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.
Bibliographical noteFunding Information:
Drs. BS Kim, PW Chung, BK Kim, MJ Lee, JW Park, JY Ahn, DW Bae, TJ Song, JH Sohn, K Oh, D Kim, JM Kim, SK Kim, YJ Choi, JM Chung, HS Moon, CS Chung, and KY Park declare that they have no competing interests. Dr. SJ Cho was involved as a site investigator of a multicentre trial sponsored by Otsuka Korea, Eli Lilly and Co. and Novartis; functioned as an advisory member for Teva; and received research support from the Hallym University Research Fund 2016 and a grant from the Korean Neurological Association (KNA-16-MI-09). Dr. MK Chu was a site investigator for a multicentre trial sponsored by Otsuka Korea, Novartis, International AG, and Eli Lilly and Co. He functioned as an advisory member for Teva and received lecture honoraria from Allergan Korea, Handok-Teva, and Yuyu Pharmaceutical Company over the past 24 months. He received grants from the Yonsei University College of Medicine (2018-32-0037) and National Research Foundation of Korea (2019R1F1A1053841).
© 2021, The Author(s).