Abstract Details

Title Pre-cluster symptoms and treatment response in cluster headache: A large cohort in Taiwanese patients

Topic Headache

Presentation(s) S41 - Emergent Sciences and Top Headache Research (4:18 PM-4:30 PM)

Poster/Presentation
Number 005

Objective

This study aimed to analyze the prevalence, symptomatology, and predictivity of upcoming bouts of pre-cluster symptoms (PCS). Also, we investigated the associations between different PCS and treatment responses for CH.

Background PCS are symptoms preceding the upcoming bouts. Some patients could predict the CH bout based on these symptoms and might have roles in pre-emptive treatment. This study analyzed the characteristic of PCS in a large Asian cohort. Moreover, we explored the linkage between PCS and the treatment outcome of CH.

Design/Methods We prospectively collected consecutive data from patients with CH. Each patient completed semi-structured interviews during CH bouts, which included 50 questions about CH symptomatology, severity, and PCS. After CH bout, we recorded responses to acute and preventive treatments. The thirty-five PCS were divided into six categories: localized (head & neck) pain, general pain, fatigue & mood changes, sleep problems, constitutional symptoms, and cranial autonomic symptoms.

Results A total of 131 CH patients (M: F= 98: 33) were recruited during the study period. The prevalence of PCS was 64.9%, with a mean (± SD) duration of 2.2 (± 3.9) days before CH bouts. Up to 64.1 % of CH patients were able to predict upcoming bouts. Among six categories of PCS, head and neck pain symptoms were most common (82.4%), and were more able to predict upcoming bouts (presence: absence= 68.5% vs. 43.5%, p=0.023, OR=2.8 [95% CI 1.1-7.1]). Moreover, PCS associated with response to CH preventive treatments: sleep alternation and restlessness before upcoming bouts are more likely responsive to verapamil (OR=2.1 [95% CI 1.0-4.3] and 2.3 [95% CI 1.1-4.6], respectively).

Conclusions

About two-thirds of CH patients had PCS. Head and neck pain symptoms were the most common PCS with the highest predictivity of the upcoming bout. Certain PCS linked to better response to verapamil, which provides insights into future treatment strategies.

Authors/Disclosures
Jr-Wei Wu, MD (Taipei Veterans General Hospital) PRESENTER	Dr. Wu has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Pfizer . Dr. Wu has received personal compensation in the range of $10,000-$49,999 for serving on a Speakers Bureau for Abbvie . Dr. Wu has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for International Headache Society (IHS). The institution of Dr. Wu has received research support from National Science and Technology Council . The institution of an immediate family member of Dr. Wu has received research support from National Science and Technology Council .
ShuTing Chen	The institution of ShuTing Chen has received research support from Ministry of Science and Technology (Taiwan). The institution of ShuTing Chen has received research support from Taipei Veterans General Hospital .
	No disclosure on file
	No disclosure on file

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