Abstract:
OBJECTIVE:To determine the pain intensity of cluster headache through a large survey by comparing it to other painful disorders. Furthermore, to investigate the relationship between maximal pain, autonomic, and other clinical symptoms, as well as demographic attributes of cluster headache. BACKGROUND:The pain of cluster headache is anecdotally considered to be one of the worst pains in existence. The link between pain and autonomic features of cluster headache is understood mechanistically through the trigeminovascular reflex, though it is not clear if this is a graded response. Links between pain and other features of cluster headache are less well understood. METHODS:This Internet-based cross-sectional survey included questions on cluster headache diagnostic criteria, which were used as part of the inclusion/exclusion criteria for the study. Respondents were asked to rate a cluster headache attack on the 0-10 numerical rating scale. Additionally, they were asked if they had experienced a list of other painful conditions such as labor pain or nephrolithiasis; if so they were asked to rate that pain as well. The survey also included demographics, mood scores, and treatment responses. RESULTS:A total of 1604 cluster headache respondents were included in the analysis. Respondents rated cluster headache as significantly (p < 0.001) more intense than every other pain condition examined. Cluster headache attacks were rated as 9.7 ± 0.6 (mean ± standard deviation) on the numerical rating scale, followed by labor pain (7.2 ± 2.0), pancreatitis (7.0 ± 1.5), and nephrolithiasis (6.9 ± 1.9). The majority of cluster headache respondents rated a cluster headache attack at maximal or 10.0 pain (72.1%, 1157/1604). Respondents with maximal pain were statistically significantly more likely to have cranial autonomic features compared to respondents with less pain: conjunctival injection or lacrimation 91% (1057/1157) versus 85% (381/447), eyelid edema 77% (887/1157) versus 66% (293/447), forehead/facial sweating 60% (693/1157) versus 49% (217/447), fullness in the ear 47% (541/1157) versus 35% (155/447), and miosis/ptosis 85% (1124/1157) versus 75% (426/447) (all p values <0.001). Respondents with maximal pain also had other statistically significant findings: more frequent attacks (4.0 ± 2.0 attacks per day vs. 3.5 ± 2.0 attacks per day), higher Hopelessness Depression Symptom Questionnaire scores (24.5 ± 16.9 vs. 21.1 ± 15.2), decreased overall effectiveness from calcium channel blockers (on a 5-point Likert scale), and more likely female: 34% (389/1157) versus 24% (108/447) (all p values <0.001). Pain intensity was not associated with restlessness, headache duration, age of onset, episodic/chronic status, or the effectiveness of any acute or preventive medication other than calcium channel blockers. CONCLUSIONS:Cluster headache is an intensely painful disorder, even in the context of other disorders considered intensely painful. Maximal pain intensity is associated with more cranial autonomic features, suggesting a graded response between pain and autonomic features. Maximal pain intensity is also associated with headache frequency but not duration, suggesting a relationship between pain intensity and mechanisms controlling headache onset, but not between pain intensity and mechanisms controlling headache offset.
journal_name
Headachejournal_title
Headacheauthors
Burish MJ,Pearson SM,Shapiro RE,Zhang W,Schor LIdoi
10.1111/head.14021subject
Has Abstractpub_date
2020-12-18 00:00:00eissn
0017-8748issn
1526-4610pub_type
杂志文章相关文献
HEADACHE文献大全abstract:BACKGROUND:A new form of headache, Headache attributed to aeroplane travel (AH), has been recognized within the International Classification of Headache Disorders 3 beta (ICHD-3beta). In 8 out of 85 AH cases we identified the coexistence of a headache with identical features of AH, but appearing during the rapid descen...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12766
更新日期:2016-02-01 00:00:00
abstract::Forty-six migraineurs and 69 age- and sex-matched controls referred for MRI scans of the brain were evaluated for the incidence of intracranial pathology. Axial long TR/short TE and long TR/long TE and sagittal short TR/short TE scans were performed in all patients. Enhancement with Gd-DTPA was performed in all contro...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1992.hed3210507.x
更新日期:1992-11-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to evaluate the course of headache in patients with moderate-to-severe headache due to aneurysmal subarachnoid hemorrhage (aSAH) and to identify its predisposing factors. BACKGROUND:Little is known about the long-term course of headache in patients with aSAH. METHODS:Since Sep...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.12612
更新日期:2015-07-01 00:00:00
abstract:BACKGROUND:Migraine is a common primary headache disorder occurring predominantly in a young, relatively healthy population. RESULTS:There is a growing literature on associations between migraine, especially migraine with aura, and ischemic stroke as well as other vascular events. Migraine as a risk factor for vascula...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1111/head.12304
更新日期:2014-03-01 00:00:00
abstract::Botulinum toxin type A, a protein long used in the successful treatment of various dystonias, has a complex mechanism of action that results in muscle relaxation. At the neuromuscular junction, the presynaptic nerve ending is packed with synaptic vesicles filled with acetylcholine, and clustered at the tip of the fold...
journal_title:Headache
pub_type: 杂志文章,评审
doi:10.1046/j.1526-4610.43.7s.4.x
更新日期:2003-07-01 00:00:00
abstract:BACKGROUND:The pathophysiology of chronic migraine (CM) is not fully understood. We aimed to examine transcranial magnetic stimulation (TMS) indices of cortical excitability in patients with CM and also performed PET studies to ascertain if there were any areas of activation and inhibition for possible correlation. ME...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2007.00853.x
更新日期:2007-07-01 00:00:00
abstract:OBJECTIVE:To investigate the habituation response pattern of patients with migraine to a simple standard stressor and to a more complex performance-dependent (achievement) stressor in three peripheral systems (electrodermal, vasomotor, and cardiovascular). We hypothesized that the migraine patients would show abnormal ...
journal_title:Headache
pub_type: 临床试验,杂志文章
doi:10.1111/j.1526-4610.2005.00270.x
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Personality traits (especially neuroticism) and childhood maltreatment have been independently related to many negative health outcomes later in life, including migraine. Studies have also shown the association between childhood maltreatment and maladaptive personality traits. The mediating role of personali...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13206
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:The protein s100b indicates astrocytal damage as well as dysfunction of the blood-brain barrier (BBB), and neuron-specific enolase (NSE) is regarded as a marker for neuronal cell loss. Recently, s100b was shown to be a potentially useful marker for migraine in children. In this study, we investigated the lev...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2008.01228.x
更新日期:2009-02-01 00:00:00
abstract::Recently, it has become obvious that disabling postoperative headache is a major problem with acoustic neuroma surgery. A questionnaire was used to retrospectively evaluate the incidence, clinical features, prognosis and possible therapeutic measures of this particular form of headache. Forty-two percent (42%) of pati...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1995.hed3502098.x
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:The buildup time of migraine headaches has not been well delineated in publications to date and we are aware of patients whose migraines last well over 72 hours. More concentration on these factors in the assessment of patients might lead to more appropriate therapeutic choices. METHOD:Prospective ascertain...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2006.00608.x
更新日期:2006-11-01 00:00:00
abstract:OBJECTIVE:To examine the likelihood of response with continued galcanezumab treatment in patients with episodic or chronic migraine without initial clinical improvement. BACKGROUND:A percentage of patients with migraine may require additional time on pharmacotherapy but discontinue treatment prematurely. Additionally,...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/head.13443
更新日期:2019-02-01 00:00:00
abstract:BACKGROUND:Medication-overuse headache (MOH) refers to headache attributed to excessive use of acute medications. The role of personality needs studies to explain the shifting from drug use to drug abuse. The main aim of this study is to study personality, according to Minnesota Multiphasic Personality Inventory, compa...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2011.01978.x
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:Many migraineurs report attack "triggers," but relatively few published data exist regarding the relative prevalences of individual triggers, variations related to gender, duration of migraine or migraine subtype, or the existence of any regional variations in the prevalences and distributions of triggers. ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2010.01753.x
更新日期:2010-09-01 00:00:00
abstract::This study examined the pharmacokinetics of 300 mg of tiaprofenic acid, a NSAID belonging to the 2-arylpropionic class, as a single oral dose, in 10 migraine patients during and out of migraine attacks. Plasma concentration of tiaprofenic acid was determined by HPLC analysis. Drug absorption appeared to be the same du...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1990.hed3010672.x
更新日期:1990-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Migraine headache is the seventh leading cause of disability worldwide causing adverse outcomes in many aspects of an individual's life. Many psychological aspects affect chronic migraine (CM): illness perception, anxiety, depressive symptoms, and job satisfaction. This observational study aim...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.13461
更新日期:2019-01-01 00:00:00
abstract::The case of a 53-year-old woman is described, who since the age of 38 years had been suffering from a unilateral headache that was at first remitting, but then evolved into an unremitting course. The headache was burning in quality, located in the left forehead and face, and was accompanied by mild ipsilateral autonom...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1992.hed3201039.x
更新日期:1992-01-01 00:00:00
abstract::To test the influence of arterial O2 saturation (SaO2) on heart rate in cluster headache, changes in pulse rate induced by hyperoxia and hypoxia were monitored in 11 cluster headache patients (6 during cluster period, and 5 during remission). The results were compared with those obtained in 11 age and sex matched heal...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1994.hed3402079.x
更新日期:1994-02-01 00:00:00
abstract:OBJECTIVE:To examine the possible pathological changes of the trigeminal vasculature in patients with neuralgia. BACKGROUND:Such a study has never been performed before. The alterations of the trigeminal vessels could have important pathophysiological implications in the trigeminal neuralgia pathogenesis. METHODS:The...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2007.00933.x
更新日期:2007-10-01 00:00:00
abstract:OBJECTIVE:In this study, we explored the relationship between migraine and sport in a physically active population of students, analyzing the risk of migraine among sporty students. BACKGROUND:The relationship between sport and migraine is controversial; moreover, several studies report on sport as a migraine trigger,...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/head.14015
更新日期:2020-11-01 00:00:00
abstract:BACKGROUND:MAP0004 is a novel orally inhaled formulation of dihydroergotamine mesylate (DHE) currently in development that has been clinically observed to provide rapid ( approximately 10 minutes) therapeutic levels of DHE but with lower rates of adverse effects (dizziness, nausea, and paresthesia) compared with intrav...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2009.01510.x
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVE:To confirm the efficacy of rizatriptan 10 mg orally disintegrating tablet (ODT) for the elimination of migraine-associated nausea. BACKGROUND:Pooled studies of rizatriptan analyzing elimination of nausea as a secondary endpoint showed that 65% of rizatriptan patients reported elimination of nausea at 2 hours...
journal_title:Headache
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1111/j.1526-4610.2007.00954.x
更新日期:2008-03-01 00:00:00
abstract:OBJECTIVE:To describe a short-term "real-life" longitudinal evolution of migraine course, quality of life, and disability in a sample of patients attending to a specialty center and to evaluate the association between the changes in patient-reported outcomes, number of reported headaches, their severity, and treatment ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2012.02279.x
更新日期:2013-02-01 00:00:00
abstract::Greater occipital nerve (GON) infiltration is widely used for the treatment of primary and secondary headache disorders mainly on the basis of open-label evidence, although recent double-blinded placebo-controlled trials have demonstrated its efficacy in cluster headache. The procedure is generally well tolerated alth...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2012.02270.x
更新日期:2012-11-01 00:00:00
abstract:OBJECTIVE:To evaluate the efficacy and safety of AVP-825, a drug-device combination of low-dose sumatriptan powder (22 mg loaded dose) delivered intranasally through a targeted Breath Powered device vs an identical device containing lactose powder (placebo device) in the treatment of migraine headache. BACKGROUND:Earl...
journal_title:Headache
pub_type: 杂志文章,随机对照试验
doi:10.1111/head.12472
更新日期:2015-01-01 00:00:00
abstract::In a questionnaire survey we determined the prevalence of problems with reading, at present as well as in the past, in adult chronic headache sufferers as compared with age- and sex-matched controls. The reading problems inquired about were those with reading in general, reading quickly, prolonged reading and reading ...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1991.hed3104244.x
更新日期:1991-04-01 00:00:00
abstract:OBJECTIVE:In this study, we attempted to evaluate the response to lithium treatment and its tolerability in the prevention of episodic cluster headache (CH) and to identify clinical predictors of response. BACKGROUND:Verapamil and lithium are the most widely used drugs in the prevention of CH attacks. Lithium is consi...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.2012.02183.x
更新日期:2012-07-01 00:00:00
abstract::In order to study the frequency and characteristics of post-angiography headache, we interviewed 45 consecutive patients (mean age +/- SD = 57 +/- 15 years; M/F = 15/30) who underwent transfemoral cerebral angiography for: ischemic cerebrovascular disease (n = 33); suspected arteriovenous malformations (n = 4; one con...
journal_title:Headache
pub_type: 杂志文章
doi:10.1111/j.1526-4610.1995.hed3501021.x
更新日期:1995-01-01 00:00:00
abstract::We describe a patient with ophthalmoplegic migraine and right abducens nerve palsy, in whom serial magnetic resonance imaging showed a transient, gadolinium-enhancing lesion in the right lower pons, during both headache and the headache-free period. The enhancing linear lesion was felt to represent intraparenchymal fi...
journal_title:Headache
pub_type: 杂志文章
doi:10.1046/j.1526-4610.2002.02031.x
更新日期:2002-02-01 00:00:00
abstract:OBJECTIVE:To describe the relationship between mood/anxiety disorders and migraine headaches emphasizing the frequency of episodes based in a cross-sectional analysis in the Brazilian Longitudinal Study of Adult Health. BACKGROUND:It has been suggested that frequency of migraine headaches can be directly associated wi...
journal_title:Headache
pub_type: 杂志文章,多中心研究
doi:10.1111/head.12397
更新日期:2014-09-01 00:00:00