Abstract
An altered autonomic balance is considered to be a pathogenetic factor in cluster headache syndrome, although there is varying data on sympathetic and/or parasympathetic activation during attacks and/or attack-free intervals. The aim of the present study was to evaluate the day/night pattern of heart rate during the active and remission phases of cluster headache. In addition, the relationship between heart rate changes and the site of pain was investigated to determine if an autonomic imbalance was related to the lateralization of pain. Thirty-nine patients (34 with primary episodic cluster headache and five with primary chronic cluster headache and 30 healthy controls underwent 24-h Holter ECG recording. Nine cluster headache patients were monitored during both phases of the disease. The data obtained confirmed the existence of a disordered chrono-organization in cluster headache (phase-shift of approximately 1 h of heart rate rhythm during the cluster period) together with a low heart rate variability and a higher occurrence of arrhythmias in cluster headache patients with right-sided pain. Differences were also observed in the cluster headache patients when headache free, excluding the pain itself as a reason for the abnormality. The chronobiological data point out a transient rhythmic dysfunction, while heart rate variability changes, mostly related either to the phase of the disease or to the site of pain, probably reflects a central, site-related, dysfunction of the autonomic nervous system in cluster headache.
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References
Headache Classification Committee of the International Headache Society. Classification and diagnostc criteria for headache disorders, cranial neuralgias and facial pain.Cephalalgia 1988;8 (suppl 7): 1–96.
Nappi G, Facchinetti F, Bono G, Petraglia F, Micieli G, Cicoli C, Genazzani AR. Lack of beta-endorphin and beta-lipotropin circadian rhythmicity in episodic cluster headache: a model for chronopathology. In: Pfaffenrath V,et al., eds.Updating in headache. Berlin: Springer-Verlag, 1985: 269–275.
Waldenlind E, Ekbom K, Friberg Y, Saaf J, Wetterberg L. Decreased nocturnal serum melatonin during active cluster headache periods.Opusc Med 1984;4: 109–112.
Chazot G, Claustrat B, Brun J, Jordan D, Sassolas G, Schott B. A chronobiological study of melatonin, cortisol, growth hormone and prolactin secretion in cluster headache.Cephalalgia 1984;14: 213–220.
Nappi G, Micieli G, Cavallini A, Zanferrari C, Sandrini G, Manzoni GC. Accompanying symptoms of cluster attacks: their relevance to the diagnostic criteria.Cephalalgia 1992;12: 165–168.
Russell D, Storsein L. Cluster headache: a computerized analysis of 24 h Holter ECG recordings and description of ECG rhythm disturbances.Cephalalgia 1983;3: 83–107.
Manzoni GC, Terzano MG, Bono G, Micieli G, Martucci N, Nappi G. Cluster headache—clinical findings in 180 patients.Cephalalgia 1983;3: 21–30.
Ewing DJ, Neilson JMM, Travis P. New method for assessing cardiac parasympathetic activity using 24 hour electrocardiograms.Br Heart J 1984;52: 396–402.
Fulan R, Guzzetti S, Crivellaro W, Dassi S, Tinelli M, Baselli G, Cerutti S, Lombardi F, Pagani M, Malliani A. Continuous 24-hour assessment of the neural regulation of systemic arterial pressure and RR variabilities in ambulant subjects.Circulation 1990;81: 537–547.
Molgaard H, Sorenswen KE, Bierregard P. Attenuated 24-h heart rate variability in apparently healthy subjects, subsequently suffering cardiac death.Clin Auton Res 1991;1: 233–237.
Lown B, Wolf M. Approaches to sudden death from coronary heart disease.Circulation 1971;14: 130–132.
Halberg F, Johnson EA, Nelson W, Runge W, Sothern R. Autorhythmometry procedures for physiologic self-measurements and their analysis.Physiol Teach 1972;1: 1–11.
Micieli G, Magri M, Sandrini G, Tassorelli C, Nappi G. Pupil responsiveness in cluster headache: a dynamic TV pupillometric evaluation.Cephalalgia 1988;8: 193–201.
Fanciullacci M, Fusco BM, Alessandri M, Campagnolo V, Sicuteri F. Unilateral impairment of pupillary response to trigeminal nerve stimulation in cluster headache.Pain 1989;36: 185–191.
Saunte C. Autonomic disorders in cluster headache, with special reference to salivation, nasal secretion and tearing.Cephalalgia 1984;4: 57–64.
Nappi G, Sjaastad O (eds). Chronobiological correlates of headache.Cephalalgia 1983;3 (suppl 1).
Kuritzki A, Hering R, Akselrod S, Zabavi I. Cardiac and autonomic nervous system manifestation in migraine. 5th International Congress ‘The Pain Clinic’, Jerusalem, Sept. 14–18, 1992 (Abstract book, p. 2).
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Micieli, G., Cavallini, A., Bosone, D. et al. Imbalance of heart rate regulation in cluster headache as based on continuous 24-h recordings. Clinical Autonomic Research 3, 291–298 (1993). https://doi.org/10.1007/BF01827329
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DOI: https://doi.org/10.1007/BF01827329