Abstract
BackgroundCluster headache (CH) is a trigeminal autonomic cephalalgia (TAC) characterized by a highly disabling headache that negatively impacts quality of life and causes limitations in daily functioning as well as social functioning and family life. Since specific measures to assess the quality of life (QoL) in TACs are lacking, we recently developed and validated the cluster headache quality of life scale (CH-QoL). The sensitivity of CH-QoL to change after a medical intervention has not been evaluated yet.MethodsThis study aimed to test the sensitivity to change of the CH-QoL in CH. Specifically we aimed to (i) assess the sensitivity of CH-QoL to change before and following deep brain stimulation of the ventral tegmental area (VTA-DBS), (ii) evaluate the relationship of changes on CH-QoL with changes in other generic measures of quality of life, as well as indices of mood and pain. Ten consecutive CH patients completed the CH-QoL and underwent neuropsychological assessment before and after VTA-DBS. The patients were evaluated on headache frequency, severity, and load (HAL) as well as on tests of generic quality of life (Short Form-36 (SF-36)), mood (Beck Depression Inventory, Hospital Anxiety and Depression Rating Scale), and pain (McGill Pain Questionnaire, Headache Impact Test, Pain Behaviour Checklist).ResultsThe CH-QoL total score was significantly reduced after compared to before VTA-DBS. Changes in the CH-QoL total score correlated significantly and negatively with changes in HAL, the SF-36, and positively and significantly with depression and the evaluative domain on the McGill Pain Questionnaire.ConclusionsOur findings demonstrate that changes after VTA-DBS in CH-QoL total scores are associated with the reduction of frequency, duration, and severity of headache attacks after surgery. Moreover, post VTA-DBS improvement in CH-QoL scores is associated with an amelioration in quality of life assessed with generic measures, a reduction of depressive symptoms, and evaluative pain experience after VTA-DBS. These results support the sensitivity to change of the CH-QoL and further demonstrate the validity and applicability of CH-QoL as a disease specific measure of quality of life for CH.
Highlights
Quality of life (QoL) scales have increasingly emerged as an essential clinical outcome measure for assessing the impact of a disorder, the symptoms, and its medical or surgical treatment on patients’ well-being and daily life.Trigeminal autonomic cephalalgias (TACs) are a group of primary headaches including cluster headache (CH), paroxysmal hemicrania, hemicrania continua, and shortlasting unilateral neuralgiform headache attacks [1]
Our findings demonstrate that changes after ventral tegmental area deep brain stimulation (VTA-DBS) in Cluster headache (CH)-quality of life (QoL) total scores are associated with the reduction of frequency, duration, and severity of headache attacks after surgery
Improvement in cluster headache quality of life scale (CH-QoL) scores is associated with an amelioration in quality of life assessed with generic measures, a reduction of depressive symptoms, and evaluative pain experience after VTA-DBS
Summary
Quality of life (QoL) scales have increasingly emerged as an essential clinical outcome measure for assessing the impact of a disorder, the symptoms, and its medical or surgical treatment on patients’ well-being and daily life.Trigeminal autonomic cephalalgias (TACs) are a group of primary headaches including cluster headache (CH), paroxysmal hemicrania, hemicrania continua, and shortlasting unilateral neuralgiform headache attacks [1]. Specific measures to assess QoL are lacking and assessment of quality of life in this population is currently limited to the use of a combination of tests including generic quality of life scales such as the SF-36 [4]. These measures might not be sensitive for CH and might, for example, fail to discriminate between CH patients and migraineurs, highlighting the need for a specific scale to assess QoL in CH [5]. Cluster headache (CH) is a trigeminal autonomic cephalalgia (TAC) characterized by a highly disabling headache that negatively impacts quality of life and causes limitations in daily functioning as well as social functioning and family life. The sensitivity of CH-QoL to change after a medical intervention has not been evaluated yet
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