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Cluster Headache: Evidence for a Disorder of Circadian Rhythm and Hypothalamic Function

Published online by Cambridge University Press:  02 December 2014

Tamara Pringsheim
Tamara Pringsheim*
Affiliation:
Department of Neurology, University of Toronto, Toronto, ON Canada
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Abstract

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This article reviews the literature for evidence of a disorder of circadian rhythm and hypothalamic function in cluster headache. Cluster headache exhibits diurnal and seasonal rhythmicity. While cluster headache has traditionally been thought of as a vascular headache disorder, its periodicity suggests involvement of the suprachiasmatic nucleus of the hypothalamus, the biological clock. Normal circadian function and seasonal changes occurring in the suprachiasmatic nucleus and pineal gland are correlated to the clinical features and abnormalities of circadian rhythm seen in cluster headache. Abnormalities in the secretion of melatonin and cortisol in patients with cluster headache, neuroimaging of cluster headache attacks, and the use of melatonin as preventative therapy in cluster headache are discussed in this review. While the majority of studies exploring the relationship between circadian rhythms and cluster headache are not new, we have entered a new diagnostic and therapeutic era in primary headache disorders. The time has come to use the evidence for a disorder of circadian rhythm in cluster headache to further development of chronobiotics in the treatment of this disorder.

Résumé:

RÉSUMÉ:

Cet article revoit la littérature sur les données en faveur d'un désordre du rythme circadien et de la fonction hypothalamique dans la céphalée vasculaire de Horton. Celle-ci a une rythmicité diurne et saisonnière. Bien qu'elle était traditionnellement considérée comme une céphalée vasculaire, sa périodicité suggère l'implication du noyau suprachiasmatique de l'hypothalamus, l'horloge biologique. La fonction circadienne normale et les changements saisonniers survenant dans le noyau suprachiasmatique et la glande pinéale sont corrélés aux manifestations cliniques et aux anomalies du rythme circadien observées dans les céphaléé de Horton. Des anomalies de la sécrétion de la mélatonine et du cortisol chez ces patients, la neuroimagerie des accès de céphalée et l'utilisation de la mélatonine comme traitement préventif des céphalées sont discutées dans cette revue. Bien que la majorité des études sur la relation entre le rythme circadien et la céphalée de Horton ne soient pas récentes, nous sommes entrés dans une nouvelle ère diagnostique et thérapeutique dans le domaine des céphalées primaires. Il est temps d'utiliser les données en faveur d'un désordre du rythme circadien dans la céphalée de Horton pour promouvoir le développement de médicaments chronobiotiques dans le traitement de cette maladie.

Type
Review Article
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 1 , February 2002 , pp. 33 - 40
Copyright
Copyright © Canadian Neurological Sciences Federation 2002

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