16th European Headache Congress

Prof.

Chair

Innate immune response, SARS-CoV-2 and Headache

Invited speaker

Invited Lecture (online)

COVID and headache

Invited lecture

Nocebo in Covid-19 infection and Anti-Covid-19 vaccination

Comparison of the primary headache, COVID-19 headache, and COVID-19 immunization headache according to the phenotype in healthcare workers

Abstract text (incl. figure legends and references) Objective: Headache is a frequent symptom during SARS-CoV-2 infection and following COVID-19 immunization. We aimed to characterize the semiology of COVID-19 headache and COVID-19 immunization headache, as well as to evaluate the influence of primary headache-migraine or tension-type headache(TTH)-on the COVID-19 headache and COVID-19 immunization headache phenotype. Methods: We performed an observational study through an online survey in healthcare workers who had SARS-CoV-2 infection and were included in the Occupational Medicine´s register of our tertiary hospital. Clinical, demographic and headache variables were collected during infection and immunization. Results: We included 109 participants with COVID-19 headache, 94/109(86,2%) women, 45.1(SD:12.45 years, 24.1(SD:4.3) BMI, 29/109(26.6%) cardiovascular risk factors, 15/112(13.39%) 15/109(13.8%) anxiety, 7/109(6.4%) depression, 22/109(20.18%) migraine as primary headache, 11/109(10,09%) TTH as primary headache. COVID-19 headache was the first symptom in 24/109(22%), appeared in Conclusions: According to our study, both COVID-19 headache and COVID-19 immunization headache frequently follow a TTH-like phenotype more than a migraine phenotype. Moreover, COVID-19 immunization headache is frequently more similar to the COVID-19 headache than to the primary headache.

Secondary headaches

Abstract lecture

Prof. Dr.

Professor

Cluster headache genome-wide association study identifies seven loci and implicates smoking as causal risk factor

Abstract text (incl. figure legends and references) Introduction: Cluster headache is a severe primary headache disorder preferentially affecting men. A high proportion of patients are smokers. Methods: We performed a genome-wide association meta-analysis of 4,043 patients with clinically diagnosed cluster headache and 21,729 controls from ten cohorts of European ancestry. Results: We confirmed the polygenic basis of cluster headache with a SNP-based heritability of 14.5%. We identified seven genome-wide significant loci, of which three are novel (WNT2, rs2402176, OR = 1.20; PLCE1, rs57866767, OR = 1.18; and LRP1, rs11172113, OR = 1.18) and four previously identified (DUSP10, rs17011182, OR = 1.38; MERTK, rs13399108, OR = 1.41; FTCDNL1, rs6714578, OR = 1.53; and FHL5, rs9486725, OR = 1.29). The prioritized genes showed enrichment for artery and brain tissue. Cluster headache shared only some genetic risk loci with migraine and is genetically correlated with cigarette smoking, risk-taking behavior, ADHD, depression and musculoskeletal pain. Mendelian randomization analysis indicated a causal effect of cigarette smoking intensity on cluster headache. Conclusion: We identify seven risk loci, of which three are novel. We provide evidence that cluster headache and migraine have a partly distinct and a partly overlapping genetic basis. Mendelian randomization analysis indicates a causal effect of cigarette smoking on the development of cluster headache, which has potential clinical implications.

Cluster headache 

Genetics genomics | RNA

Role of the Default Mode Network in Episodic Cluster Headache: Cerebral Connectivity Analysis with Hd-Eeg

Abstract text (incl. figure legends and references) Introduction: The pathophysiological mechanisms underlying episodic cluster headache (eCH), and shift between active and remission phases, are still not fully understood. Objectives: We aimed to define specific internodal connectivity patterns of the default mode network (DMN) in eCH patients, through advanced brain connectivity analyses with high-density EEG (HD-EEG). Methods: Twenty-four patients with eCH and 19 healthy controls (HCs) were enrolled. Patients with eCH were evaluated during both the active (T0) and the remission (T1) phases of disease. Of these 24 patients, 8 were registered only at T0, 10 only at T1, while 6 completed both registrations. The DMN areas considered for the analysis were: the right and left angular gyrus (RANG and LANG), the medial pre-frontal cortex (MPC) and the posterior cingulate cortex (PCC). Results: The study of internodal brain connectivity in patients showed lower connectivity at T1 (remission) when compared to T0 between PCC and MPC (T0=0.078±0.009 vs. T1=0.049±0.006, p=0.022) and between PCC and RANG (T0=0.076 ± 0.008 vs. T1=0.052±0.005, p=0.024). Furthermore, connectivity at T1 was lower when compared to HCs, specifically between PCC and MPC areas (CHe-T1=0.049±0.005 vs. HS=0.067±0.005, p=0.028). Conclusion: eCH patients evaluated during a remission phase of disease showed lower brain connectivity between specific areas of the DMN when compared with either eCH patients tested during an active phase and HCs. This finding may represent a biological marker of disease, while the fluctuation in PCC connectivity may reflect pathophysiological mechanisms involved in the shift from one phase of disease to the other.

SciSe 1
Covid-19 and vaccines related headaches and cluster headache

Appointment

Chair

Programme

SciSe 1Covid-19 and vaccines related headaches and cluster headache

Appointment

Chair

Programme

SciSe 1
Covid-19 and vaccines related headaches and cluster headache