A meta-analysis that was published in Neurology shows strong connections with the cluster headaches, migraines, and the circadian system that regulates the internal processes of the body. The study focuses on the role of the hypothalamus as well as genetics in these conditions. Cluster headaches were observed to have a circadian rhythm for 71% of patients and peaking at the night and early in the morning, and were linked to two primary circadian genes. The migraine attacks were characterized by an underlying circadian pattern in half of the people with peak times in late morning until late evening. They were also associated with two key circadian genes. The findings suggest the possibility of treatments based on circadian rhythms for headache-related disorders.
Meta-analysis Cluster headaches, migraines are strongly connected to the our circadian system.
Both migraine and cluster headache are linked in a significant way with the circadian system, which is the inner clock which regulates bodily processes, as per an analysis published in the March 29, 2023 electronic issue of Neurology the medicine journal published by the American Academy of Neurology .
The meta-analysis comprised all of the available research on cluster headaches and migraine with the circadian rhythm. It also included information about the time of headaches in the day as well as throughout the year, as well as research about whether the genes involved in those that regulate the clock in our circadian system are more prevalent for people suffering from these headaches.
The researchers also studied studies of cluster headaches and migraine as well as hormones linked to circadian systems including cortisol , melatonin and cortisol.
“The research suggests that both headache disorders are highly circadian on various levels, particularly cluster headaches,” said study author Mark Joseph Burish, MD PhD, of the University of Texas Health Science Center at Houston in Texas and an active participant in the American Academy of Neurology. “This highlights the importance of the hypothalamus–the part within the brain, which is home to the main biological clock and plays a role in migraine and cluster headache. This also raises the issue about the genetic causes of triggers like sleep patterns that are believed to be to trigger migraines and serve as indications of your body’s circadian cycle.”
For cluster headaches the meta-analysis showed the pattern of headaches that occurs in the circadian timeframe attacks for 71% of patients. The attacks peak from the late hours of evening and into the early hours of the morning. In the course of the year, patients were more prone to attacks in autumn and spring. On a genetic level it was found that cluster headaches were associated with two major circadian genes. Five out of nine genetic factors that enhance the risk to suffer from cluster headaches are associated with the expression pattern of the circadian cycle.
Cluster headache sufferers also had higher levels of cortisol and lower levels of melatonin compared to those who did not suffer from cluster headache.
The meta-analysis for migraine revealed a pattern of circadian attacks that affected 50percent of patients. The peak of attacks in the day was wide, and spanned from the early morning until the in the early evening There was a period of low-circadian activity at night, when fewer attacks occurred. The migraine was also related to two key circadian genes as well as 110 genes of the 168 linked with migraine had an expression pattern that was circadian.
Patients suffering from migraine were less melatonin-rich in their urine than those who do not suffer from migraine. Additionally, the levels of melatonin were less during migraine attacks.
“These findings raise the possibility of using treatments based on the circadian rhythm to treat headache-related conditions,” Burish said. “This could encompass both treatments that are based on the circadian rhythmlike taking medicines at specific time of the dayand treatments that result in circadian shifts, as certain medications may cause.”
The study’s only drawback was that the researchers did not have any information about the aspects that might affect the circadian rhythm including medication, other disorders like bipolar disorder, or circadian rhythm issues like working at night.
Source: “Circadian Features of Cluster Headache and Migraine: A Systematic Review, Meta-analysis and Genetic Analyses” written by Barlas Benkli Sun Young Kim, Nobuya Koike, Chorong Han, Celia Tran, Emma Silva, Yuanqing Yan, Kazuhiro Yagita, Zheng Chen, Seung-Hee Yoo, and Mark Joseph Burish, 29 March 2023. neurology.
DOI: 10.1212/WNL.0000000000207240
The study was financed through The Will Erwin Headache Research Foundation.
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