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Oliveira R, Neves-Costa A, Pedroso D, Paixão T, Barros AB, Moita LF, Gil-Gouveia R. CLOCK gene circannual expression in cluster headache. Cephalalgia 2024; 44:3331024241247845. [PMID: 38676534 DOI: 10.1177/03331024241247845] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/29/2024]
Abstract
BACKGROUND Cluster headache is a primary headache disorder characterized by bouts with circadian and circannual patterns. The CLOCK gene has a central role in regulating circadian rhythms. Here, we investigate the circannual CLOCK expression in a population of cluster headache patients in comparison to matched controls. METHODS Patients with cluster headache were sampled two to four times over at least one year, both in or outside bouts, one week after each solstice and equinox. The expression of CLOCK was measured by quantitative real-time polymerase chain reaction (RT-PCR) in the peripheral blood. RESULTS This study included 50 patients and 58 matched controls. Among the patient population, composed of 42/50 males (84%) with an average age of 44.6 years, 45/50 (90%) suffered from episodic cluster headache. Two to four samples were collected from each patient adding up to 161 samples, 36 (22.3%) of which were collected within a bout. CLOCK expression for cluster headache patients was considerably different from that of the control population in winter (p-value mean = 0.006283), spring (p-value mean = 0.000006) and summer (p-value mean = 0.000064), but not in autumn (p-value mean = 0.262272). For each season transition, the variations in CLOCK expression were more pronounced in the control group than in the cluster headache population. No statistically significant differences were found between bout and non-bout samples. No individual factors (age, sex, circadian chronotype, smoking and coffee habits or history of migraine) were related to CLOCK expression. CONCLUSIONS We observed that CLOCK expression in cluster headache patients fluctuates less throughout the year than in the control population. Bout activity and lifestyle factors do not seem to influence CLOCK expression.
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Affiliation(s)
- Renato Oliveira
- Department of Neurosciences, Barking, Havering and Redbridge University Hospitals, NHS, London, United Kingdom
- Hospital da Luz Headache Center, Lisbon, Portugal
| | - Ana Neves-Costa
- Innate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Dora Pedroso
- Innate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Tiago Paixão
- Quantitative Biology and Digital Science Unit, Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - André B Barros
- Innate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, Oeiras, Portugal
| | - Luís F Moita
- Innate Immunity and Inflammation Laboratory, Instituto Gulbenkian de Ciência, Oeiras, Portugal
- Faculdade de Medicina da Universidade de Lisboa, Lisbon, Portugal
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Belin AC, Barloese MC. The genetics and chronobiology of cluster headache. Cephalalgia 2023; 43:3331024231208126. [PMID: 37851671 DOI: 10.1177/03331024231208126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2023]
Abstract
BACKGROUND/HYPOTHESIS Cluster headache displays uniquely rhythmic patterns in its attack manifestation. This strong chronobiological influence suggests that part of the pathophysiology of cluster headache is distinctly different from migraine and has prompted genetic investigations probing these systems. METHODS This is a narrative overview of the cluster headache chronobiological phenotype from the point of view of genetics covering existing knowledge, highlighting the specific challenges in cluster headache and suggesting novel research approaches to overcome these. RESULTS The chronobiological features of cluster headache are a hallmark of the disorder and while discrepancies between study results do exist, the main findings are highly reproducible across populations and time. Particular findings in subgroups indicate that the heritability of the disorder is linked to chronobiological systems. Meanwhile, genetic markers of circadian rhythm genes have been implicated in cluster headache, but with conflicting results. However, in two recently published genome wide association studies two of the identified four loci include genes with an involvement in circadian rhythm, MER proto-oncogene, tyrosine kinase and four and a half LIM domains 5. These findings strengthen the involvement of circadian rhythm in cluster headache pathophysiology. CONCLUSION/INTERPRETATION Studying chronobiology and genetics in cluster headache presents challenges unique to the disorder. Researchers are overcoming these challenges by pooling various data from different cohorts and performing meta-analyses providing novel insights into a classically enigmatic disorder. Further progress can likely be made by combining deep pheno- and genotyping.
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Affiliation(s)
- Andrea Carmine Belin
- Centre for Cluster Headache, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Mads Christian Barloese
- Department of Functional and Diagnostic Imaging, Hvidovre Hospital, Hvidovre, Denmark
- Danish Headache Center, Department of Neurology, Rigshospitalet-Glostrup, University of Copenhagen, Glostrup, Denmark
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3
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Winsvold BS, Harder AVE, Ran C, Chalmer MA, Dalmasso MC, Ferkingstad E, Tripathi KP, Bacchelli E, Børte S, Fourier C, Petersen AS, Vijfhuizen LS, Magnusson SH, O'Connor E, Bjornsdottir G, Häppölä P, Wang Y, Callesen I, Kelderman T, Gallardo VJ, de Boer I, Olofsgård FJ, Heinze K, Lund N, Thomas LF, Hsu C, Pirinen M, Hautakangas H, Ribasés M, Guerzoni S, Sivakumar P, Yip J, Heinze A, Küçükali F, Ostrowski SR, Pedersen OB, Kristoffersen ES, Martinsen AE, Artigas MS, Lagrata S, Cainazzo MM, Adebimpe J, Quinn O, Göbel C, Cirkel A, Volk AE, Heilmann‐Heimbach S, Skogholt AH, Gabrielsen ME, Wilbrink LA, Danno D, Mehta D, Guðbjartsson DF, Rosendaal FR, Willems van Dijk K, Fronczek R, Wagner M, Scherer M, Göbel H, Sleegers K, Sveinsson OA, Pani L, Zoli M, Ramos‐Quiroga JA, Dardiotis E, Steinberg A, Riedel‐Heller S, Sjöstrand C, Thorgeirsson TE, Stefansson H, Southgate L, Trembath RC, Vandrovcova J, Noordam R, Paemeleire K, Stefansson K, Fann CS, Waldenlind E, Tronvik E, Jensen RH, Chen S, Houlden H, Terwindt GM, Kubisch C, Maestrini E, Vikelis M, Pozo‐Rosich P, Belin AC, Matharu M, van den Maagdenberg AM, Hansen TF, Ramirez A, Zwart J. Cluster Headache Genomewide Association Study and Meta-Analysis Identifies Eight Loci and Implicates Smoking as Causal Risk Factor. Ann Neurol 2023; 94:713-726. [PMID: 37486023 PMCID: PMC10952302 DOI: 10.1002/ana.26743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 06/22/2023] [Accepted: 07/07/2023] [Indexed: 07/25/2023]
Abstract
OBJECTIVE The objective of this study was to aggregate data for the first genomewide association study meta-analysis of cluster headache, to identify genetic risk variants, and gain biological insights. METHODS A total of 4,777 cases (3,348 men and 1,429 women) with clinically diagnosed cluster headache were recruited from 10 European and 1 East Asian cohorts. We first performed an inverse-variance genomewide association meta-analysis of 4,043 cases and 21,729 controls of European ancestry. In a secondary trans-ancestry meta-analysis, we included 734 cases and 9,846 controls of East Asian ancestry. Candidate causal genes were prioritized by 5 complementary methods: expression quantitative trait loci, transcriptome-wide association, fine-mapping of causal gene sets, genetically driven DNA methylation, and effects on protein structure. Gene set and tissue enrichment analyses, genetic correlation, genetic risk score analysis, and Mendelian randomization were part of the downstream analyses. RESULTS The estimated single nucleotide polymorphism (SNP)-based heritability of cluster headache was 14.5%. We identified 9 independent signals in 7 genomewide significant loci in the primary meta-analysis, and one additional locus in the trans-ethnic meta-analysis. Five of the loci were previously known. The 20 genes prioritized as potentially causal for cluster headache showed enrichment to artery and brain tissue. Cluster headache was genetically correlated with cigarette smoking, risk-taking behavior, attention deficit hyperactivity disorder (ADHD), depression, and musculoskeletal pain. Mendelian randomization analysis indicated a causal effect of cigarette smoking intensity on cluster headache. Three of the identified loci were shared with migraine. INTERPRETATION This first genomewide association study meta-analysis gives clues to the biological basis of cluster headache and indicates that smoking is a causal risk factor. ANN NEUROL 2023;94:713-726.
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Affiliation(s)
- Bendik S. Winsvold
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of NeurologyOslo University HospitalOsloNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Aster V. E. Harder
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Caroline Ran
- Centre for Cluster Headache, Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Mona A. Chalmer
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Maria Carolina Dalmasso
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Neurosciences and Complex Systems Unit (EnyS), CONICET, Hospital El Cruce 'N. Kirchner'National University A. Jauretche (UNAJ)Florencio VarelaArgentina
| | | | - Kumar Parijat Tripathi
- Division of Neurogenetics and Molecular Psychiatry, Department of PsychiatryUniklinik KölnCologneGermany
| | - Elena Bacchelli
- Department of Pharmacy and BiotechnologyUniversity of BolognaBolognaItaly
| | - Sigrid Børte
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Carmen Fourier
- Centre for Cluster Headache, Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Anja S. Petersen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | | | | | - Emer O'Connor
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | | | - Paavo Häppölä
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of HelsinkiHelsinkiFinland
| | - Yen‐Feng Wang
- Department of NeurologyTaipei Veterans General HospitalTaipeiTaiwan
- Brain Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
| | - Ida Callesen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Tim Kelderman
- Department of NeurologyGhent University HospitalGhentBelgium
| | - Victor J Gallardo
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de MedicinaUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
| | - Irene de Boer
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | | | | | - Nunu Lund
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Laurent F. Thomas
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of Clinical and Molecular MedicineNorwegian University of Science and Technology (NTNU)TrondheimNorway
- BioCore–Bioinformatics Core FacilityNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Clinic of Laboratory MedicineSt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Chia‐Lin Hsu
- Institute of Biomedical Sciences, Academia SinicaTaipeiTaiwan
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of HelsinkiHelsinkiFinland
- Department of Public HealthUniversity of HelsinkiHelsinkiFinland
- Department of Mathematics and StatisticsUniversity of HelsinkiHelsinkiFinland
| | - Heidi Hautakangas
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of HelsinkiHelsinkiFinland
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and AddictionUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Department of PsychiatryVall d'Hebron University HospitalBarcelonaSpain
- Biomedical Network Research Centre on Mental Health (CIBERSAM)Instituto de Salud Carlos IIIMadridSpain
- Department of Genetics, Microbiology, and Statistics, Faculty of BiologyUniversitat de BarcelonaBarcelonaSpain
| | | | - Prasanth Sivakumar
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Janice Yip
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Axel Heinze
- Kiel Migraine and Headache CentreKielGermany
| | - Fahri Küçükali
- Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIBAntwerpBelgium
- Department of Biomedical SciencesUniversity of AntwerpAntwerpBelgium
| | - Sisse R. Ostrowski
- Department of Clinical Immunology, Centre of Diagnostic InvestigationRigshospitaletCopenhagenDenmark
- Department of Clinical MedicineUniversity of CopenhagenCopenhagenDenmark
| | - Ole B. Pedersen
- Department of Clinical ImmunologyZealand University HospitalKøgeDenmark
| | - Espen S. Kristoffersen
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of General PracticeUniversity of OsloOsloNorway
- Department of NeurologyAkershus University HospitalLørenskogNorway
| | - Amy E. Martinsen
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
| | - María S. Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and AddictionUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Department of PsychiatryVall d'Hebron University HospitalBarcelonaSpain
- Biomedical Network Research Centre on Mental Health (CIBERSAM)Instituto de Salud Carlos IIIMadridSpain
- Department of Genetics, Microbiology, and Statistics, Faculty of BiologyUniversitat de BarcelonaBarcelonaSpain
| | - Susie Lagrata
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | | | - Joycee Adebimpe
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Olivia Quinn
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Carl Göbel
- Kiel Migraine and Headache CentreKielGermany
- Department of NeurologyUniversity Hospital Schleswig‐HolsteinLübeckGermany
| | - Anna Cirkel
- Kiel Migraine and Headache CentreKielGermany
- Department of NeurologyUniversity Hospital Schleswig‐HolsteinLübeckGermany
| | - Alexander E. Volk
- Institute of Human GeneticsUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Stefanie Heilmann‐Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital BonnBonnGermany
| | - Anne Heidi Skogholt
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | - Maiken E. Gabrielsen
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
| | | | - Daisuke Danno
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Dwij Mehta
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | | | | | - Frits R. Rosendaal
- Department of Clinical EpidemiologyLeiden University Medical CenterLeidenThe Netherlands
| | - Ko Willems van Dijk
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Einthoven Laboratory for Experimental Vascular MedicineLeiden University Medical CenterLeidenThe Netherlands
- Department of Internal Medicine, Division of EndocrinologyLeiden University Medical CenterLeidenThe Netherlands
| | - Rolf Fronczek
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Michael Wagner
- Department of Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE Bonn)BonnGermany
| | - Martin Scherer
- Department of Primary Medical CareUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | | | - Kristel Sleegers
- Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIBAntwerpBelgium
- Department of Biomedical SciencesUniversity of AntwerpAntwerpBelgium
| | - Olafur A. Sveinsson
- Faculty of Medicine, School of Health SciencesUniversity of IcelandReykjavikIceland
| | - Luca Pani
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
- Department of Psychiatry and Behavioral SciencesUniversity of MiamiMiamiFL
| | - Michele Zoli
- Department of Biomedical, Metabolic and Neural SciencesUniversity of Modena and Reggio EmiliaModenaItaly
| | - Josep A. Ramos‐Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and AddictionUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Department of PsychiatryVall d'Hebron University HospitalBarcelonaSpain
- Biomedical Network Research Centre on Mental Health (CIBERSAM)Instituto de Salud Carlos IIIMadridSpain
- Department of Psychiatry and Forensic MedicineUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of MedicineUniversity of ThessalyVolosGreece
| | - Anna Steinberg
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of NeurologyKarolinska University HospitalStockholmSweden
| | - Steffi Riedel‐Heller
- Institute of Social Medicine, Occupational Health and Public HealthUniversity of LeipzigLeipzigGermany
| | - Christina Sjöstrand
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of NeurologyDanderyd HospitalStockholmSweden
| | | | | | - Laura Southgate
- Molecular and Clinical Sciences Research InstituteSt. George's, University of LondonLondonUK
- Department of Medical & Molecular Genetics, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Richard C. Trembath
- Department of Medical & Molecular Genetics, Faculty of Life Sciences & MedicineKing's College LondonLondonUK
| | - Jana Vandrovcova
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and GeriatricsLeiden University Medical CenterLeidenThe Netherlands
| | - Koen Paemeleire
- Department of NeurologyGhent University HospitalGhentBelgium
| | - Kari Stefansson
- deCODE genetics/Amgen Inc.ReykjavikIceland
- Faculty of Medicine, School of Health SciencesUniversity of IcelandReykjavikIceland
| | | | - Elisabet Waldenlind
- Department of Clinical NeuroscienceKarolinska InstitutetStockholmSweden
- Department of NeurologyKarolinska University HospitalStockholmSweden
| | - Erling Tronvik
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of Neuromedicine and Movement Science, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Department of Neurology and Clinical NeurophysiologySt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Rigmor H. Jensen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
| | - Shih‐Pin Chen
- Brain Research CenterNational Yang Ming Chiao Tung UniversityTaipeiTaiwan
- Department of Medical Research, Division of Translational ResearchTaipei Veterans General HospitalTaipeiTaiwan
| | - Henry Houlden
- Department of Neuromuscular Diseases, Institute of NeurologyUniversity College LondonLondonUK
| | - Gisela M. Terwindt
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Christian Kubisch
- Institute of Human GeneticsUniversity Medical Center Hamburg‐EppendorfHamburgGermany
| | - Elena Maestrini
- Department of Pharmacy and BiotechnologyUniversity of BolognaBolognaItaly
| | | | - Patricia Pozo‐Rosich
- Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de MedicinaUniversitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR)BarcelonaSpain
- Headache Unit, Neurology DepartmentVall d'Hebron University HospitalBarcelonaSpain
| | - Andrea C. Belin
- Centre for Cluster Headache, Department of NeuroscienceKarolinska InstitutetStockholmSweden
| | - Manjit Matharu
- Headache and Facial Pain GroupUniversity College London Queen Square Institute of Neurology and National Hospital for Neurology and NeurosurgeryLondonUK
| | - Arn M.J.M. van den Maagdenberg
- Department of Human GeneticsLeiden University Medical CenterLeidenThe Netherlands
- Department of NeurologyLeiden University Medical CenterLeidenThe Netherlands
| | - Thomas F. Hansen
- Department of Neurology, Danish Headache Center, Rigshospitalet‐GlostrupUniversity of Copenhagen University HospitalGlostrupDenmark
- Novo Nordic Foundation Center for Protein ResearchUniversity of CopenhagenCopenhagenDenmark
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital CologneUniversity of CologneCologneGermany
- Department of Neurodegenerative Diseases and Geriatric PsychiatryUniversity Hospital BonnBonnGermany
- German Center for Neurodegenerative Diseases (DZNE Bonn)BonnGermany
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative DiseasesUniversity of Texas Health Sciences CenterSan AntonioTX
- Cluster of Excellence Cellular Stress Responses in Aging‐associated Diseases (CECAD)University of CologneCologneGermany
| | - John‐Anker Zwart
- Department of Research and Innovation, Division of Clinical NeuroscienceOslo University HospitalOsloNorway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health SciencesNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement ScienceNorwegian University of Science and Technology (NTNU)TrondheimNorway
- Institute of Clinical Medicine, Faculty of MedicineUniversity of OsloOsloNorway
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Benkli B, Kim SY, Koike N, Han C, Tran CK, Silva E, Yan Y, Yagita K, Chen Z, Yoo SH, Burish MJ. Circadian Features of Cluster Headache and Migraine: A Systematic Review, Meta-analysis, and Genetic Analysis. Neurology 2023; 100:e2224-e2236. [PMID: 36990725 PMCID: PMC10259280 DOI: 10.1212/wnl.0000000000207240] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 02/16/2023] [Indexed: 03/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cluster headache and migraine have circadian features at multiple levels (cellular, systems, and behavioral). A thorough understanding of their circadian features informs their pathophysiologies. METHODS A librarian created search criteria in MEDLINE Ovid, Embase, PsycINFO, Web of Science, and Cochrane Library. Two physicians independently performed the remainder of the systematic review/meta-analysis using Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines. Separate from the systematic review/meta-analysis, we performed a genetic analysis for genes with a circadian pattern of expression (clock-controlled genes or CCGs) by cross-referencing genome-wide association studies (GWASs) of headache, a nonhuman primate study of CCGs in a variety of tissues, and recent reviews of brain areas relevant in headache disorders. Altogether, this allowed us to catalog circadian features at the behavioral level (circadian timing, time of day, time of year, and chronotype), systems level (relevant brain areas where CCGs are active, melatonin and corticosteroid levels), and cellular level (core circadian genes and CCGs). RESULTS For the systematic review and meta-analysis, 1,513 studies were found, and 72 met the inclusion criteria; for the genetic analysis, we found 16 GWASs, 1 nonhuman primate study, and 16 imaging reviews. For cluster headache behavior, meta-analyses showed a circadian pattern of attacks in 70.5% (3,490/4,953) of participants across 16 studies, with a clear circadian peak between 21:00 and 03:00 and circannual peaks in spring and autumn. Chronotype was highly variable across studies. At the systems level, lower melatonin and higher cortisol levels were reported in cluster headache participants. At the cellular level, cluster headache was associated with core circadian genes CLOCK and REV-ERBα, and 5 of the 9 cluster headache susceptibility genes were CCGs. For migraine behavior, meta-analyses showed a circadian pattern of attacks in 50.1% (2,698/5,385) of participants across 8 studies, with a clear circadian trough between 23:00 and 07:00 and a broad circannual peak between April and October. Chronotype was highly variable across studies. At the systems level, urinary melatonin levels were lower in participants with migraine and even lower during an attack. At the cellular level, migraine was associated with core circadian genes CK1δ and RORα, and 110 of the 168 migraine susceptibility genes were CCGs. DISCUSSION Cluster headache and migraine are highly circadian at multiple levels, reinforcing the importance of the hypothalamus. This review provides a pathophysiologic foundation for circadian-targeted research into these disorders. TRIAL REGISTRATION INFORMATION The study was registered with PROSPERO (registration number CRD42021234238).
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Affiliation(s)
- Barlas Benkli
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Sun Young Kim
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Nobuya Koike
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Chorong Han
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Celia K Tran
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Emma Silva
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Yuanqing Yan
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Kazuhiro Yagita
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Zheng Chen
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Seung-Hee Yoo
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston
| | - Mark J Burish
- From the Departments of Neurology (B.B.), Biochemistry and Molecular Biology (S.Y.K., C.H., C.T., Z.C., S.-H.Y.), and Neurosurgery (Y.Y., M.J.B.), UTHealth Houston; Department of Physiology and Systems Bioscience (N.K., K.Y.), Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Japan; and Texas Medical Center Library (E.S.), The University of Texas Health Science Center at Houston.
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5
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Grangeon L, Lange KS, Waliszewska-Prosół M, Onan D, Marschollek K, Wiels W, Mikulenka P, Farham F, Gollion C, Ducros A. Genetics of migraine: where are we now? J Headache Pain 2023; 24:12. [PMID: 36800925 PMCID: PMC9940421 DOI: 10.1186/s10194-023-01547-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 02/07/2023] [Indexed: 02/21/2023] Open
Abstract
Migraine is a complex brain disorder explained by the interaction of genetic and environmental factors. In monogenic migraines, including familial hemiplegic migraine and migraine with aura associated with hereditary small-vessel disorders, the identified genes code for proteins expressed in neurons, glial cells, or vessels, all of which increase susceptibility to cortical spreading depression. The study of monogenic migraines has shown that the neurovascular unit plays a prominent role in migraine. Genome-wide association studies have identified numerous susceptibility variants that each result in only a small increase in overall migraine risk. The more than 180 known variants belong to several complex networks of "pro-migraine" molecular abnormalities, which are mainly neuronal or vascular. Genetics has also highlighted the importance of shared genetic factors between migraine and its major co-morbidities, including depression and high blood pressure. Further studies are still needed to map all of the susceptibility loci for migraine and then to understand how these genomic variants lead to migraine cell phenotypes.
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Affiliation(s)
- Lou Grangeon
- grid.41724.340000 0001 2296 5231Neurology Department, CHU de Rouen, Rouen, France
| | - Kristin Sophie Lange
- grid.6363.00000 0001 2218 4662Neurology Department, Charité – Universitätsmedizin Berlin, Berlin, Germany ,grid.6363.00000 0001 2218 4662Center for Stroke Research Berlin (CSB), Charité – Universitätsmedizin, Berlin, Germany
| | - Marta Waliszewska-Prosół
- grid.4495.c0000 0001 1090 049XDepartment of Neurology, Wrocław Medical University, Wrocław, Poland
| | - Dilara Onan
- grid.14442.370000 0001 2342 7339Hacettepe University, Faculty of Physical Therapy and Rehabilitation, Ankara, Turkey
| | - Karol Marschollek
- grid.4495.c0000 0001 1090 049XDepartment of Neurology, Wrocław Medical University, Wrocław, Poland
| | - Wietse Wiels
- grid.8767.e0000 0001 2290 8069Department of Neurology, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - Petr Mikulenka
- grid.412819.70000 0004 0611 1895Department of Neurology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Fatemeh Farham
- grid.411705.60000 0001 0166 0922Headache Department, Iranian Centre of Neurological Researchers, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Cédric Gollion
- grid.411175.70000 0001 1457 2980Neurology Department, CHU de Toulouse, Toulouse, France
| | - Anne Ducros
- Neurology Department, CHU de Montpellier, 80 avenue Augustin Fliche, 34295, Montpellier, France.
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6
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Casili G, Lanza M, Filippone A, Caffo M, Paterniti I, Campolo M, Colarossi L, Sciacca D, Lombardo SP, Cuzzocrea S, Esposito E. Overview on Common Genes Involved in the Onset of Glioma and on the Role of Migraine as Risk Factor: Predictive Biomarkers or Therapeutic Targets? J Pers Med 2022; 12:jpm12121969. [PMID: 36556190 PMCID: PMC9786313 DOI: 10.3390/jpm12121969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/22/2022] [Accepted: 11/25/2022] [Indexed: 11/29/2022] Open
Abstract
Gliomas are relatively rare but fatal cancers, and there has been insufficient research to specifically evaluate the role of headache as a risk factor. Nowadays, gliomas are difficult to cure due to the infiltrative nature and the absence of specific adjuvant therapies. Until now, mutations in hundreds of genes have been identified in gliomas and most relevant discoveries showed specific genes alterations related to migraine as potential risk factors for brain tumor onset. Prognostic biomarkers are required at the time of diagnosis to better adapt therapies for cancer patients. In this review, we aimed to highlight the significant modulation of CLOCK, BMLA1 and NOTCH genes in glioma onset and development, praising these genes to be good as potentially attractive therapeutic markers for brain tumors. A improved knowledge regarding the role of these genes in triggering or modulating glioma maybe the key to early diagnosing brain tumor onset in patients affected by a simple headache. In addition, investigating on these genes we can suggest potential therapeutic targets for treating brain tumors. These considerations open up the possibility of personalized treatments that can target each brain tumor's specific genetic abnormality.
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Affiliation(s)
- Giovanna Casili
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
| | - Marika Lanza
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
| | - Alessia Filippone
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
| | - Maria Caffo
- Unit of Neurosurgery, Department of Biomedical and Dental Sciences and Morphofunctional Imaging, University of Messina, 98122 Messina, Italy
| | - Irene Paterniti
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
| | - Michela Campolo
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
| | - Lorenzo Colarossi
- Istituto Oncologico del Mediterraneo, Via Penninazzo 7, 95029 Catania, Italy
| | - Dorotea Sciacca
- Istituto Oncologico del Mediterraneo, Via Penninazzo 7, 95029 Catania, Italy
| | | | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
| | - Emanuela Esposito
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, 98122 Messina, Italy
- Correspondence:
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7
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Chen SP, Hsu CL, Wang YF, Yang FC, Chen TH, Huang JH, Pan LLH, Fuh JL, Chang HC, Lee YL, Chang HC, Lee KH, Chang YC, Fann CSJ, Wang SJ. Genome-wide analyses identify novel risk loci for cluster headache in Han Chinese residing in Taiwan. J Headache Pain 2022; 23:147. [PMID: 36404298 PMCID: PMC9677903 DOI: 10.1186/s10194-022-01517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Accepted: 10/21/2022] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Cluster headache is a highly debilitating neurological disorder with considerable inter-ethnic differences. Genome-wide association studies (GWAS) recently identified replicable genomic loci for cluster headache in Europeans, but the genetic underpinnings for cluster headache in Asians remain unclear. The objective of this study is to investigate the genetic architecture and susceptibility loci of cluster headache in Han Chinese resided in Taiwan. METHODS We conducted a two-stage genome-wide association study in a Taiwanese cohort enrolled from 2007 through 2022 to identify the genetic variants associated with cluster headache. Diagnosis of cluster headache was retrospectively ascertained with the criteria of International Classification of Headache Disorders, third edition. Control subjects were enrolled from the Taiwan Biobank. Genotyping was conducted with the Axiom Genome-Wide Array TWB chip, followed by whole genome imputation. A polygenic risk score was developed to differentiate patients from controls. Downstream analyses including gene-set and tissue enrichment, linkage disequilibrium score regression, and pathway analyses were performed. RESULTS We enrolled 734 patients with cluster headache and 9,846 population-based controls. We identified three replicable loci, with the lead SNPs being rs1556780 in CAPN2 (odds ratio = 1.59, 95% CI 1.42‒1.78, p = 7.61 × 10-16), rs10188640 in MERTK (odds ratio = 1.52, 95% CI 1.33‒1.73, p = 8.58 × 10-13), and rs13028839 in STAB2 (odds ratio = 0.63, 95% CI 0.52‒0.78, p = 2.81 × 10-8), with the latter two replicating the findings in European populations. Several previously reported genes also showed significant associations with cluster headache in our samples. Polygenic risk score differentiated patients from controls with an area under the receiver operating characteristic curve of 0.77. Downstream analyses implicated circadian regulation and immunological processes in the pathogenesis of cluster headache. CONCLUSIONS This study revealed the genetic architecture and novel susceptible loci of cluster headache in Han Chinese residing in Taiwan. Our findings support the common genetic contributions of cluster headache across ethnicities and provide novel mechanistic insights into the pathogenesis of cluster headache.
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Affiliation(s)
- Shih-Pin Chen
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.278247.c0000 0004 0604 5314Division of Translational Research, Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chia-Lin Hsu
- grid.28665.3f0000 0001 2287 1366Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Yen-Feng Wang
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Fu-Chi Yang
- grid.278244.f0000 0004 0638 9360Department of Neurology, Tri-Service General Hospital, Taipei, Taiwan
| | - Ting-Huei Chen
- grid.23856.3a0000 0004 1936 8390Department of Mathematics & Statistics, Laval University, Quebec City, QC Canada ,grid.23856.3a0000 0004 1936 8390Cervo Brain Research Centre, Quebec City, QC Canada
| | | | - Li-Ling Hope Pan
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Jong-Ling Fuh
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsueh-Chen Chang
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | | | | | | | | | - Cathy Shen-Jang Fann
- grid.28665.3f0000 0001 2287 1366Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Shuu-Jiun Wang
- grid.278247.c0000 0004 0604 5314Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112 Taiwan ,grid.260539.b0000 0001 2059 7017Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan ,grid.260539.b0000 0001 2059 7017School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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8
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Genetic overlap between temporomandibular disorders and primary headaches: A systematic review. JAPANESE DENTAL SCIENCE REVIEW 2022; 58:69-88. [PMID: 35242249 PMCID: PMC8881721 DOI: 10.1016/j.jdsr.2022.02.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 12/18/2021] [Accepted: 02/07/2022] [Indexed: 12/14/2022] Open
Abstract
Primary headache disorders (PHD), specifically migraine, are strongly associated with temporomandibular disorders (TMD), sharing some patterns of orofacial pain. Both disorders have significant genetic contributions already studied. PRISMA guidelines were followed to conduct this systematic review, which comprehensively summarize and discuss the genetic overlap between TMD and PHD to aid future research in potential therapy targets. This review included eight original articles published between 2015 and 2020, written in English and related to either TMD and/or PHD. The genes simultaneously assessed in PHD and TMD studies were COMT, MTHFR, and ESR1. COMT was proved to play a critical role in TMD pathogenesis, as all studies have concluded about its impact on the occurrence of the disease, although no association with PHD was found. No proof on the impact of MTHFR gene regulation on either TMD or PHD was found. The most robust results are concerning the ESR1 gene, which is present in the genetic profile of both clinical conditions. This novel systematic review highlights not only the need for a clear understanding of the role of ESR1 and COMT genes in pain pathogenesis, but it also evaluates their potential as a promising therapeutic target to treat both pathologies.
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9
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Katsonis P, Wilhelm K, Williams A, Lichtarge O. Genome interpretation using in silico predictors of variant impact. Hum Genet 2022; 141:1549-1577. [PMID: 35488922 PMCID: PMC9055222 DOI: 10.1007/s00439-022-02457-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/17/2022] [Indexed: 02/06/2023]
Abstract
Estimating the effects of variants found in disease driver genes opens the door to personalized therapeutic opportunities. Clinical associations and laboratory experiments can only characterize a tiny fraction of all the available variants, leaving the majority as variants of unknown significance (VUS). In silico methods bridge this gap by providing instant estimates on a large scale, most often based on the numerous genetic differences between species. Despite concerns that these methods may lack reliability in individual subjects, their numerous practical applications over cohorts suggest they are already helpful and have a role to play in genome interpretation when used at the proper scale and context. In this review, we aim to gain insights into the training and validation of these variant effect predicting methods and illustrate representative types of experimental and clinical applications. Objective performance assessments using various datasets that are not yet published indicate the strengths and limitations of each method. These show that cautious use of in silico variant impact predictors is essential for addressing genome interpretation challenges.
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Affiliation(s)
- Panagiotis Katsonis
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | - Kevin Wilhelm
- Graduate School of Biomedical Sciences, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Amanda Williams
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Olivier Lichtarge
- Department of Molecular and Human Genetics, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. .,Department of Biochemistry, Human Genetics and Molecular Biology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. .,Department of Pharmacology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA. .,Computational and Integrative Biomedical Research Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
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10
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Cui J, Peng W, Yi T, Gao P, Zhou M, Zhu T. No significant association between SNPs in the CLOCK and ADH4 genes and susceptibility to cluster headaches: A systematic review and meta-analysis. Ann Hum Genet 2022; 86:159-170. [PMID: 35437765 DOI: 10.1111/ahg.12467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 02/17/2022] [Accepted: 03/02/2022] [Indexed: 11/27/2022]
Abstract
BACKGROUND The circadian locomotor output cycles kaput (CLOCK) gene and the alcohol dehydrogenase 4 (ADH4) gene are promising candidates for susceptibility to cluster headaches (CH). Associations of the three single nucleotide polymorphisms (SNPs)-CLOCK SNP rs1801260 and ADH4 SNPs rs1800759, and rs1126671-with CH were studied previously, but the results were inconsistent. METHODS Associations between the three SNPs (rs1801260, rs1126671, and rs1800759) and CH risk were separately assessed by pooled odds ratios (ORs) along with 95% confidence intervals (95% CIs) based on five different genetic models. Methodological quality was assessed using the Newcastle-Ottawa Quality Assessment Scale (NOS). All statistical analyses were carried out with RevMan 5.3 software. RESULTS Eight studies involving 1437 CH patients and 2541 healthy controls were selected for quantitative synthesis, from five studies on CLOCK rs1801260, five on ADH4 rs1800759, and three on ADH4 rs1126671. Our pooled data did not support associations between the three SNPs (rs1801260 in the CLOCK gene, rs1800759 and rs1126671 in the ADH4 gene) and susceptibility to CH (rs1801260: OR 1.10, 95% CI: 0.95-1.28; p = 0.19; rs1800759: OR 1.06, 95% CI: 0.93-1.22; p = 0.37; and rs1126671: OR 1.09, 95% CI: 0.92-1.28; p = 0.32). CONCLUSION We found no significant associations between the three SNPs (rs1801260 in the CLOCK gene and rs1800759 and rs1126671 in the ADH4 gene) and the susceptibility to CH across both Caucasian and Asian ethnicities in our meta-analysis.
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Affiliation(s)
- Jiarui Cui
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Wei Peng
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ting Yi
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ping Gao
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Mingze Zhou
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Tianmin Zhu
- School of Rehabilitation and Health Preservation, Chengdu University of Traditional Chinese Medicine, Chengdu, China
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11
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Abstract
Cluster headache, a primary headache disorder, consists of short (15-180 minutes), frequent (up to eight a day), unilateral attacks of facial pain with associated ipsilateral autonomic features and restlessness. The attacks are suspected to be one of the most painful human experiences, and the disorder is associated with a high rate of suicidal ideation. Proper diagnosis is key, as some of the most effective treatments, such as high flow oxygen gas, are rarely used in other headache disorders. Yet diagnostic delay is typically years for this disorder, as it is often confused with migraine and trigeminal neuralgia, and secondary causes may be overlooked. This review covers the clinical, pathophysiologic, and therapeutic features of cluster headache. Recent updates in diagnosis include the redefinition of chronic cluster headache (remission periods lasting less than three months instead of the previous one month), and recent advances in management include new treatments for episodic cluster headache (galcanezumab and non-invasive vagus nerve stimulation).
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Affiliation(s)
- Emmanuelle A D Schindler
- Department of Neurology, Yale University School of Medicine, New Haven, CT, USA
- Veterans Health Administration Headache Center of Excellence, Veterans Affairs Connecticut Healthcare System, West Haven, CT
| | - Mark J Burish
- Department of Neurosurgery, McGovern Medical School at the University of Texas Health Science Center at Houston, Houston, TX, USA
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12
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Burish MJ, Winsvold BS, Miao H. The current state of cluster headache genetics. Headache 2021; 61:990-991. [PMID: 34363404 DOI: 10.1111/head.14166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 05/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Mark J Burish
- Department of Neurosurgery, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bendik S Winsvold
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Hongyu Miao
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
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13
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Cargnin S, Sances G, Shin JI, Tassorelli C, Terrazzino S. Gene polymorphism association studies in cluster headache: A field synopsis and systematic meta-analyses. Headache 2021; 61:1060-1076. [PMID: 34309832 DOI: 10.1111/head.14168] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 04/13/2021] [Accepted: 04/29/2021] [Indexed: 12/22/2022]
Abstract
BACKGROUND A plethora of studies have attempted to identify genetic determinants of disease susceptibility and treatment response of patients with cluster headache (CH), but results are often conflicting, and no comprehensive overview with a quantitative summary of the evidence in this field is available. METHODS A systematic search of relevant publications was performed without any language restrictions on PubMed, Web of Knowledge, Cochrane Library, and OpenGrey, up to December 2020. A standardized data extraction form was used to collect relevant data from each included study. Meta-analyses were conducted for gene polymorphisms investigated in at least two studies and the Bayesian false discovery probability (BFDP) test was applied to the pooled odds ratios (ORs) to assess the credibility of the observed associations. RESULTS Among the 27 articles identified by the systematic review, 17 studies evaluating 12 single nucleotide polymorphisms (SNPs) were included in the quantitative data analysis. The pooled results showed no significant association with CH risk of 10 SNPs, including five SNPs of HCRTR2 (rs2653349, rs2653342, rs3122156, rs10498801, and rs3800539), two SNPs of ADH4 (rs1800759 and rs1126671), CLOCK rs1801260, and two SNPs (rs1006417 and ADCYAP1R1 rs12668955) previously identified by a genome-wide association study (GWAS). Conversely, the pooled results revealed the association of the HCRTR2 rs9357855 A allele with a higher risk of CH (A vs. G, OR: 1.33, 95% CI: 1.04-1.72, p = 0.026), and of GNB3 rs5443 with a higher response rate of patients with CH to triptan drugs (CT+TT vs. CC, OR: 1.96, 95% CI: 1.04-3.72, p = 0.038). However, assuming a prior probability of 0.001, the respective BFDP values being higher than 0.8 (BFDPrs9357855 = 0.998; BFDPrs5443 = 0.998) revealed lack of noteworthy results. CONCLUSIONS Well-designed GWASs and large replication studies are still needed to identify reliable genetic variants of disease susceptibility and treatment response of patients with CH.
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Affiliation(s)
- Sarah Cargnin
- Department of Pharmaceutical Sciences and Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale "A. Avogadro", Novara, Italy
| | - Grazia Sances
- Headache Science Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Cristina Tassorelli
- Headache Science Center, IRCCS Mondino Foundation, Pavia, Italy.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Salvatore Terrazzino
- Department of Pharmaceutical Sciences and Interdepartmental Research Center of Pharmacogenetics and Pharmacogenomics (CRIFF), University of Piemonte Orientale "A. Avogadro", Novara, Italy
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14
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O'Connor E, Fourier C, Ran C, Sivakumar P, Liesecke F, Southgate L, Harder AVE, Vijfhuizen LS, Yip J, Giffin N, Silver N, Ahmed F, Hostettler IC, Davies B, Cader MZ, Simpson BS, Sullivan R, Efthymiou S, Adebimpe J, Quinn O, Campbell C, Cavalleri GL, Vikelis M, Kelderman T, Paemeleire K, Kilbride E, Grangeon L, Lagrata S, Danno D, Trembath R, Wood NW, Kockum I, Winsvold BS, Steinberg A, Sjöstrand C, Waldenlind E, Vandrovcova J, Houlden H, Matharu M, Belin AC. Genome-Wide Association Study Identifies Risk Loci for Cluster Headache. Ann Neurol 2021; 90:193-202. [PMID: 34184781 DOI: 10.1002/ana.26150] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 06/26/2021] [Accepted: 06/28/2021] [Indexed: 12/19/2022]
Abstract
OBJECTIVE This study was undertaken to identify susceptibility loci for cluster headache and obtain insights into relevant disease pathways. METHODS We carried out a genome-wide association study, where 852 UK and 591 Swedish cluster headache cases were compared with 5,614 and 1,134 controls, respectively. Following quality control and imputation, single variant association testing was conducted using a logistic mixed model for each cohort. The 2 cohorts were subsequently combined in a merged analysis. Downstream analyses, such as gene-set enrichment, functional variant annotation, prediction and pathway analyses, were performed. RESULTS Initial independent analysis identified 2 replicable cluster headache susceptibility loci on chromosome 2. A merged analysis identified an additional locus on chromosome 1 and confirmed a locus significant in the UK analysis on chromosome 6, which overlaps with a previously known migraine locus. The lead single nucleotide polymorphisms were rs113658130 (p = 1.92 × 10-17 , odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.37-1.66) and rs4519530 (p = 6.98 × 10-17 , OR = 1.47, 95% CI = 1.34-1.61) on chromosome 2, rs12121134 on chromosome 1 (p = 1.66 × 10-8 , OR = 1.36, 95% CI = 1.22-1.52), and rs11153082 (p = 1.85 × 10-8 , OR = 1.30, 95% CI = 1.19-1.42) on chromosome 6. Downstream analyses implicated immunological processes in the pathogenesis of cluster headache. INTERPRETATION We identified and replicated several genome-wide significant associations supporting a genetic predisposition in cluster headache in a genome-wide association study involving 1,443 cases. Replication in larger independent cohorts combined with comprehensive phenotyping, in relation to, for example, treatment response and cluster headache subtypes, could provide unprecedented insights into genotype-phenotype correlations and the pathophysiological pathways underlying cluster headache. ANN NEUROL 2021;90:193-202.
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Affiliation(s)
- Emer O'Connor
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK.,Neurogenetics Laboratory, Institute of Neurology, University College London, London, UK.,Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Carmen Fourier
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Caroline Ran
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Prasanth Sivakumar
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | | | - Laura Southgate
- Molecular and Clinical Sciences Research Institute, St George's, University of London, London, UK.,Department of Medical & Molecular Genetics, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Aster V E Harder
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisanne S Vijfhuizen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Janice Yip
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Nicola Giffin
- Neurology Department, Royal United Hospital, Bath, UK
| | | | - Fayyaz Ahmed
- Department of Neurology, Hull Royal Infirmary, Hull, UK
| | - Isabel C Hostettler
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Brendan Davies
- Department of Neurology, University Hospital North Midlands National Health Service Trust, Stoke-on-Trent, UK
| | - M Zameel Cader
- Weatherall Institute of Molecular Medicine, University of Oxford, Oxford, UK
| | - Benjamin S Simpson
- Division of Surgery and Interventional Science, University College London, London, UK
| | - Roisin Sullivan
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Stephanie Efthymiou
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Joycee Adebimpe
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Olivia Quinn
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Ciaran Campbell
- Science Foundation Ireland FutureNeuro Research Centre, Royal College of Surgeons, Ireland School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland Dublin, Dublin, Ireland
| | - Gianpiero L Cavalleri
- Science Foundation Ireland FutureNeuro Research Centre, Royal College of Surgeons, Ireland School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland Dublin, Dublin, Ireland
| | | | - Tim Kelderman
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Koen Paemeleire
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | | | - Lou Grangeon
- Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK.,Department of Neurology, Rouen University Hospital, Rouen, France
| | - Susie Lagrata
- Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Daisuke Danno
- Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
| | - Richard Trembath
- Department of Medical & Molecular Genetics, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - Nicholas W Wood
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK.,Neurogenetics Laboratory, Institute of Neurology, University College London, London, UK
| | - Ingrid Kockum
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Bendik S Winsvold
- Department of Research, Innovation, and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Anna Steinberg
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Christina Sjöstrand
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Elisabet Waldenlind
- Division of Neurology, Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden
| | - Jana Vandrovcova
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Henry Houlden
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK
| | - Manjit Matharu
- Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK
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15
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Harder AVE, Winsvold BS, Noordam R, Vijfhuizen LS, Børte S, Kogelman LJA, de Boer I, Tronvik E, Rosendaal FR, Willems van Dijk K, O'Connor E, Fourier C, Thomas LF, Kristoffersen ES, Fronczek R, Pozo-Rosich P, Jensen RH, Ferrari MD, Hansen TF, Zwart JA, Terwindt GM, van den Maagdenberg AMJM. Genetic Susceptibility Loci in Genomewide Association Study of Cluster Headache. Ann Neurol 2021; 90:203-216. [PMID: 34180076 PMCID: PMC8362054 DOI: 10.1002/ana.26146] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 06/17/2021] [Accepted: 06/22/2021] [Indexed: 02/06/2023]
Abstract
Objective Identifying common genetic variants that confer genetic risk for cluster headache. Methods We conducted a case–control study in the Dutch Leiden University Cluster headache neuro‐Analysis program (LUCA) study population (n = 840) and unselected controls from the Netherlands Epidemiology of Obesity Study (NEO; n = 1,457). Replication was performed in a Norwegian sample of 144 cases from the Trondheim Cluster headache sample and 1,800 controls from the Nord‐Trøndelag Health Survey (HUNT). Gene set and tissue enrichment analyses, blood cell‐derived RNA‐sequencing of genes around the risk loci and linkage disequilibrium score regression were part of the downstream analyses. Results An association was found with cluster headache for 4 independent loci (r2 < 0.1) with genomewide significance (p < 5 × 10−8), rs11579212 (odds ratio [OR] = 1.51, 95% confidence interval [CI] = 1.33–1.72 near RP11‐815 M8.1), rs6541998 (OR = 1.53, 95% CI = 1.37–1.74 near MERTK), rs10184573 (OR = 1.43, 95% CI = 1.26–1.61 near AC093590.1), and rs2499799 (OR = 0.62, 95% CI = 0.54–0.73 near UFL1/FHL5), collectively explaining 7.2% of the variance of cluster headache. SNPs rs11579212, rs10184573, and rs976357, as proxy SNP for rs2499799 (r2 = 1.0), replicated in the Norwegian sample (p < 0.05). Gene‐based mapping yielded ASZ1 as possible fifth locus. RNA‐sequencing indicated differential expression of POLR1B and TMEM87B in cluster headache patients. Interpretation This genomewide association study (GWAS) identified and replicated genetic risk loci for cluster headache with effect sizes larger than those typically seen in complex genetic disorders. ANN NEUROL 2021;90:203–216
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Affiliation(s)
- Aster V E Harder
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Bendik S Winsvold
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Raymond Noordam
- Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands
| | - Lisanne S Vijfhuizen
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - Sigrid Børte
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Lisette J A Kogelman
- Department of Neurology, Danish Headache Center, Rigshospitalet, Glostrup, Denmark
| | - Irene de Boer
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Erling Tronvik
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olav's Hospital, Trondheim, Norway
| | - Frits R Rosendaal
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - Ko Willems van Dijk
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands.,Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands.,Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands
| | - Emer O'Connor
- Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK.,Neurogenetics Laboratory, Institute of Neurology, University College London, London, UK.,Headache and Facial Pain Group, The National Hospital for Neurology and Neurosurgery, London, UK
| | - Carmen Fourier
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Laurent F Thomas
- K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,BioCore - Bioinformatics Core Facility, Norwegian University of Science and Technology, Trondheim, Norway.,Clinic of Laboratory Medicine, St. Olavs Hospital, Trondheim, Norway
| | - Espen S Kristoffersen
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,Department of General Practice, HELSAM, University of Oslo, Oslo, Norway.,Department of Neurology, Akershus University Hospital, Lørenskog, Norway
| | | | - Rolf Fronczek
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Patricia Pozo-Rosich
- Headache Research Group, Vall d'Hebron Institute of Research (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,España Unidad de Cefalea, Servicio de Neurología, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Rigmor H Jensen
- Department of Neurology, Danish Headache Center, Rigshospitalet, Glostrup, Denmark
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Thomas F Hansen
- Department of Neurology, Danish Headache Center, Rigshospitalet, Glostrup, Denmark
| | - John-Anker Zwart
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway.,K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.,Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Arn M J M van den Maagdenberg
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.,Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
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16
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Mavridis T, Breza M, Deligianni C, Mitsikostas DD. Current advances in the management of cluster headaches. Expert Opin Pharmacother 2021; 22:1931-1943. [PMID: 33989098 DOI: 10.1080/14656566.2021.1924148] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Introduction: Cluster headache (CH) is probably the most severe idiopathic pain condition, yet its current medical management remains poor.Areas covered: Only repurpose medicines are currently in use for the prevention of CH, partially because the pathophysiology of the condition is still elusive. In this article we performed a systematic review to evaluate the evidence for efficacy of the currently available or emerging treatments for CH.Expert opinion: We found several ongoing randomized clinical trials testing prophylactic treatments for CH and only few for the standard ones. Recent data from randomized trials with monoclonal antibodies targeting the calcitonin gene related peptide pathway (anti-CGRP mAbs) are controversial, although its role in the pathogenesis of the condition is well documented. This inconsistency may depict inadequacies in clinical trial designing. Anti-CGRP mAbs and antagonists of pituitary adenylate cyclase-activating polypeptide (PACAP) along with neuromodulation techniques, are curing the necessary valuable evidence that could illuminate the therapeutical future for cluster headache. Orexin pathway is another attractive target for CH treatment. To improve the evidence for efficacy, we further propose that the design of the clinical trials for CH needs to be radically reviewed to allow more patients to participate.
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Affiliation(s)
- Theodoros Mavridis
- 1st Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marianthi Breza
- 1 Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Dimos D Mitsikostas
- 1 Neurology Department, Aeginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
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17
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Abstract
Cluster headache (CH), paroxysmal hemicrania (PH), short-lasting unilateral neuralgiform headache attacks (including SUNCT and SUNA), and hemicrania continua (HC) compose the group of trigeminal autonomic cephalalgias (TACs). Here, we review the recent advances in the field and summarize the current knowledge about the origin of these headaches. Similar to the other primary headaches, the pathogenesis is still much obscure. However, advances are being made in both animal models and humans studies. Three structures clearly appear to be crucial in the pathophysiology of TACs: the trigeminal nerve, the facial parasympathetic system, and the hypothalamus. The physiologic and pathologic functioning of each of these elements and their interactions is being progressively clarified, but critical questions are still open.
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Affiliation(s)
- Luca Giani
- Neuroalgology Unit, IRCCS Fondazione Istituto Neurologico "Carlo Besta", Milan, Italy
| | | | - Massimo Leone
- Neuroalgology Unit, IRCCS Fondazione Istituto Neurologico "Carlo Besta", Milan, Italy.
- Neuroalgology Unit, IRCCS Fondazione Istituto Neurologico "Carlo Besta", Via Celoria 11, 20133, Milan, MI, Italy.
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18
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Waung MW, Taylor A, Qualmann KJ, Burish MJ. Family History of Cluster Headache: A Systematic Review. JAMA Neurol 2021; 77:887-896. [PMID: 32310255 DOI: 10.1001/jamaneurol.2020.0682] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Importance Genetic and environmental factors are thought to contribute to cluster headache, and cluster headache can affect multiple members of a family. A thorough understanding of its inheritance is critical to understanding the pathogenesis of this debilitating disease. Objective To systematically review family history rates and inheritance patterns of cluster headache. Evidence Review A systematic review was performed in PubMed, Embase, and Cochrane Library. Search criteria were created by a librarian. Articles published between 1985 and 2016, after the publication date of a large review in 1985, were analyzed independently by 2 neurologists to identify family history rates and pedigrees. Pedigrees were analyzed by a genetic counselor. Findings A total of 1995 studies were found (1988 through the search criteria and 7 through other means). Forty articles met inclusion criteria: 22 large cohort studies, 1 twin-based study, and 17 case reports or small case series. Across the 22 large cohort studies, the positive family history rate of cluster headache varied between 0% and 22%, with a median of 8.2%. The largest 5 studies, of 1134, 785, 693, 609, and 500 probands each, had a positive family history in 18.0% (numerator not provided), 5.1% (40 of 785 cases), 10.0% (numerator not provided), 2.0% (12 of 609 cases), and 11.2% (56 of 500 cases), respectively. No meta-analysis was performed, given differences in methodologies. Separately, 1 twin-based study examined 37 twin pairs and reported a concordance rate of 5.4% (2 pairs). Finally, 67 pedigrees were identified. Most pedigrees (46 of 67 [69%]) were consistent with an autosomal dominant pattern, but 19 of 67 (28%) were consistent with an autosomal recessive inheritance pattern; 10 pedigrees of probable or atypical cluster headache were identified, and all were consistent with an autosomal dominant inheritance pattern. The sex ratio for cluster headache in identified pedigrees was 1.39 (103:74) in affected men and boys compared with affected women and girls, which is lower than that of the general cluster headache population. Conclusions and Relevance Cluster headache is an inherited disorder in a subset of families and is associated with multiple hereditary patterns. There is an unexpectedly high preponderance of women and girls with familial cluster headache; genetic subanalyses limited to female participants are necessary to further explore this observation, because these data are otherwise masked by the higher numbers of male participants with cluster headache. Overall, this systematic review supports the notion that familial cluster headache is likely the result of multiple susceptibility genes as well as environmental factors.
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Affiliation(s)
- Maggie W Waung
- Department of Neurology, University of California, San Francisco, San Francisco
| | - Amy Taylor
- Houston Methodist Hospital, Houston, Texas
| | - Krista J Qualmann
- McGovern Medical School, Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston
| | - Mark J Burish
- McGovern Medical School, Department of Neurosurgery, The University of Texas Health Science Center at Houston, Houston
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19
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Barloese M. Current Understanding of the Chronobiology of Cluster Headache and the Role of Sleep in Its Management. Nat Sci Sleep 2021; 13:153-162. [PMID: 33603525 PMCID: PMC7886233 DOI: 10.2147/nss.s278088] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Accepted: 01/15/2021] [Indexed: 12/11/2022] Open
Abstract
Cluster headache is uniquely rhythmic in its occurrence both diurnally and annually. This has implications for the clinical approach to the patient but also for our understanding of the role of central structures in its pathological basis. Many intrinsic and extrinsic factors seem to influence CH rhythmicity, including genetics. The proclivity for attacks to occur at night and the possible association with particular sleep phenomena, including sleep apnea, have motivated a number of studies which has improved our understanding but many questions remain unanswered. The sleep-headache interaction seems to be bidirectional and possibly both direct and indirect. The latter could involve more disperse networks of homeostatic regulation, which may better encompass recent observations. Treatment of the headache patient with concurrent sleep problems can be particularly challenging, especially considering side-effects and interactions of commonly used medications. While current treatment guidelines do not incorporate chronotherapeutic thinking, some evidence may suggest that application of such principles on an individual level may be beneficial.
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Affiliation(s)
- Mads Barloese
- Department of Clinical Physiology and Nuclear Medicine, Center for Functional and Diagnostic Imaging, Hvidovre Hospital, Hvidovre, Denmark.,Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, Glostrup, Denmark
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20
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van Reij RRI, Voncken JW, Joosten EAJ, van den Hoogen NJ. Polygenic risk scores indicates genetic overlap between peripheral pain syndromes and chronic postsurgical pain. Neurogenetics 2020; 21:205-215. [PMID: 32377986 PMCID: PMC7283206 DOI: 10.1007/s10048-020-00614-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 04/21/2020] [Indexed: 02/08/2023]
Abstract
Chronic postsurgical pain (CPSP) is a debilitating chronic pain condition that has a substantial effect on quality of life. CPSP shows considerable clinical overlap with different chronic peripheral pain syndromes, suggesting a shared aetiology. This study aims to assess the genetic overlap between different chronic pain syndromes and CPSP, providing relevant biological context for potential chronic pain markers of CPSP. To analyse the genetic overlap between CPSP and chronic peripheral pain syndromes, recent GWAS studies were combined for polygenic risk scores (PRS) analysis, using a cohort of CPSP patients as starting point. Biological contextualisation of genetic marker, overlap between CPSP and chronic pain syndromes, was assessed through Gene Ontology (GO), using Pathway Scoring Algorithm (PASCAL) and REVIGO. PRS analyses suggest a significant genetic overlap between CPSP and 3 chronic pain disorders: chronic widespread pain (CWP, p value threshold = 0.003, R2 0.06, p = 0.003), rheumatoid arthritis (RA, p value threshold = 0.0177, R2 = 0.04, p = 0.017) and possibly sciatica (p value threshold = 0.00025, R2 = 0.03, p = 0.045). Whereas no significant genetic overlap was found with cluster headache and migraine, the outcome for osteoarthritis (OA) was inconsistent between the cohorts. This is likely related to cohort composition, as repeated random reallocation of patients' nullified CPSP/OA outcome variation between the discovery and replication cohorts. GO analyses suggested an aetiological involvement of genetic markers that control neurological signalling (specifically sodium channels) and inflammatory response. The current study reaffirms the impact of sample size, cohort composition and open data accessibility on the unbiased identification of genetic overlap across disorders. In conclusion, this study is the first to report genetic overlap between regulatory processes implicated in CPSP and chronic peripheral pain syndromes. Interaction between neurological signalling and inflammatory response may explain the genetic overlap between CPSP, CWP and RA. Enhanced understanding of mechanisms underlying chronification of pain will aid the development of new therapeutic strategies for CPSP with sodium channel biochemistry as a potential candidate.
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Affiliation(s)
- Roel R I van Reij
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Center+, 6200, MD, Maastricht, The Netherlands.
- Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6200, MD, Maastricht, The Netherlands.
| | - Jan Willem Voncken
- Department of Molecular Genetics, Maastricht University Medical Center+, 6200, MD, Maastricht, The Netherlands
| | - Elbert A J Joosten
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Center+, 6200, MD, Maastricht, The Netherlands
- Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6200, MD, Maastricht, The Netherlands
| | - Nynke J van den Hoogen
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Center+, 6200, MD, Maastricht, The Netherlands
- Department of Translational Neuroscience, School for Mental Health and Neuroscience (MHeNs), University of Maastricht, 6200, MD, Maastricht, The Netherlands
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21
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van Reij RRI, Hoofwijk DMN, Rutten BPF, Weinhold L, Leber M, Joosten EAJ, Ramirez A, van den Hoogen NJ. The association between genome-wide polymorphisms and chronic postoperative pain: a prospective observational study. Anaesthesia 2020; 75 Suppl 1:e111-e120. [PMID: 31903573 PMCID: PMC6973279 DOI: 10.1111/anae.14832] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/17/2019] [Indexed: 12/19/2022]
Abstract
Chronic postoperative pain is common and can have a negative impact on quality of life. Recent studies show that genetic risk factors are likely to play a role, although only gene‐targeted analysis has been used to date. This is the first genome‐wide association study to identify single‐nucleotide polymorphisms associated with the development of chronic postoperative pain based on two independent cohorts. In a discovery cohort, 330 women scheduled for hysterectomy were genotyped. A case–control association analysis compared patients without chronic postoperative pain and the 34 who had severe chronic postoperative pain 3 months after surgery. No single‐nucleotide polymorphisms reached genome‐wide significance, but several showed suggestive associations with chronic postoperative pain (p < 1 × 10−5). Single‐nucleotide polymorphisms with significance p < 1 × 10−5 were followed up in a replication cohort consisting of 203 men and women scheduled for orthopaedic or abdominal surgery. Ten of these patients developed severe chronic postoperative pain. A single‐nucleotide polymorphism in NAV3 was significantly replicated with chronic postoperative pain in the replication cohort (p = 0.009). Meta‐analysis revealed that two loci (IQGAP1 and CRTC3) were significantly associated with chronic postoperative pain at 3 months (IQGAP1 p = 3.93 × 10−6 β = 2.3863, CRTC3 p = 2.26 × 10−6, β = 2.4209). The present genome‐wide association study provides initial evidence for genetic risk factors of chronic postoperative pain and supports follow‐up studies.
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Affiliation(s)
- R R I van Reij
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, the Netherlands
| | - D M N Hoofwijk
- School for Mental Health and Neuroscience, Faculty of Health, Medicine and Life Sciences, University of Maastricht, the Netherlands
| | - B P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, University of Maastricht, the Netherlands
| | - L Weinhold
- Department of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Germany
| | - M Leber
- Department of Psychiatry and Psychotherapy, University of Cologne, Germany
| | - E A J Joosten
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, the Netherlands
| | - A Ramirez
- Department of Psychiatry and Psychotherapy, University of Bonn, Germany
| | - N J van den Hoogen
- Department of Anaesthesiology and Pain Management, Maastricht University Medical Center, Maastricht, the Netherlands
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22
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Calcitonin Gene-Related Peptide (CGRP) and Cluster Headache. Brain Sci 2020; 10:brainsci10010030. [PMID: 31935868 PMCID: PMC7016902 DOI: 10.3390/brainsci10010030] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2019] [Revised: 12/28/2019] [Accepted: 12/30/2019] [Indexed: 02/06/2023] Open
Abstract
Cluster headache (CH) is a severe primary headache with a prevalence of 1/1000 individuals, and a predominance in men. Calcitonin gene-related peptide (CGRP) is a potent vasodilator, originating in trigeminal neurons and has a central role in CH pathophysiology. CGRP and the CGRP receptor complex have recently taken center stage as therapeutic targets for primary headaches, such as migraine. Multiple CGRP and CGRP receptor monoclonal antibodies, as well as small molecule antagonists (gepants) are on their way constituting a new frontier of migraine and possibly CH medication. During a CH attack, there is an activation of the trigeminal-autonomic reflex with the release of CGRP, and inversely if CGRP is administered to a CH patient in an active disease phase, it triggers an attack. Increased levels of CGRP have been found in ipsilateral jugular vein blood during the active phase of CH. This process is hypothesized to have a key role in the intense pain perception and in the associated distinctive vasodilation. So far, clinical tests of CGRP antibodies have been inconclusive in CH patients. This review summarizes the current state of knowledge on the role of CGRP in CH pathology, and as a target for future treatments.
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Hong D, Fang P, Yao S, Chen J, Zhang X, Chen S, Zhang J, Tan D, Wang L, Han X, Xin L, Wang Y, Liu M, Cong L, Zhong S, Ouyang H, Gao X, Zhang J. Variants in MME are associated with autosomal-recessive distal hereditary motor neuropathy. Ann Clin Transl Neurol 2019; 6:1728-1738. [PMID: 31429185 PMCID: PMC6764622 DOI: 10.1002/acn3.50868] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 07/23/2019] [Accepted: 07/26/2019] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE To identify a new genetic cause in patients segregating distal hereditary motor neuropathy (dHMN) with an autosomal recessive pattern. METHODS Whole-exome sequencing was conducted in two siblings and was combined with segregation analysis. Additionally, 83 unrelated dHMN patients with unknown genetic cause were screened. RNA analysis was performed using blood lymphocytes and HEK293 cells transfected with mutant plasmids. Immunohistochemistry and Western blot analysis was applied to the nerve tissue. The enzymatic activities of mutant proteins were measured in the cultured cells to verify the pathogenicity of variants. RESULTS The clinical features of the patients showed late-onset phenotype of distal motor neuropathy without sensory involvement. We identified that compound heterozygous variants of c.1342C>T and c.2071_2072delGCinsTT in the membrane metalloendopeptidase (MME) gene co-segregated with the phenotype in a dHMN family. In an additional group of 83 patients with dHMN, compound heterozygous variants of c.1416+2T>C and c.2027C>T in MME were identified in one patient. The splice site variant c.1416+2T>C results in skipping of exon 13. The stop variant c.1342C>T induces mRNA degradation via nonsense-mediated mRNA decay. Transcript levels of MME in the lymphocytes showed no significant differences between the patients and controls. We also identified that MME variants were associated with mild decrease in protein expression in the sural nerve and significant impairments of enzymatic activity. INTERPRETATION Variants in the MME gene were associated with not only a Charcot-Marie-Tooth neuropathy phenotype but also with an autosomal-recessive dHMN phenotype. Loss of function may play a role in the pathogenesis of dHMN.
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Affiliation(s)
- Daojun Hong
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China.,Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Pu Fang
- Department of Neurology, The First Affiliated Hospital of Nanchang University, Nanchang, China
| | - Sheng Yao
- Department of Neurology, The Sixth Medical Center of PLA General Hospital, Beijing, China
| | - Juanjuan Chen
- Department of Neurology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Xiaolei Zhang
- Department of Neurology, Shanxi Province People's Hospital, Taiyuan, China
| | - Shuyun Chen
- Department of Neurology, Affiliated Hospital of Guiyang Medical University, Guiyang, China
| | - Jingfen Zhang
- Department of Neurology, Inner Mongolia Baotou City Central Hospital, Baotou, China
| | - Dandan Tan
- Department of Neurology, Affiliated Hospital of Jiujiang Medical College, Jiujiang, China
| | - Li Wang
- Department of Neurology, Traditional Chinese Medicine Hospital of Lianyungang, Lianyungang, China
| | - Xinsheng Han
- Department of Neurology, Kaifeng City People's Hospital, Kaifeng, China
| | - Ling Xin
- Department of Health, Exercise Science, and Recreation Management, University of Mississippi, University Park, Mississippi
| | - Yan Wang
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Meige Liu
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Lu Cong
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Shanshan Zhong
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Hui Ouyang
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Xuguang Gao
- Department of Neurology, Peking University People's Hospital, Beijing, China
| | - Jun Zhang
- Department of Neurology, Peking University People's Hospital, Beijing, China
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Ran C, Fourier C, Arafa D, Liesecke F, Sjöstrand C, Waldenlind E, Steinberg A, Belin AC. Anoctamin 3: A Possible Link between Cluster Headache and Ca 2+ Signaling. Brain Sci 2019; 9:E184. [PMID: 31366133 PMCID: PMC6721385 DOI: 10.3390/brainsci9080184] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 07/24/2019] [Accepted: 07/29/2019] [Indexed: 12/27/2022] Open
Abstract
Cluster headache is a severe primary headache characterized by extremely painful attacks of unilateral headache. Verapamil is commonly used as a prophylactic treatment with good effect. In order to search for new pathways involved in the pathophysiology of cluster headache, we analyzed genetic variants that were previously linked to verapamil response in migraine in a Swedish cluster headache case-control sample. We used TaqMan qPCR for genetic screening and performed a gene expression analysis on associated genes in patient-derived fibroblasts, and further investigated which reference genes were suitable for analysis in fibroblasts from cluster headache patients. We discovered a significant association between anoctamin 3, a gene encoding a calcium-activated ion channel, and cluster headache. The association was not dependent on verapamil treatment since the associated variant, rs1531394, was also overrepresented in patients not using verapamil. No difference was found in the anoctamin 3 gene expression between controls and patients. Also, we determined that TBP, IPO8 and PDHB were suitable reference genes in cluster headache fibroblasts. This finding is the first report of an association between a variant in a gene encoding an ion-channel and cluster headache, and the first significant genetic evidence of calcium involvement in cluster headache pathophysiology.
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Affiliation(s)
- Caroline Ran
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden.
| | - Carmen Fourier
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
| | - Donia Arafa
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
| | - Franziska Liesecke
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
| | - Christina Sjöstrand
- Department of Clinical Neuroscience, Karolinska University Hospital, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Elisabet Waldenlind
- Department of Clinical Neuroscience, Karolinska University Hospital, Tomtebodavägen 18A, 171 77 Stockholm, Sweden
| | - Anna Steinberg
- Division of Neurology, Karolinska University Hospital, Eugeniavägen 3, 171 76 Solna, Sweden
| | - Andrea Carmine Belin
- Department of Neuroscience, Karolinska Institutet, Biomedicum D7, Solnavägen 9, 171 65 Stockholm, Sweden
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Frederiksen SD, Haanes KA, Warfvinge K, Edvinsson L. Perivascular neurotransmitters: Regulation of cerebral blood flow and role in primary headaches. J Cereb Blood Flow Metab 2019; 39:610-632. [PMID: 29251523 PMCID: PMC6446417 DOI: 10.1177/0271678x17747188] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Revised: 11/04/2017] [Accepted: 11/06/2017] [Indexed: 12/17/2022]
Abstract
In order to understand the nature of the relationship between cerebral blood flow (CBF) and primary headaches, we have conducted a literature review with particular emphasis on the role of perivascular neurotransmitters. Primary headaches are in general considered complex polygenic disorders (genetic and environmental influence) with pathophysiological neurovascular alterations. Identified candidate headache genes are associated with neuro- and gliogenesis, vascular development and diseases, and regulation of vascular tone. These findings support a role for the vasculature in primary headache disorders. Moreover, neuronal hyperexcitability and other abnormalities have been observed in primary headaches and related to changes in hemodynamic factors. In particular, this relates to migraine aura and spreading depression. During headache attacks, ganglia such as trigeminal and sphenopalatine (located outside the blood-brain barrier) are variably activated and sensitized which gives rise to vasoactive neurotransmitter release. Sympathetic, parasympathetic and sensory nerves to the cerebral vasculature are activated. During migraine attacks, altered CBF has been observed in brain regions such as the somatosensory cortex, brainstem and thalamus. In regulation of CBF, the individual roles of neurotransmitters are partly known, but much needs to be unraveled with respect to headache disorders.
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Affiliation(s)
- Simona D Frederiksen
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Kristian A Haanes
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Karin Warfvinge
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
- Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University, Lund, Sweden
| | - Lars Edvinsson
- Department of Clinical Experimental Research, Glostrup Research Institute, Rigshospitalet Glostrup, Glostrup, Denmark
- Division of Experimental Vascular Research, Department of Clinical Sciences, Lund University, Lund, Sweden
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Abstract
BACKGROUND Cluster headache is the most severe primary headache disorder. A genetic basis has long been suggested by family and twin studies; however, little is understood about the genetic variants that contribute to cluster headache susceptibility. METHODS We conducted a literature search of the MEDLINE database using the PubMed search engine to identify all human genetic studies for cluster headache. In this article we provide a review of those genetic studies, along with an overview of the pathophysiology of cluster headache and a brief review of migraine genetics, which have both been significant drivers of cluster headache candidate gene selection. RESULTS The investigation of cluster headache genetic etiology has been dominated by candidate gene studies. Candidate selection has largely been driven by the pathophysiology, such as the striking rhythmic nature of the attacks, which spurred close examination of the circadian rhythm genes CLOCK and HCRTR2. More recently, unbiased genetic approaches such as genome-wide association studies (GWAS) have yielded new genetic avenues of interest including ADCYAP1R1 and MME. CONCLUSIONS The majority of candidate genes studied for cluster headache suffer from poor reproducibility. Broader genetic interrogation through larger unbiased GWAS, exome, and whole genome studies may provide more robust candidates, and in turn provide a clearer understanding of the causes of cluster headache.
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Affiliation(s)
| | | | - Nunu Lund
- 2 Danish Headache Center, Department of Neurology, University of Copenhagen, Denmark
| | - Rigmor Jensen
- 2 Danish Headache Center, Department of Neurology, University of Copenhagen, Denmark
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Burish MJ, Chen Z, Yoo SH. Emerging relevance of circadian rhythms in headaches and neuropathic pain. Acta Physiol (Oxf) 2019; 225:e13161. [PMID: 29969187 DOI: 10.1111/apha.13161] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Accepted: 06/29/2018] [Indexed: 12/13/2022]
Abstract
Circadian rhythms of physiology are the keys to health and fitness, as dysregulation, by genetic mutations or environmental factors, increases disease risk and aggravates progression. Molecular and physiological studies have shed important light on an intrinsic clock that drives circadian rhythms and serves essential roles in metabolic homoeostasis, organ physiology and brain functions. One exciting new area in circadian research is pain, including headache and neuropathic pain for which new mechanistic insights have recently emerged. For example, cluster headache is an intermittent pain disorder with an exceedingly precise circadian timing, and preliminary evidence is emerging linking several circadian components (eg, Clock and Nr1d1) with the disease. In this review, we first discuss the broad metabolic and physiological relevance of the circadian timing system. We then provide a detailed review of the circadian relevance in pain disease and physiology, including cluster headache, migraine, hypnic headache and neuropathic pain. Finally, we describe potential therapeutic implications, including existing pain medicines and novel clock-modulating compounds. The physiological basis for the circadian rhythms in pain is an exciting new area of research with profound basic and translational impact.
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Affiliation(s)
- Mark J. Burish
- Department of Neurosurgery; University of Texas Health Science Center at Houston; Houston Texas
| | - Zheng Chen
- Department of Biochemistry and Molecular Biology; University of Texas Health Science Center at Houston; Houston Texas
| | - Seung-Hee Yoo
- Department of Biochemistry and Molecular Biology; University of Texas Health Science Center at Houston; Houston Texas
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Vollesen AL, Benemei S, Cortese F, Labastida-Ramírez A, Marchese F, Pellesi L, Romoli M, Ashina M, Lampl C. Migraine and cluster headache - the common link. J Headache Pain 2018; 19:89. [PMID: 30242519 PMCID: PMC6755613 DOI: 10.1186/s10194-018-0909-4] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 08/20/2018] [Indexed: 01/07/2023] Open
Abstract
Although clinically distinguishable, migraine and cluster headache share prominent features such as unilateral pain, common pharmacological triggers such glyceryl trinitrate, histamine, calcitonin gene-related peptide (CGRP) and response to triptans and neuromodulation. Recent data also suggest efficacy of anti CGRP monoclonal antibodies in both migraine and cluster headache. While exact mechanisms behind both disorders remain to be fully understood, the trigeminovascular system represents one possible common pathophysiological pathway and network of both disorders. Here, we review past and current literature shedding light on similarities and differences in phenotype, heritability, pathophysiology, imaging findings and treatment options of migraine and cluster headache. A continued focus on their shared pathophysiological pathways may be important in paving future treatment avenues that could benefit both migraine and cluster headache patients.
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Affiliation(s)
- Anne Luise Vollesen
- Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Silvia Benemei
- Health Sciences Department, University of Florence and Headache Centre, Careggi University Hospital, Florence, Italy
| | - Francesca Cortese
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza, University of Rome, Polo Pontino, Latina, Italy
| | - Alejandro Labastida-Ramírez
- Dep Internal Medicine, Division of Vascular Pharmacology, Erasmus Medical Center, Rotterdam, The Netherlands
| | | | - Lanfranco Pellesi
- Medical Toxicology, Headache and Drug Abuse Center, University of Modena and Reggio Emilia, Modena, Italy
| | - Michele Romoli
- Neurology Clinic, University of Perugia - S.M. Misericordiae Hospital, Perugia, Italy
| | - Messoud Ashina
- Danish Headache Center and Department of Neurology, Rigshospitalet Glostrup, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Christian Lampl
- Department of Neurogeriatric Medicine, Headache Medical Center Linz, Ordensklinikum Linz Barmherzige Schwestern, Seilerstaette 4, 4010, Linz, Austria.
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Rubio-Beltrán E, Correnti E, Deen M, Kamm K, Kelderman T, Papetti L, Vigneri S, MaassenVanDenBrink A, Edvinsson L. PACAP38 and PAC 1 receptor blockade: a new target for headache? J Headache Pain 2018; 19:64. [PMID: 30088106 PMCID: PMC6081277 DOI: 10.1186/s10194-018-0893-8] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Accepted: 07/24/2018] [Indexed: 12/21/2022] Open
Abstract
Pituitary adenylate cyclase activating polypeptide-38 (PACAP38) is a widely distributed neuropeptide involved in neuroprotection, neurodevelopment, nociception and inflammation. Moreover, PACAP38 is a potent inducer of migraine-like attacks, but the mechanism behind this has not been fully elucidated. Migraine is a neurovascular disorder, recognized as the second most disabling disease. Nevertheless, the antibodies targeting calcitonin gene-related peptide (CGRP) or its receptor are the only prophylactic treatment developed specifically for migraine. These antibodies have displayed positive results in clinical trials, but are not effective for all patients; therefore, new pharmacological targets need to be identified. Due to the ability of PACAP38 to induce migraine-like attacks, its location in structures previously associated with migraine pathophysiology and the 100-fold selectivity for the PAC1 receptor when compared to VIP, new attention has been drawn to this pathway and its potential role as a novel target for migraine treatment. In accordance with this, antibodies against PACAP38 (ALD 1910) and PAC1 receptor (AMG 301) are being developed, with AMG 301 already in Phase II clinical trials. No results have been published so far, but in preclinical studies, AMG 301 has shown responses comparable to those observed with triptans. If these antibodies prove to be effective for the treatment of migraine, several considerations should be addressed, for instance, the potential side effects of long-term blockade of the PACAP (receptor) pathway. Moreover, it is important to investigate whether these antibodies will indeed represent a therapeutic advantage for the patients that do not respond the CGRP (receptor)-antibodies. In conclusion, the data presented in this review indicate that PACAP38 and PAC1 receptor blockade are promising antimigraine therapies, but results from clinical trials are needed in order to confirm their efficacy and side effect profile.
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Affiliation(s)
- Eloisa Rubio-Beltrán
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.
| | - Edvige Correnti
- Department of Child Neuropsychiatry, University of Palermo, Palermo, Italy
| | - Marie Deen
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Glostrup, Denmark
| | - Katharina Kamm
- Department of Neurology, University Hospital, LMU Munich, Munich, Germany
| | - Tim Kelderman
- Department of Neurology, Ghent University Hospital, Ghent, Belgium
| | - Laura Papetti
- Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simone Vigneri
- Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo; Pain Medicine Unit, Santa Maria Maddalena Hospital, Occhiobello, Italy
| | - Antoinette MaassenVanDenBrink
- Division of Vascular Medicine and Pharmacology, Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Lars Edvinsson
- Department of Internal Medicine, Institute of Clinical Sciences, Lund University, Lund, Sweden
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Rozen TD. Linking Cigarette Smoking/Tobacco Exposure and Cluster Headache: A Pathogenesis Theory. Headache 2018; 58:1096-1112. [PMID: 30011061 DOI: 10.1111/head.13338] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/09/2018] [Indexed: 12/16/2022]
Abstract
INTRODUCTION To propose a hypothesis theory to establish a linkage between cigarette smoking and cluster headache pathogenesis. BACKGROUND Cluster headache is a primary headache syndrome grouped under the trigeminal autonomic cephalalgias. What distinguishes cluster headache from all other primary headache conditions is its inherent connection to cigarette smoking. It is undeniable that tobacco exposure is in some manner related to cluster headache. The connection to tobacco exposure for cluster headache is so strong that even if an individual sufferer never smoked, then that individual typically had significant secondary smoke exposure as a child from parental smoking behavior and in many instances both scenarios exist. The manner by which cigarette smoking is connected to cluster headache pathogenesis is unknown at present. If this could be determined this may contribute to advancing our understanding of cluster headache pathophysiology. METHODS/RESULTS Hypothesis statement. CONCLUSION The hypothesis theory will include several principles: (1) the need of double lifetime tobacco exposure, (2) that cadmium is possibly the primary agent in cigarette smoke that leads to hypothalamic-pituitary-gonadal axis toxicity promoting cluster headache, (3) that the estrogenization of the brain and its specific sexually dimorphic nuclei is necessary to develop cluster headache with tobacco exposure, and (4) that the chronic effects of smoking and its toxic metabolites including cadmium and nicotine on the cortex are contributing to the morphometric and orexin alterations that have been previously attributed to the primary headache disorder itself.
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Wei DYT, Yuan Ong JJ, Goadsby PJ. Cluster Headache: Epidemiology, Pathophysiology, Clinical Features, and Diagnosis. Ann Indian Acad Neurol 2018; 21:S3-S8. [PMID: 29720812 PMCID: PMC5909131 DOI: 10.4103/aian.aian_349_17] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023] Open
Abstract
Cluster headache is a primary headache disorder affecting up to 0.1% of the population. Patients suffer from cluster headache attacks lasting from 15 to 180 min up to 8 times a day. The attacks are characterized by the severe unilateral pain mainly in the first division of the trigeminal nerve, with associated prominent unilateral cranial autonomic symptoms and a sense of agitation and restlessness during the attacks. The male-to-female ratio is approximately 2.5:1. Experimental, clinical, and neuroimaging studies have advanced our understanding of the pathogenesis of cluster headache. The pathophysiology involves activation of the trigeminovascular complex and the trigeminal-autonomic reflex and accounts for the unilateral severe headache, the prominent ipsilateral cranial autonomic symptoms. In addition, the circadian and circannual rhythmicity unique to this condition is postulated to involve the hypothalamus and suprachiasmatic nucleus. Although the clinical features are distinct, it may be misdiagnosed, with patients often presenting to the otolaryngologist or dentist with symptoms. The prognosis of cluster headache remains difficult to predict. Patients with episodic cluster headache can shift to chronic cluster headache and vice versa. Longitudinally, cluster headache tends to remit with age with less frequent bouts and more prolonged periods of remission in between bouts.
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Affiliation(s)
- Diana Yi-Ting Wei
- Department of Basic and Clinical Neuroscience, Headache Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK
| | - Jonathan Jia Yuan Ong
- Department of Basic and Clinical Neuroscience, Headache Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Medicine, Division of Neurology, National University Health System, University Medicine Cluster, Singapore
| | - Peter James Goadsby
- Department of Basic and Clinical Neuroscience, Headache Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR-Wellcome Trust King's Clinical Research Facility, King's College Hospital, London, UK
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Holland PR, Barloese M, Fahrenkrug J. PACAP in hypothalamic regulation of sleep and circadian rhythm: importance for headache. J Headache Pain 2018; 19:20. [PMID: 29508090 PMCID: PMC5838029 DOI: 10.1186/s10194-018-0844-4] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Accepted: 02/12/2018] [Indexed: 12/12/2022] Open
Abstract
The interaction between sleep and primary headaches has gained considerable interest due to their strong, bidirectional, clinical relationship. Several primary headaches demonstrate either a circadian/circannual rhythmicity in attack onset or are directly associated with sleep itself. Migraine and cluster headache both show distinct attack patterns and while the underlying mechanisms of this circadian variation in attack onset remain to be fully explored, recent evidence points to clear physiological, anatomical and genetic points of convergence. The hypothalamus has emerged as a key brain area in several headache disorders including migraine and cluster headache. It is involved in homeostatic regulation, including pain processing and sleep regulation, enabling appropriate physiological responses to diverse stimuli. It is also a key integrator of circadian entrainment to light, in part regulated by pituitary adenylate cyclase-activating peptide (PACAP). With its established role in experimental headache research the peptide has been extensively studied in relation to headache in both humans and animals, however, there are only few studies investigating its effect on sleep in humans. Given its prominent role in circadian entrainment, established in preclinical research, and the ability of exogenous PACAP to trigger attacks experimentally, further research is very much warranted. The current review will focus on the role of the hypothalamus in the regulation of sleep-wake and circadian rhythms and provide suggestions for the future direction of such research, with a particular focus on PACAP.
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Affiliation(s)
- Philip R Holland
- Department of Basic and Clinical Neuroscience, Headache Group, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Mads Barloese
- Department of Clinical Physiology, Nuclear Medicine and PET, 70590 Rigshospitalet, Copenhagen, Denmark.
| | - Jan Fahrenkrug
- Department of Clinical Biochemistry, Faculty of Health and Medical Sciences, Bispebjerg Hospital, University of Copenhagen, Copenhagen, Denmark
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Abstract
Cluster headache is an excruciating, strictly one-sided pain syndrome with attacks that last between 15 minutes and 180 minutes and that are accompanied by marked ipsilateral cranial autonomic symptoms, such as lacrimation and conjunctival injection. The pain is so severe that female patients describe each attack as worse than childbirth. The past decade has seen remarkable progress in the understanding of the pathophysiological background of cluster headache and has implicated the brain, particularly the hypothalamus, as the generator of both the pain and the autonomic symptoms. Anatomical connections between the hypothalamus and the trigeminovascular system, as well as the parasympathetic nervous system, have also been implicated in cluster headache pathophysiology. The diagnosis of cluster headache involves excluding other primary headaches and secondary headaches and is based primarily on the patient's symptoms. Remarkable progress has been achieved in developing effective treatment options for single cluster attacks and in developing preventive measures, which include pharmacological therapies and neuromodulation.
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Affiliation(s)
- Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Martinistrasse 52, D-20246 Hamburg, Germany
| | | | - Delphine Magis
- University Department of Neurology CHR, CHU de Liege, Belgium
| | - Patricia Pozo-Rosich
- Headache and Craniofacial Pain Unit, Neurology Department, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Headache Research Group, VHIR, Universitat Autònoma Barcelona, Barcelona, Spain
| | - Stefan Evers
- Department of Neurology, Krankenhaus Lindenbrunn, Coppenbrügge, Germany
| | - Shuu-Jiun Wang
- Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taipei, Taiwan
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Hoffmann J, May A. Diagnosis, pathophysiology, and management of cluster headache. Lancet Neurol 2017; 17:75-83. [PMID: 29174963 DOI: 10.1016/s1474-4422(17)30405-2] [Citation(s) in RCA: 159] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Revised: 09/20/2017] [Accepted: 09/20/2017] [Indexed: 01/12/2023]
Abstract
Cluster headache is a trigeminal autonomic cephalalgia characterised by extremely painful, strictly unilateral, short-lasting headache attacks accompanied by ipsilateral autonomic symptoms or the sense of restlessness and agitation, or both. The severity of the disorder has major effects on the patient's quality of life and, in some cases, might lead to suicidal ideation. Cluster headache is now thought to involve a synchronised abnormal activity in the hypothalamus, the trigeminovascular system, and the autonomic nervous system. The hypothalamus appears to play a fundamental role in the generation of a permissive state that allows the initiation of an episode, whereas the attacks are likely to require the involvement of the peripheral nervous system. Triptans are the most effective drugs to treat an acute cluster headache attack. Monoclonal antibodies against calcitonin gene-related peptide, a crucial neurotransmitter of the trigeminal system, are under investigation for the preventive treatment of cluster headache. These studies will increase our understanding of the disorder and perhaps reveal other therapeutic targets.
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Affiliation(s)
- Jan Hoffmann
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Arne May
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
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Sundrum T, Walker CS. Pituitary adenylate cyclase-activating polypeptide receptors in the trigeminovascular system: implications for migraine. Br J Pharmacol 2017; 175:4109-4120. [PMID: 28977676 DOI: 10.1111/bph.14053] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 08/24/2017] [Accepted: 09/11/2017] [Indexed: 12/13/2022] Open
Abstract
The neuropeptide pituitary adenylate cyclase-activating polypeptide (PACAP) has been implicated in a wide range of functions including vasodilatation, neuroprotection, nociception and neurogenic inflammation. PACAP activates three distinct receptors, the PAC1 receptor, which responds to PACAP, and the VPAC1 and VPAC2 receptors, which respond to both PACAP and vasoactive intestinal polypeptide. The trigeminovascular system plays a key role in migraine and contains the trigeminal nerve, which is the major conduit of craniofacial pain. PACAP is expressed throughout the trigeminovascular system and in higher brain regions involved in processing pain. Evidence from human clinical studies suggests that PACAP may act outside the blood-brain barrier in the pathogenesis of migraine. However, the precise mechanisms involved remain unclear. PACAP potentially induces migraine attacks by activating different receptors in different cell types and tissues. This complexity prompted this review of PACAP receptor pharmacology, expression and function in the trigeminovascular system. Current evidence suggests that the PAC1 receptor is the likely pathophysiological target of PACAP in migraine. However, multiple PACAP receptors are expressed in key parts of the trigeminovascular system and further work is required to determine their contribution to PACAP physiology and the pathology of migraine. LINKED ARTICLES This article is part of a themed section on Molecular Pharmacology of GPCRs. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v175.21/issuetoc.
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Affiliation(s)
- Tahlia Sundrum
- School of Biological Sciences, University of Auckland, Auckland, New Zealand
| | - Christopher S Walker
- School of Biological Sciences, University of Auckland, Auckland, New Zealand.,Maurice Wilkins Centre and Centre for Brain Research, University of Auckland, Auckland, New Zealand
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Ran C, Fourier C, Michalska JM, Steinberg A, Sjöstrand C, Waldenlind E, Belin AC. Screening of genetic variants in ADCYAP1R1, MME and 14q21 in a Swedish cluster headache cohort. J Headache Pain 2017; 18:88. [PMID: 28831700 PMCID: PMC5567453 DOI: 10.1186/s10194-017-0798-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2017] [Accepted: 08/09/2017] [Indexed: 01/03/2023] Open
Abstract
Background We have genotyped a Swedish cluster headache case-control population for three genetic variants representing the most significant markers identified in a recently published genome wide association study on cluster headache. The genetic variants were two common polymorphisms; rs12668955 in ADCYAP1R1 (adenylate cyclase activating polypeptide 1 receptor type 1), rs1006417, an intergenic variant on chromosome 14q21 and one rare mutation, rs147564881, in MME (membrane metalloendopeptidase). Results We screened 542 cluster headache patients and 581 controls using TaqMan real-time PCR on a 7500 fast cycler, and pyrosequencing on a PSQ 96 System. Statistical analysis for genotype and allele association showed that neither of the two common variants, rs12668955 and rs1006417 were associated with cluster headache. The MME mutation was investigated with pyrosequencing in patients, of whom all were wild type. Conclusion In conclusion rs12668955 and rs1006417 do not impact the risk of developing cluster headache in the Swedish population. Also, rs147564881 does not seem to be enriched within the Swedish cluster headache patient group.
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Affiliation(s)
- Caroline Ran
- Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden.
| | - Carmen Fourier
- Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Julia M Michalska
- Department of Neuroscience, Karolinska Institutet, 171 77, Stockholm, Sweden
| | - Anna Steinberg
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
| | - Christina Sjöstrand
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
| | - Elisabet Waldenlind
- Department of Clinical Neuroscience, Karolinska University Hospital, Stockholm, Sweden
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