Abstract
Although many patients with cluster headaches (CH) are disabled by their condition, few studies have examined this in detail. This cross-sectional, multicenter observational study prospectively collected demographic and clinical questionnaire data from 224 consecutive patients with CH. We assessed headache impact using the six-item Headache Impact Test (HIT-6) and evaluated the factors associated with the impact of CH. Participants with a HIT-6 score ≥ 60 were classified into a severe impact group. The majority (190, 84.8%) of the participants were classified into the severe impact group. These patients were characterized by younger age, earlier onset of CH, longer duration of each headache attack, higher pain intensity, more cranial autonomic symptoms, a higher proportion of depression or anxiety, higher score of stress, and lower score of quality of life. The anxiety (OR = 1.19, 95% CI: 1.08–1.31, p = 0.006), greater pain intensity (OR = 1.06, 95% CI: 1.02–1.10, p = 0.002), and age (OR = 0.99, 95% CI: 0.99–1.00, p = 0.008) were significant predictors for a severe impact of CH patients. According to the HIT-6 results, most of the CH patients were significantly affected by CH. As well as pain intensity, anxiety and age modulated CH’s impact on their lives.
Highlights
Cluster headache (CH) is one of the most painful and disabling primary headache disorders, but the severity and rate of disability have not been fully assessed using a headache-specific tool
Unlike the Migraine Disability Assessment Scale (MIDAS), which focuses on migraine patients and assesses disability related to daily life, the HIT-6 can be applied to a variety of headache disorders to measure their impact over a wide range of domains
In the post-hoc analysis using Tukey’s test, the HIT-6 score was lower for the patients with probable CH than those with chronic CH (p = 0.009), but there were no differences among the other groups
Summary
Cluster headache (CH) is one of the most painful and disabling primary headache disorders, but the severity and rate of disability have not been fully assessed using a headache-specific tool. Headache-specific tools used to measure headache-related disability include the Headache Disability Inventory[4], Headache Impact Questionnaire (HImQ)[5,6], Migraine-specific Quality of Life Questionnaire[7], Migraine Disability Assessment Scale (MIDAS)[8], and six-item Headache Impact Test (HIT-6)[9]. Unlike the MIDAS, which focuses on migraine patients and assesses disability related to daily life, the HIT-6 can be applied to a variety of headache disorders to measure their impact over a wide range of domains.
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