Cho Soohyun, Lee Mi Ji, Chu Min Kyung, Park Jeong Wook, Moon Heui-Soo, Chung Pil-Wook, Sohn Jong-Hee, Kim Byung-Su, Kim Daeyoung, Oh Kyungmi, Kim Byung-Kun, Cho Soo-Jin
Department of Neurology, Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu, Korea.
Department of Neurology, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
J Clin Neurol. 2025 May;21(3):220-229. doi: 10.3988/jcn.2024.0457.
The pain lateralization in cluster headache (CH) may be related to the asymmetry in the functions of the brain hemispheres. The right-sided dominance of pain in CH has been found inconsistently across studies, and so we aimed to characterize this and identify the factors influencing pain lateralization during current and previous bouts.
This study enrolled 227 patients from the Korean Cluster Headache Registry between October 2018 and December 2020. We evaluated the side of pain during current and previous bouts, demographic features, and clinical characteristics, including handedness. Multivariable logistic regression analyses were performed to identify factors associated with the side of pain.
The 227 patients with CH included 131 (57.7%) with right-sided pain and 86 (37.9%) with left-sided pain during the current bout (<0.001). The 189 patients with previous bouts of CH included 86.8% who consistently reported the same side of pain throughout multiple bouts (side-locked pain), with a higher prevalence of pain on the right than the left side (55.0% vs. 31.7%, <0.001). Multivariable analyses revealed that higher age at diagnosis (odds ratio [OR]=1.045, =0.031) and shorter CH attacks (OR=0.992, =0.017) were associated with left-side-locked pain. However, handedness was not associated with the lateralization of left-side-locked pain.
This study has confirmed the predominance of right-sided pain throughout multiple CH bouts. We found that higher age at diagnosis and shorter CH attacks were associated with left-side-locked pain, suggesting that certain clinical factors are associated with the pain laterality. However, the underlying mechanisms linking these factors to lateralized pain remain unclear and therefore require further investigation.
丛集性头痛（CH）中的疼痛侧别可能与大脑半球功能的不对称性有关。CH疼痛右侧优势在各研究中的发现并不一致，因此我们旨在对此进行描述，并确定影响当前及既往发作期间疼痛侧别的因素。
本研究纳入了2018年10月至2020年12月期间韩国丛集性头痛登记处的227例患者。我们评估了当前及既往发作时的疼痛侧别、人口统计学特征以及包括利手在内的临床特征。进行多变量逻辑回归分析以确定与疼痛侧别相关的因素。
227例CH患者中，当前发作时131例（57.7%）为右侧疼痛，86例（37.9%）为左侧疼痛（<0.001）。189例有CH既往发作史的患者中，86.8%在多次发作中始终报告同一侧疼痛（锁侧疼痛），右侧疼痛的患病率高于左侧（55.0%对31.7%，<0.001）。多变量分析显示，诊断时年龄较大（比值比[OR]=1.045，=0.031）和CH发作时间较短（OR=0.992，=0.017）与左侧锁侧疼痛相关。然而，利手与左侧锁侧疼痛的侧别无关。
本研究证实了在多次CH发作中右侧疼痛占优势。我们发现诊断时年龄较大和CH发作时间较短与左侧锁侧疼痛相关，提示某些临床因素与疼痛侧别有关。然而，将这些因素与侧别性疼痛联系起来的潜在机制仍不清楚，因此需要进一步研究。
