Pilati Laura, Torrente Angelo, Alonge Paolo, Vassallo Lavinia, Maccora Simona, Gagliardo Andrea, Pignolo Antonia, Iacono Salvatore, Ferlisi Salvatore, Di Stefano Vincenzo, Camarda Cecilia, Brighina Filippo
Department of Biomedicine, Neurosciences and Advanced Diagnostics (Bi.N.D.), University of Palermo, 90127 Palermo, Italy.
Headache Center "Casa della Salute Cittadella San Rocco", AUSL Ferrara, 44121 Ferrara, Italy.
Neurol Int. 2023 Mar 15;15(1):497-507. doi: 10.3390/neurolint15010029.
The cluster headache is a primary headache characterized by attacks of unilateral pain associated with ipsilateral cranial autonomic features. These attacks recur in clusters during the years alternating with periods of complete remission, and their onset is often during the night. This annual and nocturnal periodicity hides a strong and mysterious link among CH, sleep, chronobiology and circadian rhythm. Behind this relationship, there may be the influence of genetic components or of anatomical structures such as the hypothalamus, which are both involved in regulating the biological clock and contributing even to the periodicity of cluster headaches. The bidirectional relationship manifests itself also with the presence of sleep disturbances in patients affected by cluster headaches. What if the key to studying the physiopathology of such disease could rely on the mechanisms of chronobiology? The purpose of this review is to analyze this link in order to interpret the pathophysiology of cluster headaches and the possible therapeutic implications.
丛集性头痛是一种原发性头痛，其特征为单侧疼痛发作，并伴有同侧颅神经自主神经症状。这些发作在数年内呈丛集性复发，期间交替出现完全缓解期，且发作常发生在夜间。这种年度性和夜间周期性隐藏了丛集性头痛、睡眠、时间生物学和昼夜节律之间强大而神秘的联系。在这种关系背后，可能存在遗传因素或下丘脑等解剖结构的影响，它们都参与调节生物钟，甚至对丛集性头痛的周期性也有作用。这种双向关系在丛集性头痛患者出现睡眠障碍时也有所体现。如果研究这种疾病病理生理学的关键可以依赖于时间生物学机制会怎样呢？本综述的目的是分析这种联系，以解释丛集性头痛的病理生理学及可能的治疗意义。
