR2. More recently, unbiased genetic approaches such as genome-wide association studies (GWAS) have yielded new genetic avenues of interest including ADCYAP1R1 and MME. Conclusions The majority of candidate genes studied for cluster headache suffer from poor reproducibility. Broader genetic interrogation through larger unbiased GWAS, exome, and whole genome studies may provide more robust candidates, and in turn provide a clearer understanding of the causes of cluster headache.

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Headache

10.1093/med/9780199658602.003.0003 ◽

2015 ◽

Cited By ~ 1

Author(s):

Peter J. Goadsby

Keyword(s):

Cluster Headache ◽

Severe Pain ◽

Primary Headache ◽

Headache Disorder ◽

Headache Disorders ◽

Important Work ◽

Pain Experience ◽

Global Impact ◽

Primary Headache Disorder ◽

The World

Headache disorders are the dominant cause of neurological disability in the world and the most common reason for neurological referral in any country studied. Yet for much of the first half the twentieth century, research was mired in peripheral mechanistic sideshows. Migraine, the most common disabling primary headache disorder, has been established as primarily a brain problem, with important advances in classification, treatment, and biological understanding. Cluster headache, perhaps the most severe pain experience of humans, has found its nidus in the diencephalon; treatments are evolving and biology being unravelled. Contributions to headache disorders resonate across humanity, so important work here has a global impact for good.

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Clinical profile and functional disability of patients with migraine

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.176188 ◽

2016 ◽

Vol 07 (02) ◽

pp. 250-256 ◽

Cited By ~ 3

Author(s):

Vishnu Renjith ◽

Mamatha Shivananda Pai ◽

Flavia Castelino ◽

Aparna Pai ◽

Anice George

Keyword(s):

Functional Disability ◽

Tertiary Care ◽

Sampling Technique ◽

Primary Headache ◽

Headache Disorder ◽

Episodic Migraine ◽

Clinical Profile ◽

Care Hospital ◽

Cross Sectional Survey ◽

Cross Sectional

ABSTRACT Background: Migraine is a common disabling primary headache disorder. Globally, migraine was ranked as the seventh highest cause of disability. Aim: The aim of the study was to explore the clinical profile and functional disability of patients with migraine. Settings and Design: A cross-sectional survey was conducted at the neurology outpatient department of a tertiary care hospital in Karnataka. Materials and Methods: Using a consecutive sampling technique, 60 patients were recruited for the study. Descriptive and inferential statistics were used to analyze the data. Results: Majority of the participants were in the age group of 18–40 years with a mean age 35.22 years. There was a female preponderance with 70% of study participants being females. The various symptoms experienced by patients include throbbing pain (90%), photophobia (93.3%), phonophobia (85%), nausea (76.7%), and vomiting (41.7%). Most of the subjects (73.3%) under the study belonged to moderate to severe levels of functional disability. About 53.3% of patients were in the category of episodic migraine and 46.7% were in the category of chronic migraine. Conclusion: Migraine is associated with moderate to severe functional disability. Frequency of migraine has a positive correlation with the levels of disability/migraine disability assessment scores of migraineurs.

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Update on Treatment of Cluster Headache

Journal of the Korean Neurological Association ◽

10.17340/jkna.2021.3.1 ◽

2021 ◽

Vol 39 (3) ◽

pp. 113-120

Author(s):

Jong-Hee Sohn ◽

Mi Ji Lee ◽

Soo-Jin Cho

Keyword(s):

Cluster Headache ◽

Preventive Treatment ◽

Primary Headache ◽

Headache Disorder ◽

Preventive Therapy ◽

Systemic Steroid ◽

Novel Treatments ◽

Primary Headache Disorder ◽

Cranial Autonomic Symptoms ◽

High Flow Oxygen

Cluster headache (CH) is characterized by severe unilateral short-lasting headache attacks, accompanying ipsilateral cranial autonomic symptoms or the sense of restlessness and agitation, or both. CH is a highly disabling primary headache disorder but often not optimally treated. High-flow oxygen and parenteral triptans are the most effective treatment to treat an acute CH attack. Transitional treatments include systemic steroid therapy and sub-occipital steroid injection. For preventive therapy, verapamil and lithium are recommended as first-line treatments. Novel treatments have appeared, such as neuromodulation and medication targeting calcitonin gene-related peptide (CGRP) or its receptor. Galcanezumab, the only anti-CGRP receptor monoclonal antibody with proven efficacy for the preventive treatment of episodic CH, represents an important advance for pharmacological treatment of CH. Neuromodulation strategies, such as the non-invasive vagus nerve stimulation and the sphenopalatine ganglion stimulation, have been proven effective in reducing the intensity and frequency of attacks, and also to be safe and well tolerated.

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No structural brain alterations in new daily persistent headache – a cross sectional VBM/SBM study

Cephalalgia ◽

10.1177/03331024211045653 ◽

2021 ◽

pp. 033310242110456

Author(s):

Steffen Naegel ◽

Julia Zeller ◽

Anders Hougard ◽

Christopher Michael Weise ◽

Stefan Zuelow ◽

...

Keyword(s):

Grey Matter ◽

Statistical Parametric Mapping ◽

Primary Headache ◽

Headache Disorder ◽

Future Research ◽

New Daily Persistent Headache ◽

Cross Sectional ◽

Primary Headache Disorders ◽

Persistent Headache ◽

Structural Brain

Objective To identify grey matter alterations in patients suffering new daily persistent headache to enrich the pathophysiological concept of this rare headache disorder characterised by a distinct, clearly remembered onset and its instant chronification. Method Magnetic resonance-based voxel-based and surface-based morphometry was used to investigate 23 patients suffering from new daily persistent headache and 23 age- and gender-matched healthy controls with 1.5 Tesla MRI. Independent statistical analysis was performed at three sites using statistical parametric mapping, as well as FSL(FMRIB Software Library)-based approaches. Results No grey matter changes were detected using this sophisticated and cross-checked method. Conclusion The absence of structural brain changes in patients with new daily persistent headache contribute to the recent discussion regarding structural alterations in primary headache disorders in general and does not provide evidence for grey matter changes being associated with the pathophysiology of new daily persistent headache. Future research will have to determine the underlying pathophysiological mechanisms of this disorder.

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CACNA1A Gene Polymorphisms in Cluster Headache

Cephalalgia ◽

10.1046/j.1468-2982.2001.00281.x ◽

2001 ◽

Vol 21 (10) ◽

pp. 953-958 ◽

Cited By ~ 30

Author(s):

C Sjöstrand ◽

V Giedratis ◽

K Ekbom ◽

E Waldenlind ◽

J Hillert

Keyword(s):

Cluster Headache ◽

Primary Headache ◽

Headache Disorder ◽

Familial Hemiplegic Migraine ◽

Hemiplegic Migraine ◽

Promising Candidate ◽

Primary Headache Disorder ◽

Increased Risk ◽

Ihs Criteria ◽

Cacna1a Gene

Cluster headache (CH) is a primary headache disorder where the aetiological and pathophysiological mechanisms still are largely unknown. An increased risk of CH in first- and second-degree relatives suggests the importance of genetic factors. Mutations of the P/Q type calcium channel alpha 1 subunit (CACNA1A) gene on chromosome 19p13 have been shown to cause several neurological disorders with a wide clinical spectrum, mainly episodic diseases. Missence mutations of the gene cause familial hemiplegic migraine (FHM) and it is also likely to be involved in the more common forms of migraine. The CACNA1A gene is thus a promising candidate gene for CH. In this study we performed an association analysis of an intragenic polymorphic (CA)n-repeat with marker D19S1150 and a (CAG)n-repeat in the 3′UTR region, in 75 patients with CH according to IHS criteria and 108 matched controls. Genotypes and allele frequencies were similarly distributed in patients and controls. Linkage disequilibrium between the two markers was similar in patients and controls. We conclude that an importance of the CACNA1A gene in sporadic CH is unlikely.

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Migraine with aura is the predominant phenotype among acute post-traumatic headache in sports

Neurology ◽

10.1212/01.wnl.0000550644.02631.94 ◽

2018 ◽

Vol 91 (23 Supplement 1) ◽

pp. S28.3-S29

Author(s):

Seifert Tad

Keyword(s):

Migraine With Aura ◽

Female Athletes ◽

Primary Headache ◽

Headache Disorder ◽

The United States ◽

Health Concern ◽

Common Symptom ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Post Traumatic

IntroductionHeadache is the most common symptom after traumatic brain injury (TBI), a global health concern with an estimated 2.5 million people in the United States reporting TBI in a single year. Regrettably, there is little evidence on the medical management of post-traumatic headache (PTH). Generally, treatment is approached as the primary headache disorder it most closely resembles in phenotype. In the lay public, the majority of PTHs exhibit migraine or probable migraine characteristics; however, PTH phenotypes within a sporting context have not been reported.MethodsThis cross-sectional survey evaluated the characteristics of headache in 102 student-athletes, ages 13–23 who had sustained sport-related concussion. Acute post-traumatic headache and sport-related concussion were defined by the International Classification of Headache Disorders and the Concussion in Sport Group definitions, respectively. The sample included male and female athletes from a variety of sports, with differing degrees of contact exposure. The survey collected data on personal and family history of headache, as well as specific headache characteristics.ResultsThe study included 54 males and 48 females. Migraine with aura (45.4%) was the predominant phenotype is this cross sectional cohort of sport-related acute post-traumatic headache. This was followed by migraine without aura (22.7%), tension-type headache (21.8%), and other (10.1%).ConclusionsMigraine with aura is a common phenotype among sport-related acute PTH. Further studies should evaluate for potential differences in recovery trajectories when compared to other headache phenotypes.

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