Patients with cluster headache show worse working memory, disturbance of mood, and poorer quality of life, compared with healthy controls, according to a report in the February issue of Headache. Furthermore, there are discernable differences between patients with episodic and chronic cluster headache with regard to mood and cognitive function.
Cluster headache is commonly regarded as one of the most disabling headache conditions. In a recent report, lead author Mariam Torkamani, BSc, and colleagues sought to expand what limited research is available on the severe impact of cluster headache by further characterizing its impact on quality of life and other neuropsychiatric dimensions. Ms. Torkamani is an Honorary Research Assistant in the Cognitive Motor Neuroscience Group at the University College of London.
The investigators conducted a cross-sectional study to investigate various aspects of cognitive function, including intelligence, executive function, memory, mood, disability, and quality of life in 22 patients with episodic or chronic cluster headache, compared with age-matched healthy controls.
Their results showed that intelligence and executive function are intact in patients with cluster headache, but that patients with cluster headache perform significantly worse than healthy controls on tests of working memory and report greater cognitive failures. Approximately one-third of the episodic and chronic cluster headache groups achieved “caseness” for depression. Self-reported anxiety was greater in people with chronic cluster headache than in people with episodic cluster headache. Approximately 75% of the former participants, compared with 38% of the latter group, achieved “caseness” on the measure of anxiety. Patients with cluster headache reported high levels of disability that were not significantly different between the two groups. On the whole, patients with cluster headache reported poor quality of life, compared with healthy controls, but this difference was not statistically significant.
According to the authors, the results highlight the severe impact of cluster headache on the mental health of patients with episodic cluster headache and those with chronic cluster headache, compared with healthy controls. The findings particularly highlight “the high incidence of anxiety disorders in this painful and unpredictable condition. The results also indicate poor quality of life and the severely disabling nature of cluster headache. Despite the impairment in quality of life and high levels of health-related disability and psychiatric comorbidity found in cluster headache, cognitive function remained largely intact in both episodic cluster headache and chronic cluster headache patients.”
The authors further reported that “the high levels of disability and mood disturbance in cluster headache warrant direct management of these problems in clinical practice. Antidepressant medication and/or psychotherapy to help patients come to terms with the disabling nature of their cluster headache may both prove of value.”
