2023-08-14 14:15:53
Cluster headache is a type of headache that mainly affects men and is characterized by episodes of very sharp pain that affects one side of the head, especially around the eyes and above the ear. They can occur more than once a day for a period of time between three weeks and three months and, in some cases, can become chronic. Many factors are involved in its development, including genetics.
To learn more about the causes of the disease, a genetic study has been carried out aimed at identifying regions of the genome associated with a higher risk of suffering from the disease.
The international study, in which the Headache and Neurological Pain group of the Vall d’Hebron Research Institute (VHIR) in Barcelona has participated, has detected eight regions of the genome related to the risk of cluster headache, some of which show that tobacco plays a key role in these patients.
The research team, headed by Bendik S. Winsvold, from Oslo University Hospital in Norway, has also had the collaboration of the VHIR Psychiatry, Mental Health and Addictions group.
The research was based on genetic data from 4,777 cluster headache patients and 31,575 healthy people, mostly from Europe and also from East Asia. In this way, eight regions of the genome associated with an increased risk of cluster headache were identified, among which are several genes related to the brain and arteries, which reinforces the role that blood vessels may play in the pathology. .
Among the results, the finding of a genetic relationship between headache and tobacco stands out. “These results are in line with previously known data, since approximately 80% of people with cluster headaches smoke and, among those who do not, the majority have been exposed to tobacco smoke from their parents during childhood.” , explains Dr. Patricia Pozo-Rosich, Section Head of the Neurology Service and Headache Unit at Vall d’Hebron University Hospital, Head of the VHIR Headache and Neurological Pain group and director of the MABC (Migraine Adaptive Brain Center ) from Vall d’Hebron.
Doctors Patricia Pozo-Rosich and Alicia Alpuente with a cluster headache patient. (Photo: FIR-HUVH)
Using statistical analyses, the study has confirmed the cause-effect relationship between tobacco and cluster headache, that is, that smoking is a cause of this type of headache. Although the mechanisms are not known in detail, the researchers emphasize that tobacco affects the expression of some genes related to the development of this pathology. For example, smoking has been shown to increase the expression of the MERTK gene and decrease it in the CFTR gene, and these changes are also seen in cluster headache patients.
The effect that smoking has on these genes can persist for decades. This is why Dr. Pozo-Rosich emphasizes that “the relationship we have found between tobacco and cluster headache provides one more reason to avoid tobacco.” “In the case of patients who suffer from cluster headaches, it is especially advisable to quit smoking, since, in addition, tobacco tends to cause more severe symptoms and makes response to treatment more difficult,” she adds.
In addition to smoking, the genetic relationship of cluster headache with depression, defiant behavior, attention deficit hyperactivity disorder (ADHD) and musculoskeletal pain was also analyzed.
Researchers have also examined the relationship between two different headache types: cluster headache and migraine. Although some regions of the genome shared between the two diseases are identified, it is observed that there is a different genetic basis between the two. This finding corresponds to the fact that they are two different ailments despite having some characteristics in common and that, therefore, they also require specific attention for each case.
Compared to previous studies, the one presented now has a much larger sample of patients: in total, data from more than 35,000 people have been analysed. This has been possible thanks to the creation of the International Cluster Headache Genetics Consortium, which has the participation of 16 headache research groups from 13 countries and is working to discover the genetic causes of this disease.
The study is entitled “Cluster Headache Genomewide Association Study and Meta-Analysis Identifies Eight Loci and Implicates Smoking as Causal Risk Factor”. And it has been published in the academic journal Annals of Neurology. (Source: Research Institute Foundation – Vall d’Hebron University Hospital (FIR-HUVH))
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