Department of Neurology, Severance Hospital, College of Medicine, Yonsei University, Seoul, Korea.
Department of Neurology, Bundang Jesaeng General Hospital, Daejin Medical Center, Seongnam, Korea.
Sci Rep. 2021 Mar 25;11(1):6916. doi: 10.1038/s41598-021-86408-7.
Although cranial autonomic symptoms (CAS) are typical in cluster headache (CH), some individuals with CH show no CAS during their headache attacks. Probable cluster headache (PCH) is a subtype of CH that fulfils all but one criterion of CH. This study aimed to investigate the frequency and clinical features of CH and PCH without CAS in comparison to those with CAS. We analysed data from the Korea Cluster Headache Registry, a prospective multicentre registry involving data from 16 hospitals. Of the 216 participants with CH and 26 with PCH, 19 (8.8%) and 7 (26.9%), respectively, did not have CAS. Participants with CH without CAS exhibited less severe anxiety (General Anxiety Disorder-7 score, median [interquartile range], 2.0 [1.0-6.0] vs 8.0 [3.0-12.0], p = 0.001) and depression (Patient Health Questionnaire-9 score, 3.0 [1.0-7.0] vs 7.0 [3.0-11.0], p = 0.042) than those with CAS. Among participants with PCH, headache intensity was less severe in participants without CAS than in those with CAS (numeric rating scale, 8.0 [7.0-8.0] vs 9.5 [8.0-10.0], p = 0.015). In conclusion, a significant proportion of participants with CH and PCH did not have CAS. Some clinical features of CH and PCH differed based on the presence of CAS.
虽然颅自主症状（CAS）是丛集性头痛（CH）的典型表现，但有些 CH 患者在头痛发作时没有 CAS。可能的丛集性头痛（PCH）是 CH 的一种亚型，除了符合 CH 的一个标准外，其余均符合。本研究旨在调查无 CAS 的 CH 和 PCH 的频率和临床特征，并与有 CAS 的患者进行比较。我们分析了韩国丛集性头痛登记处的数据，该登记处是一个涉及 16 家医院的前瞻性多中心登记处。在 216 名 CH 患者和 26 名 PCH 患者中，分别有 19 名（8.8%）和 7 名（26.9%）没有 CAS。无 CAS 的 CH 患者焦虑程度较轻（一般焦虑障碍-7 评分，中位数[四分位数范围]，2.0[1.0-6.0]vs8.0[3.0-12.0]，p=0.001）和抑郁（患者健康问卷-9 评分，3.0[1.0-7.0]vs7.0[3.0-11.0]，p=0.042）比有 CAS 的患者轻。在 PCH 患者中，无 CAS 的患者头痛强度比有 CAS 的患者轻（数字评分量表，8.0[7.0-8.0]vs9.5[8.0-10.0]，p=0.015）。总之，相当一部分 CH 和 PCH 患者没有 CAS。一些 CH 和 PCH 的临床特征因是否存在 CAS 而有所不同。
