Cluster headache patients exhibited a blunted autonomic response to the head-up tilt test compared to healthy controls, including a smaller change in the normalized low-frequency component (2.89 vs 13.38, p<0.05).
Case-Control (n=54)
Does the autonomic response to head-up tilt table test differ in cluster headache patients compared to healthy controls?
Cluster headache patients exhibit a blunted autonomic response to orthostatic stress, supporting the involvement of central autonomic mechanisms in the disorder's pathophysiology.
Absolute Event Rate: 2.89% vs 13.38%
p-value: p=<0.05
BACKGROUND: Cluster headache (CH) is a disabling headache disorder with chronobiological features. The posterior hypothalamus is involved in CH pathophysiology and is a hub for autonomic control. We studied autonomic response to the head-up tilt table test (HUT) including heart rate variability (HRV) in CH patients and compared results to healthy controls. METHODS AND MATERIALS: Twenty-seven episodic and chronic CH patients and an equal number of age-, sex- and BMI-matched controls were included. We analyzed responses to HUT in the time and frequency domain and by non-linear analysis. RESULTS: CH patients have normal cardiovascular responses compared to controls but increased blood pressure. In the frequency analysis CH patients had a smaller change in the normalized low- (LF) (2.89 vs. 13.38, p < 0.05) and high-frequency (HF) (-2.86 vs. -13.38, p < 0.05) components as well as the LF/HF ratio (0.81 vs. 2.62, p < 0.05) in response to tilt. In the Poincaré plot, the change in ratio between long- and short-term variation was lower in patients (SD1/SD2, -0.05 vs. -0.17, p < 0.05). CONCLUSIONS: CH patients show decreased autonomic response to HUT compared to healthy controls. This can be interpreted as dysregulation in the posterior hypothalamus and supports a theory of central autonomic mechanisms involvement in CH.
Barloese et al. (Fri,) conducted a case-control in Cluster headache (n=54). Cluster headache vs. Healthy controls was evaluated on Change in normalized low-frequency (LF) component in response to tilt (p=<0.05). Cluster headache patients exhibited a blunted autonomic response to the head-up tilt test compared to healthy controls, including a smaller change in the normalized low-frequency component (2.89 vs 13.38, p<0.05).
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