Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache
ObjectiveTo investigate the possible subgroups of patients with Cluster Headache (CH) by using K-means cluster analysis.MethodsA total of 209 individuals (mean (SD) age: 39.8 (11.3) years), diagnosed with CH by headache experts, participated in this cross-sectional multi-center study. All patients c...
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Frontiers Media S.A.
2022-05-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2022.898022/full |
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| author | Pinar Yalinay Dikmen Cagla Ari Erdi Sahin Mustafa Ertas Fusun Mayda Domac Elif Ilgaz Aydinlar Aysenur Sahin Aynur Ozge Hilal Ozguner Omer Karadas Javid Shafiyev Doga Vuralli Doga Vuralli Doga Vuralli Cile Aktan Emel Oguz-Akarsu Necdet Karli Mehmet Zarifoglu Hayrunisa Bolay Hayrunisa Bolay Hayrunisa Bolay Esme Ekizoglu Elif Kocasoy Orhan Bahar Tasdelen Betul Baykan |
| author_facet | Pinar Yalinay Dikmen Cagla Ari Erdi Sahin Mustafa Ertas Fusun Mayda Domac Elif Ilgaz Aydinlar Aysenur Sahin Aynur Ozge Hilal Ozguner Omer Karadas Javid Shafiyev Doga Vuralli Doga Vuralli Doga Vuralli Cile Aktan Emel Oguz-Akarsu Necdet Karli Mehmet Zarifoglu Hayrunisa Bolay Hayrunisa Bolay Hayrunisa Bolay Esme Ekizoglu Elif Kocasoy Orhan Bahar Tasdelen Betul Baykan |
| author_sort | Pinar Yalinay Dikmen |
| collection | DOAJ |
| description | ObjectiveTo investigate the possible subgroups of patients with Cluster Headache (CH) by using K-means cluster analysis.MethodsA total of 209 individuals (mean (SD) age: 39.8 (11.3) years), diagnosed with CH by headache experts, participated in this cross-sectional multi-center study. All patients completed a semi-structured survey either face to face, preferably, or through phone interviews with a physician. The survey was composed of questions that addressed sociodemographic characteristics as well as detailed clinical features and treatment experiences.ResultsCluster analysis revealed two subgroups. Cluster one patients (n = 81) had younger age at diagnosis (31.04 (9.68) vs. 35.05 (11.02) years; p = 0.009), a higher number of autonomic symptoms (3.28 (1.16) vs. 1.99(0.95); p < 0.001), and showed a better response to triptans (50.00% vs. 28.00; p < 0.001) during attacks, compared with the cluster two subgroup (n = 122). Cluster two patients had higher rates of current smoking (76.0 vs. 33.0%; p=0.002), higher rates of smoking at diagnosis (78.0 vs. 32.0%; p=0.006), higher rates of parental smoking/tobacco exposure during childhood (72.0 vs. 33.0%; p = 0.010), longer duration of attacks with (44.21 (34.44) min. vs. 34.51 (24.97) min; p=0.005) and without (97.50 (63.58) min. vs. (83.95 (49.07) min; p = 0.035) treatment and higher rates of emergency department visits in the last year (81.0 vs. 26.0%; p< 0.001).ConclusionsCluster one and cluster two patients had different phenotypic features, possibly indicating different underlying genetic mechanisms. The cluster 1 phenotype may suggest a genetic or biology-based etiology, whereas the cluster two phenotype may be related to epigenetic mechanisms. Toxic exposure to cigarettes, either personally or secondarily, seems to be an important factor in the cluster two subgroup, inducing drug resistance and longer attacks. We need more studies to elaborate the causal relationship and the missing links of neurobiological pathways of cigarette smoking regarding the identified distinct phenotypic classes of patients with CH. |
| first_indexed | 2024-04-13T17:27:51Z |
| format | Article |
| id | doaj.art-6b9945b448b145f795a1831b845fd6cf |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-04-13T17:27:51Z |
| publishDate | 2022-05-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-6b9945b448b145f795a1831b845fd6cf2022-12-22T02:37:41ZengFrontiers Media S.A.Frontiers in Neurology1664-22952022-05-011310.3389/fneur.2022.898022898022Cluster Analysis Revealed Two Hidden Phenotypes of Cluster HeadachePinar Yalinay Dikmen0Cagla Ari1Erdi Sahin2Mustafa Ertas3Fusun Mayda Domac4Elif Ilgaz Aydinlar5Aysenur Sahin6Aynur Ozge7Hilal Ozguner8Omer Karadas9Javid Shafiyev10Doga Vuralli11Doga Vuralli12Doga Vuralli13Cile Aktan14Emel Oguz-Akarsu15Necdet Karli16Mehmet Zarifoglu17Hayrunisa Bolay18Hayrunisa Bolay19Hayrunisa Bolay20Esme Ekizoglu21Elif Kocasoy Orhan22Bahar Tasdelen23Betul Baykan24Department of Neurology, Acibadem University School of Medicine, Istanbul, TurkeyDepartment of Neurology, Siirt State Hospital, Siirt, TurkeyDepartment of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDepartment of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDepartment of Neurology, Erenkoy Training and Research Hospital for Psychiatric and Neurological Disorders, University of Health Sciences, Istanbul, TurkeyDepartment of Neurology, Acibadem University School of Medicine, Istanbul, TurkeyDepartment of Neurology, Acibadem University School of Medicine, Istanbul, TurkeyDepartment of Neurology, Mersin University Faculty of Medicine, Mersin, TurkeyDepartment of Neurology, Mersin University Faculty of Medicine, Mersin, TurkeyDepartment of Neurology, Gulhane School of Medicine, University of Health Sciences, Ankara, TurkeyDepartment of Neurology, Gulhane School of Medicine, University of Health Sciences, Ankara, TurkeyDepartment of Neurology and Algology, Gazi University Faculty of Medicine, Ankara, TurkeyNeuroscience and Neurotechnology Center of Excellence (Nörom), Ankara, TurkeyGazi University, Neuropsychiatry Center, Ankara, TurkeyDepartment of Neurology and Algology, Gazi University Faculty of Medicine, Ankara, Turkey0Department of Neurology, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey0Department of Neurology, Bursa Uludag University, Faculty of Medicine, Bursa, Turkey0Department of Neurology, Bursa Uludag University, Faculty of Medicine, Bursa, TurkeyDepartment of Neurology and Algology, Gazi University Faculty of Medicine, Ankara, TurkeyNeuroscience and Neurotechnology Center of Excellence (Nörom), Ankara, TurkeyGazi University, Neuropsychiatry Center, Ankara, TurkeyDepartment of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyDepartment of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey1Department of Bioistatistics and Medical Informatics, Mersin University Faculty of Medicine, Mersin, TurkeyDepartment of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, TurkeyObjectiveTo investigate the possible subgroups of patients with Cluster Headache (CH) by using K-means cluster analysis.MethodsA total of 209 individuals (mean (SD) age: 39.8 (11.3) years), diagnosed with CH by headache experts, participated in this cross-sectional multi-center study. All patients completed a semi-structured survey either face to face, preferably, or through phone interviews with a physician. The survey was composed of questions that addressed sociodemographic characteristics as well as detailed clinical features and treatment experiences.ResultsCluster analysis revealed two subgroups. Cluster one patients (n = 81) had younger age at diagnosis (31.04 (9.68) vs. 35.05 (11.02) years; p = 0.009), a higher number of autonomic symptoms (3.28 (1.16) vs. 1.99(0.95); p < 0.001), and showed a better response to triptans (50.00% vs. 28.00; p < 0.001) during attacks, compared with the cluster two subgroup (n = 122). Cluster two patients had higher rates of current smoking (76.0 vs. 33.0%; p=0.002), higher rates of smoking at diagnosis (78.0 vs. 32.0%; p=0.006), higher rates of parental smoking/tobacco exposure during childhood (72.0 vs. 33.0%; p = 0.010), longer duration of attacks with (44.21 (34.44) min. vs. 34.51 (24.97) min; p=0.005) and without (97.50 (63.58) min. vs. (83.95 (49.07) min; p = 0.035) treatment and higher rates of emergency department visits in the last year (81.0 vs. 26.0%; p< 0.001).ConclusionsCluster one and cluster two patients had different phenotypic features, possibly indicating different underlying genetic mechanisms. The cluster 1 phenotype may suggest a genetic or biology-based etiology, whereas the cluster two phenotype may be related to epigenetic mechanisms. Toxic exposure to cigarettes, either personally or secondarily, seems to be an important factor in the cluster two subgroup, inducing drug resistance and longer attacks. We need more studies to elaborate the causal relationship and the missing links of neurobiological pathways of cigarette smoking regarding the identified distinct phenotypic classes of patients with CH.https://www.frontiersin.org/articles/10.3389/fneur.2022.898022/fullCluster Headachecluster analysiscigarette smokingtobacco exposuretrigeminal autonomic cephalagiaautonomic features |
| spellingShingle | Pinar Yalinay Dikmen Cagla Ari Erdi Sahin Mustafa Ertas Fusun Mayda Domac Elif Ilgaz Aydinlar Aysenur Sahin Aynur Ozge Hilal Ozguner Omer Karadas Javid Shafiyev Doga Vuralli Doga Vuralli Doga Vuralli Cile Aktan Emel Oguz-Akarsu Necdet Karli Mehmet Zarifoglu Hayrunisa Bolay Hayrunisa Bolay Hayrunisa Bolay Esme Ekizoglu Elif Kocasoy Orhan Bahar Tasdelen Betul Baykan Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache Frontiers in Neurology Cluster Headache cluster analysis cigarette smoking tobacco exposure trigeminal autonomic cephalagia autonomic features |
| title | Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache |
| title_full | Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache |
| title_fullStr | Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache |
| title_full_unstemmed | Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache |
| title_short | Cluster Analysis Revealed Two Hidden Phenotypes of Cluster Headache |
| title_sort | cluster analysis revealed two hidden phenotypes of cluster headache |
| topic | Cluster Headache cluster analysis cigarette smoking tobacco exposure trigeminal autonomic cephalagia autonomic features |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2022.898022/full |
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