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Title: CH history, genetic link and nicotine Post by Annette on May 5th, 2008, 9:09pm It is interesting to note that CH is a relatively new disease. Considering the amount of pain and the unusual physical manifestation one would speculate that had CH existed for a very long time, there should some description of it early in the medical history of man. However, the very first description of a head pain that matches CH was in 1641. The first text book report of CH was in 1745. The name cluster headache was not coined until 1952 when the cyclical nature of the condition was first noted. http://www.springerlink.com/content/8g039438847x6x05/ Since a very high percentage of CHers smoke, lets look at the history of tobacco. Although tobacco was smoked by the Mayans thousands of years ago, it was only used in high quantity to produce psychedelic effects in shamans and high priests. Native American Indian men smoked tobacco only during special ceremonies. Christopher Columbo discovered tobacco on his famous trip in 1498. Tobacco was then slowly introduced into Europe, Asia and the Middle East from 1500 to 1600. However, not until 1604 that the first commercialised tobacco plant was formed in America which began to supply England and Europe with large quantities. The number of smokers ( all men ) increased steadily from 1600. The first description of CH was in 1641. Was it a coincidence? Now lets look at CH in women. CH in women was considered rare initially, but the gap is closing. Before 1960s M: F ratio 6.2 -1 1960s 5.6 -1 1970s 4.3 -1 1980s 3 -1 1990s 2.1 -1 What about the rate of smoking tobacco in woman ? I couldnt find one for US but found one for Australia, which I would say is quite representative of the industrialised countries. http://i18.photobucket.com/albums/b149/bargainbazzar/zzzzz.gif So as men and women started to smoke and gradually increasing the amount of tobacco consumed, there seem to be a correlation of CH reported. Is it still coincidental ? Now lets look at CH and nicotine. So far apart from the observation that most CHers smoke and the above seemingly coincidental ratio, we havent really got an concrete causal correlation between the two. Or have we ? The first genetic risk factor for CH has been identified in the Hypocretin Receptor 2 gene. CH appears to be associated with the G1246A polymorphism of this gene. http://www.neurology.org/cgi/content/abstract/66/12/1917 http://www.ncbi.nlm.nih.gov/pubmed/15477554 Hypocretin 1 and 2 are two newly identified peptides produced exclusively in the dorsal and lateral hypothalamus. They have widespread neuroexcitatory activies throughout the brain. http://www.ncbi.nlm.nih.gov/sites/entrez?Db=pubmed&Cmd=ShowDetailView&TermToSearch=9419374 They have a major role in the hypothalamic control of hunger, the circadian clock through sleep-wake mechanisms and pain perception via the brain stem. Starting to sound familiar ? Now its interesting to note that nicotine from tobacco binds to the same receptors and mimic the effects of hypocretins. http://www.jneurosci.org/cgi/content/full/25/21/5225/FIG2 http://www.jneurosci.org/cgi/content/abstract/25/21/5225 What would happen if excessive nicotine intake over the long period of time ( even generations ) causes abnormal reactions in the hypothalamus which starts to derail the circadian clock? This will no doubt lead to an imbalance of melatonin and serotonin. Can this lead to the development of CH ? In theory it can. Prof Goadsby has found an abnormal area in the hypothalamus that is related to CH. Could this have been caused by nicotine exposure? We will need more detailed studies to look at it specifically. http://news.bbc.co.uk/1/hi/health/380497.stm Furthermore Hypocretin has a direct effects on other neurotransmitters such as dopamine, norepinephrine and GABA, all of which are involved in the mechanism of CH. So what does all this mean ? It means there is a link between nicotine in tobacco and CH. Does one cause the other? We will need more studies to determine. In the mean time, you are welcome to draw your own conclusion. Thank you for reading and painfree wishes to all :) |
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Title: Re: CH history, genetic link and nicotine Post by BMoneeTheMoneeMan on May 5th, 2008, 9:20pm Thats pretty interesting stuff, Annette. Keep in mind I have no idea what the hell a hypocretin is. My first guess would be a very slow slow person, but I dont think thats right. How could we study the morphing of genes through generations? Can we inspect this gene to see if we all have this malformed gene thingy? Interesting. |
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Title: Re: CH history, genetic link and nicotine Post by George_J on May 5th, 2008, 9:34pm on 05/05/08 at 21:09:33, Annette wrote:
Well...in the case of those who have never smoked who developed CH, (like me--I started with CH long before I began smoking) the bottom line is that we're then talking about inheritance of an acquired characteristic--and that contradicts what I, at least, understand about natural selection. Quote:
Unless it can be shown that the G1246A polymorphism of the Hypocretin Receptor 2 gene conferred some other selective advantage that has allowed its spread throughout the population since the advent of smoking...well...I don't see how this gene could have an increased frequency--without invoking Larmarckian inheritance of acquired characteristics. Just my couple of cent's worth for discussion's sake. :) Best wishes, George |
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Title: Re: CH history, genetic link and nicotine Post by Batch on May 5th, 2008, 9:38pm Annette, You've obviously gone to a lot of effort researching this topic and developed a very credible treatise. In my mind... this outstanding work is worthy of publication... Where can you get an article on this topic published? I've a feeling you'll have a lot of neurologist in agreement with your hypothesis and willing to weigh in with comments. Please keep us posted... V/R, Batch |
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Title: Re: CH history, genetic link and nicotine Post by Giovanni on May 5th, 2008, 9:41pm I believe my doctor thinks along the same lines as you Annette about the smoking thing. She has raised enough hell with me over the years. If you ever see a group of CHers, looks like a barn fire, or a LA freeway. John :D |
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Title: Re: CH history, genetic link and nicotine Post by DennisM1045 on May 5th, 2008, 9:44pm Annette, You are on quite a roll lately 8) Another facinating post. Unfortunately I'm in the same boat as B$ and can't tell how much water all this holds but it's a very interesting theory Annette. I wonder if there is hope for future generations as we slowly reduce smoking rates across the globe. -Dennis- |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 5th, 2008, 10:00pm Very valid point of argument George. However, CH is not a monofacet condition. It has many possible causative mechanisms. The hypocretin hypothesis is just one of many. Abnormal neuronal activites on the Hypocretin receptors have only been proven to cause abnormality in the sleep wake cycle of the circadian clock controlled by the hypothalamus. There are extensive studies on this for narcolepsy. We actually have 2 circadian clocks. One is run by the hypothalamus which keeps a 22-24 hrs time. This is more like a day clock if you like. This is the one affected by Hypocretins. The other clock is the Pineal gland. This one is controlled by sunlight and the production of serotonin and melatonin. This one changes according to the seasons as the length of day light varies throughout the year. This is more like a year clock. Both clocks are linked through the activities of neurotransmitters such as serotonin via the hypothalamus. Abnormalities in either of these clocks can lead to abnormal functioning of the hypothalamus which potentially can cause CH. Various things can cause insults to the pineal gland. Head injury, certain drugs and chronic brain chemical imbalances due to chronic allergy, drug use and even diet can potentially affect the pineal gland enough to start causing the 2nd clock to malfunction. Lastly, as hypocretin receptor is only the first to be detected in CH, there may be other alleles to be discovered. Some genes can remain dormant for generations and only become activated in one particular person, often for unknown reason. It would be great if all CHers and their immediate relatives can have a genetic test for this particular receptor. The result of such a study would be a lot more revealing. Who knows George, maybe because your CH was purely genetically caused that you have always experienced strictly cyclical patterns of CH. May be it was why you didnt experience the " jumping all over the place" CH like some others? Just out of interest, did you notice any change in the pattern, intensity, or characteristic of your CH before and after you started to smoke ? |
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Title: Re: CH history, genetic link and nicotine Post by krojo on May 5th, 2008, 10:08pm This is a really interesting topic and the historical aspect is fascinating. I too have heard that there's a higher frequency of smoking in the CH population than the general population (I smoke heavily and am a CH sufferer). I also believe that there's no documented evidence linking smoking and CH outside of this statistic. I'm really curious to know if there's any study showing a cessation in CH with cessation of smoking. Anybody heard of such a study? I actually quit smoking once, for 15 months, specifically because I thought it may stop my episodic CH. It did actually, but I started smoking again so don't know if it would have stuck. It could have just been a longer-than-usual remission (which for me is usually closer to 12 months). Comments are appreciated. -Rob |
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Title: Re: CH history, genetic link and nicotine Post by George_J on May 5th, 2008, 10:11pm on 05/05/08 at 22:00:14, Annette wrote:
No, no significant change in the pattern, intensity, or characteristics of my CH after I began smoking. I started with CH at the age of 13. Began smoking in college at the age of 18. Perhaps an oddity in my genetic makeup made smoking abnormally attractive to me--although I do know that the vasoconstrictive effect of nicotine means that I'll invariably smoke when a hit is ended. It helps. Won't stop one from starting, won't kill one, but it seems to speed the disappearance of the afterburn. It's probably one of the reasons I still smoke. Let it never be said that I am a completely rational creature. ;) All the best, George |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 5th, 2008, 10:21pm on 05/05/08 at 22:08:17, krojo wrote:
So far there isnt any study on cessation of smoking to cessation of CH activity. However, there have been in the last 2 years that I have been here occasional reports from a few individuals who said quitting smoking had helped them, either by reducing the intensity or by lengthening the remission periods. The difficulty with episodic CHers is the remission time can vary naturally from a few months to a few years so if one is to stop smoking, one will need to stop for at least 3+ years to be able to determine if that was the cessation of smoking that actually helped CH. Most smokers, CHers or not, find it really difficult to stop and the rate of resuming within the first 12 months is high. Another concern is if long term exposure to nicotine has caused some permanent damage to the neurons then cessation of smoking later in life may not bring the desire effect. Unlike other cells in the body, neurons in the brain dont recover or renew in most instances. Any damage to brain cells is likely to stay, unfortunately. For future generations, it would be interesting to test for this receptor gene in the children of CHers, then follow them up longitudinally through the years to see whether its the smokers that are more likely to develop CH ? |
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Title: Re: CH history, genetic link and nicotine Post by jjslugdog on May 5th, 2008, 10:36pm When I went to Nursing school in '86, they taught that there was no genetic link in cancer. Stuff changes, doesn't it? My daddy had clusters, and I've got 'em. If there is no genetic link, think of what the odds are that we'da both had them. Both of us, of course, heavy smokers. |
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Title: Re: CH history, genetic link and nicotine Post by AlienSpaceGuy on May 5th, 2008, 11:05pm Quote:
Assuming heredity transmission of an acquired trait is pure Lysenkoism. ::) http://en.wikipedia.org/wiki/Trofim_Lysenko http://en.wikipedia.org/wiki/Lysenkoism [smiley=smokin.gif] |
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Title: Re: CH history, genetic link and nicotine Post by kevmd on May 5th, 2008, 11:13pm maybe its late or maybe I'm naturally stupid but there are so many words in this thread I never heard of. Seriously, I hope one of these theories people post will eventually cure my CH. Lets see, I am 32 years old and I smoke so the odds are pretty certain I'll have these for the rest of my life. Aren't I positive tonight? |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 5th, 2008, 11:25pm on 05/05/08 at 23:05:04, AlienSpaceGuy wrote:
Pardon me but what exact acquired trait are you talking about here? Are you referring to smoking as an acquired trait ? or are you talking about CH as an acquire trait ? I can't reply properly to your comment without a clear understanding of what it means. Please elaborate further. Thank you. |
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Title: Re: CH history, genetic link and nicotine Post by nani on May 5th, 2008, 11:34pm Interesting. I wonder, though. Is it possible that CH symptoms were just looked at as supernatural events rather than illness prior to 1641? Seriously. Think of a k10 dance. Kinda looks like a demonic possession in a way. There is a lot I don't understand about this info, but I still have to think the tobacco/CH connection is still a chicken/egg conundrum. |
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Title: Re: CH history, genetic link and nicotine Post by Linda_Howell on May 5th, 2008, 11:52pm Quote:
Salem witch trials come to mind doesn't it? |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 12:02am on 05/05/08 at 23:34:42, nani wrote:
That is entirely possible, but unlikely. When looking up the history and earlier reports/descriptions of migraine, the closest cousin to CH, there was mention of its typical symptoms thousands of years ago. In fact it was our friend Hippocrates who described it very well with symptoms of aura, head pain and nausea. http://www.healthguidance.org/entry/2866/1/A-Brief-History-Of-Migraines.html I would say that there must be at least a few doctors prior to the 1960s who would not dismiss classical CH symptoms to demonic dances, if they had seen it. |
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Title: Re: CH history, genetic link and nicotine Post by AussieBrian on May 6th, 2008, 1:45am on 05/05/08 at 23:34:42, nani wrote:
Fair comment, too. Recent research has put that particular question to bed (the chicken that laid the egg came first) but Annette's hypothesis is just as valid as a point of discussion. Around the same time as tobacco was moving around the world we saw the spread of Indian corn (forgive me if that term's no longer PC), potatoes, opium, tea and spices, the beginnings of the Industrial Revolution and smog, soap, underwear and Women's suffrage. And that's even before the Great Carrot Plague!! Excuse my interruption, Annette, and please continue with your most interesting idea because unless we consider all avenues, there's no point exploring any. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 2:58am on 05/06/08 at 01:45:30, AussieBrian wrote:
Ah no my dear Brian, it was certainly not the chicken nor the egg that came first, it was the Jungle Fowl ( Gallus ) that came first. This bird that has been around as long as some dinosaurs ( at least 5000 years ago ) came before both the chicken and the egg ! 8) http://en.wikipedia.org/wiki/Red_Junglefowl In regard to the other things that were spreading around the world at the same time as tobacco, such as Indian corn or potatoes or even the great carrot, I am sorry but I wont be looking at their possible link to CH. Why ? Because even if I can prove a causal link, there wont be any massively profitable company to stage a class action on. Opium may have some pretty loaded manufacturers and distributors, but I still dont fancy facing an angry God Father in Courts ! ;) |
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Title: Re: CH history, genetic link and nicotine Post by sandie99 on May 6th, 2008, 3:37am This has been very interesting. :) I've never smoked, but my father did all through my childhood but he quit smoking few years before his death. My ch begun back in 2001, the same fall I moved to London and begun my uni studies. During my first year, I went to the uni karaoke nights with my friends, but eventually stopped, because the uni bar was always filled with students who smoked like there's no tomorrow and the smoke made me cough in my pre-ch days and sometimes triggered a hit during my early ch days. Unless dad's smoking altered his genes which I got and getting some passive smoke to my system, that's my links to tobacco. Sanna |
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Title: Re: CH history, genetic link and nicotine Post by Bob P on May 6th, 2008, 7:25am I contend that clusterheads display an addictive personality. They smoke a lot, drink a lot, hang around message boards, etc. I think that the condition that causes clusters also effects brain chemistry to cause this addictive trait. Therefore clusters cause smoking, not vice versa. Or more corectly, the brain disformity that causes clusters, causes us to have addictive personalities which leads to smoking. So my philosophy is the hypothalamus is the chicken, ch and smoking are both eggs. |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 7:50am on 05/06/08 at 07:25:23, Bob P wrote:
Ding, ding, ding! Give the man a cigar! This is the theory to which I also subscribe. Not only does it make it a tad easier to justify smoking (not the real reason I think it's correct, but it is a nice salve for my guilty conscience), but I would think that clusters would be far more prevalent amongst smokers if the converse were true - if smoking caused clusters, that is. |
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Title: Re: CH history, genetic link and nicotine Post by Paul98 on May 6th, 2008, 8:38am on 05/05/08 at 22:00:14, Annette wrote:
I wonder if it is possible for the Pineal gland and the Hypothalamus to become chemically "uncoupled" ? Severe sleep deprivation (5+ days of absolutely no sleep) has been reported to brake a cycle. Perhaps this resets the clocks. I tend to agree with Bob P. about our condition predisposing us to an "addictive personality" I had quit smoking for 8 years and some of my worst cycles were during that time. With respect to CH being a modern ailment, I could see migrain being written about way back in ancient times without observers thinking they were nut jobs but at the same time I could easily see a CH sufferer looked upon as being posessed. I'm sure headbashing was done back then like some do today. I have always wondered about trepanning. Poor ba$$tards! Thought provoking post Annette. -P. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 9:16am on 05/06/08 at 07:25:23, Bob P wrote:
I used to think that too, the problem is when I tried to prove that theory, I could not find evidences to sustain it . For that theory to work, one would expect: 1- CH was present before tobacco. There was no evidence of that. 2- CHers would more likely start smoking AFTER the start of CH. There is no evidence of this, most CHers who smoke, do so years before CH starts. ( In schizophrenics, where it is proven that their abnormal brain function caused them to be more addicted to nicotine, the majority started smoking AFTER becoming symptomatic ). 3- The prevalence of CH in women should stay the same. What caused the steady rate of increase? What is the difference between women of 1990s compared to 1960s that make them more susceptible to CH ? The only noticeable difference is the change in lifestyle. 3- It has been proven that nicotine addiction ( and a lot of other addictions ) are related to the dopamine pathway. The higher the dopamine level, the more the person should smoke. Dopamine level in an episodic CHer drops to normal during remission, but there is no reduction in the consumption of nicotine reported. There is no evidence that CHers smoke less during remission. While this has been noted with schizophrenics, who smoke a lot more during periods of psychosis but less when in remission. 4- Niccotine should have some noticeable effect on the condition. When schizophrenics stop smoking, their symptoms temporarily worsen. This does not happen in CHers, there is never any report that stopping smoking causes an increase in CH activities, if anything there has been a few reports that it helped. 5- There have been case reports of schizophrenics stopping smoking when in remission longer than 3 years. There has been no such report in episodic CHers. I started my research on the relationship between nicotine consumption and CH, the evidences I found led me the other way. I would love it if you Bob or anyone else can find evidences that suggests CH causes smoking. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 9:28am on 05/06/08 at 07:50:19, Brew wrote:
Clusters would be far more prevalent amongst smokers unless there needs to be also a certain genetic or anatomical brain defect that is required for the symptoms of CH to manifest. I dont think you need to subscribe to any theory to make the choice to smoke Bill. People continue to smoke despite concrete evidence that smoking causes lung cancers. I have cared for many dying lung cancer patients who continued to smoke until their last breath. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 9:37am on 05/06/08 at 08:38:49, Paul98 wrote:
I have not looked into sleep deprivation stopping a CH cycle. I am currently looking into REM sleep and CH activies. Melatonin affects REM sleep and it seems to stop some night hits in a number of CHers, so there must be a strong link there. Regarding head bashing CH being looked upon as a mental illness instead of a physical illness, I would say thats likely for a kip 9 or 10, but I would argue that how often does a CHer get those in relation to lower kip hits? The majority of CH hits are kip8 or lower, kip 10 are rare thank God. I would say someone with a kip 6 or 7 pacing the room squeezing his head with a red teary eye would not look anymore crazy than one lying in bed crying in pain with a migraine. |
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Title: Re: CH history, genetic link and nicotine Post by seasonalboomer on May 6th, 2008, 9:39am What a fantastic conversation going on here!!!! Annette's proposition is interesting and certainly doesn't seem as though it is as far-out as some "chaos theory". The idea that our ingestion of tobacco at sustained daily/hourly levels that probably exceed that which mayans and native americans would have ingested during special ceremonies may be a case of too much of a good (or bad) thing. Scott |
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Title: Re: CH history, genetic link and nicotine Post by Giovanni on May 6th, 2008, 10:13am I am personnal happy to see Annette pursue anything that might have caused this terrible thing happen to us. We might not all agree, but at least something to think about. John |
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Title: Re: CH history, genetic link and nicotine Post by monty on May 6th, 2008, 10:22am Hypocretin can reduce melatonin production, and nicotine does the same. This interaction is definitely worth considering and may explain some of the dysfunction. An interaction between nicotine and caffeine might be even worse - there is research that shows that caffeine in the evening can be pretty disruptive of melatonin. As far as what the space guy is talking about with Lysenkoism: putting the phrases 'abnormal reactions' and 'over generations' together the way you did implies an interaction between phenotype and genotype that is not there. Maybe not what you meant, but it could be interpreted that way. Before the 1600s, the medical literature is pretty sketchy and can't be counted on to document the prevalence of rare conditions. Even in 'modern' countries, diagnosing it is not always straight-forward and consistent. Other things to consider as circadian disruptors over this same time period include the shift to artificial lighting and clocks. |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 6th, 2008, 10:24am Great thread and I shall try to keep this short. Great reference to Christopher Colombo too Annette. Wasn't he the fictional detective who solved murders in brilliant, if unorthodox ways, and smoked cigars incessantly? ;) ;;D I've been looking at the role of smoking and nicotine in CH for quite some time, but don't tend to shout about it very much given the inherent controversy involved. However, on the history thing, I reckon that the reason why it hadn't been reported upon until Nicolaas Tulp did so, was because of its relative rarity and lack of distinction with other [primary] headaches given the paucity of shareable information available all those moons ago. Even Hippocrates may have got it wrong because symptoms such as aura, nausea etc. can also be associated with what we now know as trigeminal autonomic cephalalgias. All the evidence, albeit scant, does suggest that people have probably been suffering from headaches from the dawn of time. Apparently, the earliest account of headache appeared in literature during the 7th century BC: Headache roameth over the desert, blowing like the wind. This man it hath struck and Like one with heart disease he staggereth Like one bereft of reason he is broken, Like that which hath been cast in the fire he is shrivelled Like a wild ass... his eyes are full of cloud... Then somewhat later in the 11th century AD, eight different types of headaches - then known as sodas - were identified in literature, accompanied with some often bizarre forms of treatment. Cluster headache may have indeed been associated with this particular one: Hemicranea: with severe pain extending to the roots of the affected part. Treated with blood letting and expurgation of the inducing humor; must be brought to the sneeze with aroma of marjoram or oil of bitter almonds at the nostril of the affected side. Should anoint for head before onset of paroxysm with oil of daffodils or peonies. Some people may find humor in treatment with daffodils and peonies ::) The gender smoking stats are very interesting and are something I had been meaning to look up for some time. However, I think that the sex profile prevalence changes in CH are more to do with increased awareness of the condition over time, particularly in primary care, coupled with the fact that the professionals now realise that women do get CH and hence the migraine misdiagnosis is less prevalent. I'm also interested in the incidence of heavy drinking amongst our population, but have yet to compare it to general trends, but that's probably for another thread. The orexin link has also always perplexed me. As many here will know, I've always looked at this in relation to the potential importance of sleep, or perhaps more importantly the lack of it (as per Paul's post), but the polymorphisms you mention in this context shouldn't be ignored. More recently though, they have been looking at potential polymorphisms in CLOCK genes, which may or may not be relevant in CH (watch this space). Oh, and by the way, we have many more biological clocks than the two you mentioned; don't get me going on chronobiology (especially with reference to the pineal gland) or else I'll never shut up :-X And whilst we're here: Quote:
Fortunately, many neurons do recover or are renewed under certain circumstances, through the action of neurogenesis; something that again I won't go into here as it would warrant a completely different thread. However, I do agree with your overall hypothesis inasmuch as there is definitely a link between smoking and nicotine and cluster headache. Many years ago, Flo's stance was that nicotine (which stimulates the nicotinic acetylcholine receptors) can trigger the release of calcitonin gene related peptide (CGRP), which is associated with the central mechanism theory of cluster headache pathogenesis. He also believes that all this is tied in with an acetylcholine problem in CH patients. We as sufferers tend to have low levels of choline, which can limit the formation of acetylcholine. Acetylcholine is a neurotransmitter that, amongst many other things, has anti-inflammatory properties. Perhaps we have a natural deficiency of acetylcholine (that may be genetically based) that increases our risk of nicotine addiction, or perhaps smoking causes a malfunction of our choline system, which increases the risk of cluster headache to those more predisposed (as you suggest)? Also, nicotine phase-advances the circadian neuronal activity rhythm in suprachiasmatic nuclei explants (in the rat anyway), which suggests a hypothalamic role. The suprachiasmatic nucleus is THE master clock in the human body and is housed within the hypothalamus and is probably the area which shows activity during attacks and where there is increased cell growth (Goadsby et al). Finally, I also subscribe to Bob P's theory that CH sufferers have a higher likelihood of addiction; particularly smoking and drinking, which is possibly fuelled by the possible abnormality within the hypothalamus. The hypothalamus has also recently been linked with addiction. I would bet at least a fiver that CH sufferers also have an above average population profile in terms of gambling ;) -Lee |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 10:26am This is a bit side tracked but this is what I have wondered. What would happen if the words spread out there that CH can be caused by cigarette smoking ? If that is proven, there will be potential class actions against tobacco companies for compensation since they have failed to warn people of this risk, just as it has happened with tobacco links to lung cancer. Will that be a bad thing ? I dont think so, because firstly it may allow CHers who smoke to gain monetary compensation that will be very helpful in many cases. Secondly it may scare the tobacco companies enough to see them pouring money into researches to prove that CH is caused by something else, not tobacco. One of the biggest problem with researches on CH is the lack of funding since the condition is so rare. How good would it be if companies with billions of dollars in profit wanting to pour money into CH research? I can understand the resistant mentality here, like Bill said, as it makes it less comfortable for a CHer to continue to smoke thinking that it may cause the severe suffering in the first place. However, would it make it easier to bear if one can use it to claim thousands if not ten of thousands of dollars in compensation ? I am not saying this will happen for sure, of course. However, as John said, its something interesting to think about. :) |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 10:46am on 05/06/08 at 10:22:05, monty wrote:
Yes, there is also something to be said about the coupling of nicotine to caffeine, but the information I found so far was too confusing for me to post about yet. I appreciate your intepretation on behalf of SpaceGuy but I would still rather wait for him to respond and clarify before I reply to his comment. Regarding artificial light disrupting the circadian clock, that is not so straight forward. In light treatment used for Seasonal Affective Disorder ( SAD ), a condition affected purely by the change of daylight, it has been found that it has to be at least 2500 lux to be affective ( ie strong enough to reset the circadian clock). Most light treatment is about 10000 lux which is a lot higher than a normal room lighting at 400 lux. A bright sunny day may register at 100000 lux. Although medical record prior to the 1960s did not report much on the prevalence of rare condition, but it is interesting that there had been NO record of a description of any headache with symptoms classical of CH prior to 1641. There had been no record of any headache that occured several times a day at exactly the same times, I would have thought that anyone observing that would find it interesting enough to document. I would love it if anyone who believes in different theories can actually come up with researched evidences, rather just personal hunches and impression. That way it will make the discussions more interesting and valid. |
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Title: Re: CH history, genetic link and nicotine Post by Racer1_NC on May 6th, 2008, 10:54am on 05/06/08 at 07:25:23, Bob P wrote:
One of the few times I can say I agree with Bob. Bill |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 10:58am on 05/06/08 at 10:26:41, Annette wrote:
My first reaction is that it would be complete and utter conjecture. There is nothing that confirms which came first - the chicken or the egg (i.e., the smoking or the CH), or which causes the other. The tobacco company lawyers would eat this theory for lunch and most likely spit it back up in time for tea. |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 11:04am on 05/06/08 at 10:46:47, Annette wrote:
Sorry - That would not be in the storied tradition of my agnostic leanings. If you have a theory, go ahead and prove it. I'll always give it a listen. I have my inklings, but I'm not out to set the world on its ear, so I'll just remain comfortable believing what I choose and leave the rest. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 11:08am Thanks Lee for your post :) I would hope you will post more on your researches despite potential controversy here or anywhere else. Controversy is good as it makes you think and it makes you have to prepare better to be able to "defend" your hypothesis which is what happens in the real world of scientific/medical researches. I agree with you that it is possible that CH was simply "missed" prior to 1641, but personally I think its highly unlikely. Although it does have similar symptoms to migraine and hemicrania but it also has quite different characteristics which should be peculiar enough to raise attention to itself. For now, until someone comes up with a record of some type of headaches with classic symptoms of CH prior to 1641, we simply have to accept that this is the only information we have to work on. Neurogenesis does happen, I am well aware of that but that is rare. Even when new cells are generated there has been evidence that they dont carry out the exact same mechanisms as the ones what died. It is more common for other types of neurons to mutate and take over the functions rather than a brand new cells being regenerated. Have you got any evidence to show that cells in the hypothalamus and pineal glands can regenerate ? With the male:female ratio it is possible that women were just misdiagnosed with migraine more. However, recent studies on CH in Asian countries where women smoke a lot less than men still show a large difference in M:F ratio. In this recent article published in 2004, where 104 CH sufferers were recruited from 2 major headache centres in Taiwan, 90 were men and only 14 were women, giving a ratio of 6.4:1, similar to what was found in European countries back in the 1960s. http://cat.inist.fr/?aModele=afficheN&cpsidt=15979923 Please help me along here Lee by posting what else you have found. If you need to, please dont hesitate to start new threads on whatever theories you have come up with. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 11:13am on 05/06/08 at 11:04:21, Brew wrote:
Of course Bill, this is not a religion I am peddling here. No one has to change their mind about anything unless they choose to. I am simply forwarding a thought to be considered. Regarding tobacco company lawyers chewing the theory and spitting it out, if it can get that far it would have already been a major achievement in my book. |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 6th, 2008, 11:21am I thought you'd missed my post Annette ;;D On the note of CH actually causing smoking, this Kiwi study (although not directly related to CH) is interesting and relatively hot off the press. If "general" primary headache can increase the risk of daily smoking, I wonder what CH does in this respect? I have a full copy if anyone is interested. Quote:
I could murder a fag and I don't even smoke ;;D -Lee |
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Title: Re: CH history, genetic link and nicotine Post by seasonalboomer on May 6th, 2008, 11:23am Regarding tobacco companies...I have no interest in the theory with regard to pointing out some fault or responsibility. I smoked. I knew it was stupid when I did it. Generations before smoked - no one knew any better - no one much cared. Average life span and a series of wars didn't really point toward the need to have a healthy vessel into your 80's. |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 6th, 2008, 11:51am on 05/06/08 at 11:08:47, Annette wrote:
As they say at the end though Annette, racial and geographical factors might contribute to these discrepancies. Also, epidemiologic surveys have often been poo-poo-ed, methodologically speaking, in non-western societies. Not saying they're right, of course, but a population based study conducted in China in 1985 reported only 14 CH cases of 246,812 inhabitants (0.0006%). In this study, the prevalence of migraine (0.7%) was also markedly lower than was to be expected, which is somewhat spurious. Don't get me wrong though, I still think there's a link. -Lee |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 11:51am on 05/06/08 at 11:13:14, Annette wrote:
What I said has nothing to do with religion. Merely consider the Greek roots of the word "agnostic." a = against or not gno = know or knowledge agnostic = not knowing A lot of what you have posited is something I'll never know, nor do I care to. I have a tendency to use anecdotal evidence when I evaluate things. That's what I've done here. All I'm saying is, you have a theory - knock yourself out trying to prove it. I'll always consider the evidence. I don't have any for my beliefs (namely that the same set of circumstances that cause CH also cause sufferers to have more highly addictive personalities). |
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Title: Re: CH history, genetic link and nicotine Post by Bob P on May 6th, 2008, 11:59am I believe the national average for smokers is around 20%. A survey of 12,000+ clusterheads shows a smoking prevelance of 50%. So they do definitely smoke more. Of course, that leaves 50% of clusterheads who don't smoke. |
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Title: Re: CH history, genetic link and nicotine Post by monty on May 6th, 2008, 12:03pm on 05/06/08 at 10:26:41, Annette wrote:
In the case of lung cancer, it wasn't simply that they failed to warn people. It was that the companies knew and conspired to mislead the public so they would not be motivated to quit. When the nature of the conspiracy was exposed, the companies settled. Although it sounded like a large dollar amount, it was small enough in terms of the companies revenue and profits to keep them in business. |
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Title: Re: CH history, genetic link and nicotine Post by Jean on May 6th, 2008, 12:08pm I wonder what the percentage of CH suffers born to mothers who smoke is? Also those exposed to smokers in the home while growing up. Jeannie |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 4:54pm on 05/06/08 at 12:08:12, Jean wrote:
Hi Jean, There isnt any such data, I have looked. However, from the people who frequent this board, I would say high, exactly how high I dont think anyone knows. There isnt any data on the effect of passive smoking and CH either. We can only look to lung cancer and passive smoking for clues and studies there say that it can be worse for passive smokers as their bodies have not built an immunity to cigarette. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 5:16pm I think it will be very interesting to see what data will emerge from China re prevalence of CH and the ratio between man:woman with CH, in relation to tobacco smoking. China is currently the biggest consumer of tobacco in the world. However, it started way behind America and European countries. The number of smokers ( as in percentage of population ) and the number of cigarette smoked per day have only just caughted up to those measured in the West in the 1950s. http://www.cnn.com/HEALTH/9811/19/china.usa.smoking/index.html For now, as Lee has pointed out, the number of CH cases reported in China is low compared to its huge population. It would be very interesting to see if this number will increase alongside the increase in tobacco consumption in the next 50 years. The increase if there will be, will not be influenced strongly by genetic inheritance due to China's population control policy. The trend of other medical conditions caused by smoking such as lung cancer has already followed those seen earlier in Western countries, lets see what CH development will be like in China. |
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Title: Re: CH history, genetic link and nicotine Post by monty on May 6th, 2008, 5:29pm I think China's rate of CH will increase as it gets Bibles, television and western medicine; not all of these factors may be causative. ;) |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 6th, 2008, 6:33pm Simply because my mine works in such a way... I personally feel that the documented cases of CH in any given populatiion is directly related to the amount of knowlege any given physician has about CH and it's diagnostic criteria. We as a population of sufferers know full well that in Western Medicine, few doctors and even skilled neurologists are well versed in CH. I would imaging that would be the case in other countries as well. Many doctors can't get past the "features of a Cluster sufferer" being quite tall, with lionine faces, orange peal skin, hazle eyes, MALE, heavy drinkers and heavy smokers. There is a very great possibility that the Dx of CH was in paret made due to the fact the patient smokes. Patients not fiitting the above features have been natoriously misdiagnosed with other headache types. With the term CH catching on (thanks in part to OUCH and it work) we see as a CH community the misdiagnosis of CH in persons who's symptoms are clearly not indicitive of CH. It's almost as if the doctor can't instantly stae for certain it's migrain or tension, then slap this new "Cluster Headache" lable on it. Either way, my best educated guess would be that any research into a causal relatinship betweennicotine and CH would be scewed at best. Although the incidence of smoking in the CH population is higher than in a general population, it still doesn't account for the nearly half of the CH population of non/never-smoked sufferers. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 6:44pm on 05/06/08 at 18:33:01, Redd wrote:
And that would be great too ! It took Thomas Edison 1000 tries before he managed to make a light bulb that worked ! Personally I would rather look and not find than not look in the first place. :) |
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Title: Re: CH history, genetic link and nicotine Post by Bob P on May 6th, 2008, 7:15pm Speaking of lights, this one's been burning for 107 years http://www.centennialbulb.org/photos.htm |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 6th, 2008, 7:16pm I don't fault you for trying Annette. I'm simply thinking critically about the situation. I just don't feel that given the history of hit or miss diagnosis of this condition to begin with and the universal lack of in depth knowlege of CH by the medical community, that any research into exposure to nicotine as a causal factor for the development of CH could be statistically significant. Not unless the results of research into why non/never smokers and those not exposed to significan't levels of second hand smoke is used as a sister research project as a control group. |
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Title: Re: CH history, genetic link and nicotine Post by Kevin_M on May 6th, 2008, 7:18pm I don't have an opinion but smoking, nicotine, and CH are difficult to see as all increasing in unison. It doesn't appear to be the case. on 05/05/08 at 21:09:33, Annette wrote:
Quote:
The chart does not show an increase in smoking. From 1945 to 1992, men smoking dropped from 72% of the population to 28%, while the incidence of clusters increased. A graph would show a decrease of smoking with an increase of clusters, they go in opposite directions. Quote:
Along with a two-thirds drop in smoking, the content of nicotine per cigarette since 1954 has also dropped by two-thirds. Again, CH increasing and nicotine decreasing aren't in unison. Quote:
A two-thirds drop in smoking for men and a two-thirds drop in nicotine content per cigarette over the last fifty+ years doesn't seem to correspond with the higher incidence of CH. Less smoking, less nicotine per cigarette, more CH. A difficult span to rationalize. Although CH'ers may smoke more, I'd presently see Bob P's idea about smoking. on 05/06/08 at 17:16:42, Annette wrote:
They've smoked without filters much longer in the last century but still CH has a low incidence. |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 6th, 2008, 7:32pm Although I can see the surface connection between addictive personalities and CH and nicotine, I'm more in the school of thought that... ... due to the vascoconstrictive nature of nicotine and the effect of vascoconstrictors to ease CH pain, smoking sufferers have a more difficult time quitting because of the relationship between smoking and even the slightest amount of relief of the pain. |
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Title: Re: CH history, genetic link and nicotine Post by Linda_Howell on May 6th, 2008, 7:53pm My friend Margo in San Diego has a very young son with CH. How old was Jasper (Helens son) when he developed them? 3? |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 6th, 2008, 8:04pm And Helen never smoked from what I can recall. Thanks for reminding us of this Linda, it sheds a whole new perspective to this. |
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Title: Re: CH history, genetic link and nicotine Post by AussieBrian on May 6th, 2008, 8:09pm on 05/06/08 at 19:53:14, Linda_Howell wrote:
It's the exception that tests the rule and science wouldn't be the same without it. Thank you Galileo, and go Annette. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 8:16pm on 05/06/08 at 19:18:30, Kevin_M wrote:
About the percentage of smokers shown as dropping in Australia but the total population of Australia has grown considerably from 1950 therefore the absolute number of smokers was still increasing. I havent looked into the content of nicotine per cigarette over the years. That would be an interesting thing to look into. Whether or not it is relevant depends on how much nicotine exposure is necessary , if it is, to exert a causative effect on CH or CH genes. The effect may or may not be linearly dose related. The correlation between the number of smokers and the number of CH can not be used as proof of cause. It can simply be used as a question mark to see if its worth looking into. Since there has not been a proven answer one way or the other, its interesting to say the least to take a closer look. The answer will lie in future studies on the implication of the polymorphism of this gene and how it triggers CH in a person, and the effect, if any, of nicotine or other chemicals in the tobacco that may exert on this gene. |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 8:21pm The hypothalamus is considered to be the pain/pleasure center of our brains. Leading theories as to the cause of CH point to the hypothalamus. If our defective hypothalamuses are responsible for CH, could it not then be responsible for our collective penchant for addictions? And would it then be plausible that statistically we might be outside the norm when it comes to what we consider to be painful and/or pleasurable? I wonder if, for example, CH'ers represent a higher than normal percentage of sado/masochists, or anything else where pain and pleasure get opposite billing, as compared to a cross section of society? Sorry - it's just how my mind works sometimes. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 8:24pm on 05/06/08 at 19:53:14, Linda_Howell wrote:
That is because CH is multifacets ie many things can lead to CH. Its not caused by ONE thing. There will always be exception to the rule. Argument like that is similar to saying I smoked all my life and I didnt get lung cancer therefore cigarette smoking can not cause lung cancer in anyone else ! Jasper's case is a perfect example of genetic cause of CH. Its like diabetes, if you have a bad diet and unhealthy lifestyle all your life you can develop diabetes type II later in life. However if you inherit the gene you can develop type 1 diabetes from birth. Just because those little babies with the wrong set of gene dont have to eat any sugary food to develop diabetes, we can not come to the conclusion that therefore bad diet will not cause diabetes in others. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 8:39pm on 05/06/08 at 20:21:10, Brew wrote:
The hypothalamus is not the centre of pain or pleasure. Pain is felt by the sensory nerves of various nerve pathways and systems, and most originate/communicate with the brainstem. Disable your brain stem with anaesthetic and you wont feel much pain anymore. The pleasure centre is in the limbic system, where emotions are experienced. What connect these centres to the stimuli of the outside world are the neurotransmitters, such as dopamine and noradrenaline. The balance of these neurotransmitters is controlled by the hypothalamus. Its the imbalances in these chemicals that lead to abnormal signals being conveyed to various parts of the brain and nervous system. A faulty hypothalamus can do this, external drugs can do this, other environmental factors can do this and even diet can do this too. Interestingly Hypocretin 1 and 2 do have direct effect on the pain pathways via the dorsal reticular nucleus and the periaquaduct. As I said above, CHers compared to the norm tend to be more addictive to chemicals from nicotine to alcohol to various drugs. I dont know about other forms of addiction such as gambling. This could be an explanation as to why more CHers smoke than not. However, it has been my observation that most CHers who smoke do so well before the first CH cycle, unlike schizophrenics who tend to start smoking after becoming ill. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 8:42pm Since researches done directly for CH is rather scarce, I had to look at parallel conditions and situations to compare. If one looks at the situation with cigarette smoking and lung cancers, although the increase in cases of lung cancer was recorded through the years since tobacco was introduced into the Western countries, it was not proven until the carcinogenic chemicals in the cigarette was found to be directly causal to various types of lung cancer. Then for a while people were led to believe that lower tar and lower nicotine in "light" cigarette was less risky, until it was proven again that those were just as deadly as the higher ones. The last point was that passive smokers believed they were safe, until it was proven that they were actually worse off because of lack of inbuilt immunity from not smoking. All these findings took time to prove and have now led to the policy of smoking being banned in all public places. Based on that experience, there is a definite possibility that similar results could be found with cigarette smoking and CH. What started all the studies into cigarette smoking and lung cancer was the simple observation that most people with lung cancer smoked. Obviously there will always be isolated cases that dont fit the mould. There will always be people who smoke heavily all their lives and nothing happens to them and there will be those who never as much as taken a whiff who would get ill. However, its the majority we are interested in. I am not discounting totally the argument that CH can influence personality causing an addictive trait. Its proven as in schizophrenics that abnormal dopaminergic pathway can certainly do so by rendering nicotine more rewarding to the affected brains. This however does not prove that nicotine or something else in the smoked tobacco can not cause the condition. Nicotine is addictive in its own right and you dont need to have an addictive tendency to become chemically dependent on it. As stated above, its observed that schizophrenics are more likely to start smoking or to smoke more when becoming symptomatic, especially during psychosis where the dopamine is high. As far as I could see, there was no report of this relating to CH. Most CHers who smoke do so years before the first attack and they dont seem to smoke more or less according to how bad the cycle is. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 8:52pm on 05/06/08 at 19:32:46, Redd wrote:
That is a very interesting thought ! I need to ask this question though, how MUCH pain relief from CH does a cigarette give ? Is it something quantifiable? or is it more the "feel good" effect caused by the dopamine release via nicotine that make people notice the pain less? George said having a cigarette after a hit helped ease the after burn effect and thats why he kept on smoking. Would oxygen do the same ? Would oxygen get rid of this afterburn effect? I would say yes. Oxygen is known to get rid of even worse pain such as shadows. Why arent CHers addicted to oxygen ? Simple, because oxygen eases the pain but doesnt give the brain any "rewards" like nicotine does. Its different in schizophrenics where its proven and measurable that those who stop smoking do experience a temporary worsening of their ( psychotic ) symptoms. This isnt observed in CH. |
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Title: Re: CH history, genetic link and nicotine Post by Kevin_M on May 6th, 2008, 8:54pm on 05/06/08 at 20:16:34, Annette wrote:
That wouldn't appear to be complete figuring. Quote:
Going by your charted years 1945 - 1992 and the corresponding percentages. ( I chose 1995 to be conservative, the population in '92 would be slightly less) 78% of 7 million is 5,460,000 28% of 18.1 million is 5,068,000 That is not an increasing number of men smokers, if men were half the population. |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 9:07pm on 05/06/08 at 20:39:13, Annette wrote:
Fuck it. I'm out. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 9:08pm on 05/06/08 at 20:54:17, Kevin_M wrote:
Thanks for that Kevin :) . I will need to try to find if there is a record of number of CH diagnosed in men in Australia and whether it increased through the years or not. Plus whether there was a big increase in number of women being diagnosed with CH as the absolute number of woman smokers would have increased substantially. If the number of diagnosed men stay relatively the same and the number of woman with CH diagnosed increased substantially, then it would still be valid. Have you come across any report of the rate of cigarette smoking in US men and women from 1950 until now ? |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 9:09pm on 05/06/08 at 21:07:25, Brew wrote:
I am sorry Bill. Did I offend you somehow ? |
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Title: Re: CH history, genetic link and nicotine Post by tanner on May 6th, 2008, 9:12pm on 05/06/08 at 20:24:59, Annette wrote:
Lotus..... [smiley=huh.gif] , am I confused or are you not the same person that a relatively short time ago came to this forum seeking help, answers, insight, vibes and support because Daniel was having serious issues that were leading you to believe that he might be a clusterhead??? Now, in again a very short space in time you have managed to figure out the (many different) causes of our shared syndrome :o. You have positively identified a cluster gene? While your theories are compelling to some and I am one who believes that all angles should be checked and re-checked to try and help with the effort to find an answer........ this is starting to sound like the same psychobabble that I have been hearing from a multitude of the (know it all faction) of the medical community for the last 24 freakin years. I would like to point out that I have not yet met a cannibal that has CH.......might be worth looking at 8)......tim modified to add that I could really use a smoke right now! 24 miles to town and not a sympathetic soul in site.....crap, i guess i will have to stay the course :P |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 6th, 2008, 9:14pm on 05/06/08 at 21:09:58, Annette wrote:
I merely have nothing left to contribute to this thread. |
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Title: Re: CH history, genetic link and nicotine Post by Kevin_M on May 6th, 2008, 9:18pm on 05/06/08 at 21:08:10, Annette wrote:
No, I didn't look. I took this for granted in your first post of this thread, just above the chart: Quote:
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Title: Re: CH history, genetic link and nicotine Post by Kevin_M on May 6th, 2008, 9:30pm on 05/06/08 at 21:12:56, tanner wrote:
Tim, I think she is putting an idea out there and has found that there has been a gene associated with CH. I don't think she identified it. Quote:
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 6th, 2008, 9:30pm on 05/06/08 at 21:12:56, tanner wrote:
Hi Tim Yes its me. Its the same old me who came here asking a whole host of questions 2 years ago. In the last 2 years I have spent a lot of time reading up on CH and following the latest studies on CH. What I have come to know about CH is all the published work that I have managed to read and what I have learnt from the people here. I certainly did not find the gene associated with CH. I simply found the article talking about it. It was certainly not me who discovered that many things can cause CH, it was those in research who believed it to be so and published about it. The only thing I have done is to add my own thoughts to what I have read and share them here. I dont expect people to take what I say for granted, but as something they may or may not be interested in. I am sorry if posting what I found here sounds like psychobabble to you. I guess this is why Flo dont come here anymore and why Lee said he preferred to keep all his findings to himself. I looked into archive and found a thread started by Flo in 2004 raising the same question of the Hypocretin receptor gene in relation to nicotine and no one was interested then either. Looks like not much has been changed. I will stop the psychobabble now. Thank you all . :) |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 6th, 2008, 9:31pm Just to keep the topic on CH and it's realated qualities lets leave schizophrenics out of the equasion. Schizophrenia is not caused by hypothalamic disfunction so therefore does not enter into this querry. Just because some of the same neurotransmitters are involved doesn't give liberty to make any compairisons between one condition with the other. Since I can't access the reports, please link to a study where I can see conclusively that hypothalamic cell abnormality and dysfunction is related to Schizophrenia. Then I can comment further. |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 6th, 2008, 10:31pm Thank you for the liks via PM Annette, and when I have the chance to pour over them I'll paste and reply with my professional sufferer opinion...(just trying to keep it light humored here\ as it's intended.) |
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Title: Re: CH history, genetic link and nicotine Post by BMoneeTheMoneeMan on May 6th, 2008, 10:44pm I think I would have to agree. It seems like the only smart way about it: Annette, until you can come up with hard concrete proof of what exactly causes CH, there's no sense in researching theories regarding the cause of CH. ::) |
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Title: Re: CH history, genetic link and nicotine Post by KatzPurr on May 6th, 2008, 11:00pm Interesting thread to say the least, though I not sure why some have gotten so fired up about it. I think any research out there is certainly worth considering, but even if there was a significant study linking smoking or anything else to ch, there will always be and exception to the rule. Like sandie and a few others I do not smoke, nor have I ever been a smoker. I also do not have an addictive personality in any way shape or form. I am not a drinker, gambler, junkie, or otherwise. In my case, the only link to smoking I can provide is that both my parents smoked (for a very short time before I was born), my mom started again for several years after divorcing my dad, but then quit. My grandfathers' on both my mother and father's side smoked and my grandmother on my mother's side smoked very little. Anyway, that's my two cents, even though it's not particularly scientific. |
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Title: Re: CH history, genetic link and nicotine Post by AussieBrian on May 7th, 2008, 1:24am on 05/06/08 at 22:44:06, BMoneeTheMoneeMan wrote:
You're gunna have to run that one by me again, BMonee. I know I'm old and slow but how can the proof be found without researching the theories? All the theories. |
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Title: Re: CH history, genetic link and nicotine Post by Pinkfloyd on May 7th, 2008, 1:54am First of all, let me commend you for the work you've done on this subject. That said, let me just comment on a couple points. on 05/06/08 at 10:46:47, Annette wrote:
This may or may not be true. It certainly isn't something that you can make a statement of fact. The only fact is that you didn't find anything on the internet from before 1641. The world was much different before 1641. My guess is that at least some of those skulls they find from 1000 BC that have trepanning holes drilled into their temples, just might have had clusters. We still find ancient writings (ex; dead sea scrolls) that describe things we hadn't known to have existed prior to the microwave. Between 1300 and 1700, I think the Black Plague and the other plagues were keeping most of the record keepers and physicians pretty busy, or dead. Maybe a little too busy to worry about someone with a "headache"? Before this time period (1300s), record keeping was sparse at best. It's also very possible that before that time, they had a very good treatment for clusters and it wasn't that big a deal. If you go back and read the Rig Veda (circa 1000 - 1500 BC) you'd find that they were treating dibilitating headaches, with magic mushrooms. Then again, people banging their heads on the cave walls most likely would have been clubbed to death as being useless for the hunt. Just because it isn't there (yet), doesn't prove anything. on 05/06/08 at 10:46:47, Annette wrote:
Many of your passages are littered with your own personal hunches and impressions, although you state them as facts. Many statements, just like the one about nothing before 1641, are just what you are telling others not to make. That's not playing very fair IMHO. I was also a little offended by your suggestion that it would be good to sue tobacco companies. First of all, as was pointed out, it wouldn't do any good because it would have been an unintended consequence, not like hiding data on it's cancer causing effects. Second of all, even if sued, they would never throw billions of dollars at trying to find the "real" cause of clusters. They'd have no reason to. That research, even with billions of dollars, would still most likely take decades. Even if it took 10 years, it would never be completed before a lawsuit was settled. They would have absolutely no incentive to search for the cause of clusters. I would also never sue anyone or any entity, for personal gain, just because they "have the money" and that is what you intimated. Even if they didn't cause it, they'd spend the money to defend themselves by researching the "real" cause. Lastly, as I said in the beginning, you did a lot of work on this and have come up with some interesting theories, and for that I do commend you. Bobw |
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Title: Re: CH history, genetic link and nicotine Post by tanner on May 7th, 2008, 3:23am on 05/07/08 at 01:24:15, AussieBrian wrote:
I am with you 100% mate! The key word is theories. Use it while you are postulating and it changes the tone of the entire post and throws it back to where it should be.......we are all searching. Don't make that clear and you are running the risk of making visitors to the site think that we have more answers than we do. Been away awhile but I still think the micro-brew research may still be our best bet.........................Cheers...........Tim |
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Title: Re: CH history, genetic link and nicotine Post by AussieBrian on May 7th, 2008, 7:33am on 05/07/08 at 03:23:08, tanner wrote:
You've caught me out completely on that one, Tim, because this is the first I've heard about 'micro-brew research'' and while you believe it to be our best bet, I'm not happy leaving it as our only bet. As you say, it's 'research', and all research is good research until proven otherwise. It may surprise you to learn that some people are even researching magic mushrooms (of all things) with a view towards finding a cure. Research has given us oxygen and Imetrex while suggesting capsaicin and voodoo may be a little less than effective. Kudzu, melatonin and Red Bull as opposed to dentistry, sinal surgery and tin-foil hats. Annette's research seems to be towards possible causative factors, as opposed to palliative care, and no harm can from it while we all remain open minded. |
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Title: Re: CH history, genetic link and nicotine Post by nani on May 7th, 2008, 9:46am We can sit here and theorize until the cows come home. Gathering info from the Internet may be helpful for us personally, but in order for real research to happen, we would have to come up with some convincing evidence and present it to a university or hospital to pursue. In the case of psychedelic treatments and kudzu, the anecdotal evidence came from sufferers. Annette, I do have to ask how you arrived at this conclusion: on 05/06/08 at 21:30:36, Annette wrote:
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Title: Re: CH history, genetic link and nicotine Post by BMoneeTheMoneeMan on May 7th, 2008, 9:54am on 05/07/08 at 01:24:15, AussieBrian wrote:
In order to get an egg, you need to have a chicken. It's too bad sarcasm doesn't work so well on the internets, cause i am laying it on pretty thick. |
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Title: Re: CH history, genetic link and nicotine Post by monty on May 7th, 2008, 11:14am on 05/07/08 at 07:33:24, AussieBrian wrote:
Wasn't the 'micro-brew' a veiled reference to the mushrooms? I can't imagine that producing beer on a small scale would be beneficial to clusters in any way. Or am I missing something? |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 7th, 2008, 11:33am on 05/07/08 at 11:14:47, monty wrote:
Just venturing a guess here, but the micro-brew reference could be addressing the fact that for some CHers, beer/alcohol is a trigger for a hit, where for others it is not? |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 7th, 2008, 12:11pm on 05/06/08 at 20:24:59, Annette wrote:
This is a crucial statement and is one that I've been banging on about for years. It only works though if you agree with the theory of predisposition i.e. some people are predisposed to develop cluster headache and some more so than others. I've posted the following before on a couple of occasions in slightly different guises, and it's been a real thread-killer in the past, but ho hum, here it is again. As with many things in life, I believe cluster headache is a factor of both nature and nurture. Firstly, I think that sufferers are born with a natural propensity to develop the symptoms and pain of these so-called headaches. This is a hereditary factor based on genes of one of the parents; and the reason why it can and does skip generations is that the abnormal genes that cause CH can lie dormant unless triggered by external factors. All the clinical evidence suggests that we have to start with the hypothalamus. Most practitioners who specialise in CH agree that the abnormality within the hypothalamus is the root cause of the pain, which when in cycle releases hormones and chemicals that innervate (stimulate) the trigeminal ganglion, which in turn causes the domino effect of pain and cranial autonomic symptoms through the trigeminal nerve down one side of the face and head. This theory is backed up by the uncanny regularity of attacks (circannual and circadian), much lower levels of plasma testosterone (amongst men) during attacks and bouts, and alterations in the natural production of hormones/chemicals that affect endogenous biologic clocks. The most recent research involving PET studies amongst CH sufferers put the icing on the cake for me, which in summary showed an increase in functional activity of the hypothalamus amongst CH sufferers, which up until very recently has not seen in migraine. Furthermore, it has always been assumed that primary headaches are caused by abnormal brain function rather than an abnormality in the brain. However, by using magnetic resonance imaging (MRI), which visualises the structure and function of the brain by providing detailed images in any plane, it showed that there is a significant increase in the volume of grey matter in the brain. This increased area was consistent with the location of activation seen in the PET studies; that is, the hypothalamus. This is the prime reason why CH is thought to be caused by an abnormality within the hypothalamus. These abnormalities were seen when sufferers were both in and out of bout and were interpreted as an excessive growth of grey cells within the hypothalamus, or more probably, within the suprachiasmatic nucleus (SCN), the previously mentioned master-clock. I also think the pineal gland is closely linked with this theory, but I won't throw a spanner in the works on this one as yet. So, sufferers may possibly inherit a brain abnormality from their parent's genes. The extent of this abnormality determines the pattern(s) of CH amongst sufferers; so in fact, there may well be a variety of different types of CH based on the extent of this abnormality and how sufferers live their lives. This may be why specific triggers of attacks are not ubiquitous and not all medications work for everyone. I've no idea as to how many different types of CH there are, we're all different, but it's likely to be on a sliding scale based on the current yardstick of episodic to chronic; perhaps something like this:
The crucial thing is that the abnormality that sufferers are born with is not fixed. Everyone who is unlucky enough to have the abnormality has the propensity for it to develop over time - classically from episodic to chronic and sometimes vice versa. This is where the controversy may start creeping in. Although the abnormality is pre-determined at birth, I also believe that there are other external factors (nurture) that can influence the pattern and type of CH. Sufferers who are born with a particularly low abnormality may not develop CH until they are exposed to specific external forces. So in a nutshell, someone who has a slight abnormality may move up the "intensity" scale because of external forces, and conversely, sufferers who have extreme abnormalities can and do move down the scale also due to external forces. Here's the tricky bit: what are these external forces? I would suggest that they are anything that can alter the natural balance of hormones and chemicals in the body; so it would make sense that it's all to do with consumption and lifestyle, possibly (not exclusive and in no particular order) as follows:
So in summary, I believe that there is just one type of CH (which is closely linked to the other TACs), but within this, there are many different strains. To understand the potential mechanisms involved we have to go right back to the root cause, which is currently thought to be due to an abnormality within the hypothalamus. The extent of an individual's abnormality (possibly genetically linked) will dictate the initial onset and subsequent pattern of CH, but these are not fixed and in turn are influenced by specific external factors. As external factors change over time, so does the pattern of an individual's CH, modifying these different strains. So CH isn't black or white (episodic or chronic) but should be classified more in terms of a continuum: still largely dictated by periods of remission, but also frequency of occurrence and attack intensity, and the extent of influence of differing external factors. There's more of course, if anyone is interested, but that should do for now. -Lee |
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Title: Re: CH history, genetic link and nicotine Post by Giovanni on May 7th, 2008, 6:01pm on 05/06/08 at 20:21:10, Brew wrote:
Brew, I wonder why my undefective hypothalamus became suddenly defective at the age of 47? John |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 7th, 2008, 6:14pm on 05/07/08 at 18:01:18, Giovanni wrote:
My humble opinion - it has always been defective. The defect is only a gateway of sorts. But I'm not a doctor, so my opinion and $1.50 will get you a cup of coffee, but you better have the $1.50. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 7th, 2008, 6:31pm on 05/07/08 at 12:11:12, LeeS wrote:
This is exactly what I have come to realise . We all agree that everyone's cluster is different. The only common denominator is the amount of pain and the characteristics of it. However, when we compare the history of one CHer to another, there is often nothing similar. Even in ones history, CH appears to morph and change and become influenced by different things at different times. That is an indication of the multifacet nature of it. When one starts to look into the biochemistry of CH and see how many factors are involved, how many neurotransmitters are involved... its no longer a surprise. The difficulty arises when we pursuit one factor deeper and discuss about this particular factor, there will always be people who protest " but that does not affect me". However, if one tries to discuss enough factors to include everyone, the discussion will become so diluted that it loses its value. In regard to nature, researchers have finally come up with a gene that is strongly associated with CH. Even then there were people who did not have this gene and still had CH. Prof Goadsby came up with the anatomical abnormality in the hypothalamus, again this was not detected in all the CHers who had the scan. When looking at nurture, its so vast a subject where should one start? It would be wise to start with something that is most common in CHers. Personally I have looked at two in details : stress and cigarette smoking. Both have evidences to support their role in the development of CH. The next one I am interested in is the pineal gland with its involvement in the sleep/wake cycle and REM sleep. The hypothesis and the theories are put forward not as gospel for people to take for granted. They are put forth as interesting findings that people might like to look into further for themselves and to discuss. Its there to be shred apart the way all hypothesis and theories should be. What I was looking for is for people to contribute with what they know or with personal experiences one way or another. For eg, if putting it forward encouraged people to come share that how stopping/starting smoking helped or did not help with CH then we would gain further information that is currently not available. Even if the theory gets completely disproved by the majority reporting that stopping smoking permanently does not do a thing for their CH then we have learnt something new too. Either way its useful and helpful. What doesnt help is when personal attack which has nothing to do with the topic of discussion get thrown in or when opinions are voiced just for the sake of argument. Still someone PMed me commented that since the personal attack did not start until page 3 that indeed for me its a new record. I guess I cant complain. Thank you very much to everyone who have read the thread and have contributed. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 7th, 2008, 8:40pm During my research, I came across this thread started by Flo in 2004, which barely had any interest/response to it at all. http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=medsarchive2004;action=display;num=1097672966 This is what happens when information is presented purely in its scientific form, no one understands it enough to become interested or excited about it. Most people will read it and think " I dont understand so it doesnt apply to me". However, when one presents the same information interpreted at a more personal level with ones own thoughts and speculations then the discussion tends to turn into personal issues and comments instead. How do we get past this ? Or we cant ? Modified to add: In hindsight I would say I have achieved more than Flo did by adding my personal theory and interpretations to the material. I dare say more people became interested on the topic this time around than 4 years ago. However that meant I got swiped at more than Flo did. Was it worth it ? YES ! |
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Title: Re: CH history, genetic link and nicotine Post by Pinkfloyd on May 7th, 2008, 11:52pm on 05/07/08 at 18:31:18, Annette wrote:
It has been looked at (by meducal professions) and stopping smoking does not appear to make any beneficial difference in one's clusters. Long term smoking does cause damage in various ways. Can smoking, and the resulting damage potentiate the onset of clusters, possibly. Maybe even probably in those people predisposed to cluster headaches. Stopping smoking does not reverse this damage nor does it "cure" clusters. The damage has been done. Can it possibly make then a little less severe? The only possibility for this in my opinion is that once the lungs clear as much as they can, it may make things better due to a more efficient oxygen supply. The damage to the vascular system that most likely contributes to the pain cycles, won't be significantly repaired, in long term smokers. Clusters are not alone in being triggered by a myriad of different combinations. Most, if not all, vascular related headaces are also caused by differing combinations of events and circumstances. This is one reason that different treatments work for different people and why different triggers are sometimes present from one person to the next. The human body in it's state of perfection, is a finely tuned instrument. If you, or your environment F**k with it, there are consequences. Many of which we still don't fully understand. Bobw |
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Title: Re: CH history, genetic link and nicotine Post by Pinkfloyd on May 7th, 2008, 11:56pm on 05/07/08 at 20:40:43, Annette wrote:
Really? I think you underestimate the people on this board. But then, maybe you are just too smart for us. <geeesh> Bobw |
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Title: Re: CH history, genetic link and nicotine Post by Batch on May 8th, 2008, 1:07am Annette, Outstanding! I still say Your efforts here are worth publication if for no other reason than to stimulate a similar exchange among neurologists and medical scientists working on the cluster headache disorder. I'd say that you and Lee took us way beyond Red Bull and Kudzu with help from AussieBrian and others tuned into your hypothesis and willing to contribute and stand by your right offer it as a discussion. You also carried on multiple dialogs on as many different levels of understanding our disorder in a most professional and scientific manner. We do need more science... Thank you and Well done. I've been following the writings and letters to the editor at JNNP offered by Dr. Vinod Gupta M.D. and neurologist. Being a fighter pilot it was easy to recognize another Type 1 personality. I think you and Lee may find the following provides yet another structure that can be used to shape our search for the cause(s), treatment, and someday a cure or lasting preventive for our disorder. Please take care, and again, Well Done! V/R, Batch "Science is a process; accretion of data in the absence of a central concept thwarts or impedes the process. Key issues that can evolve into a comprehensive theory for cluster headache include:[4][5][6][7][8][9][10] 1. The self-limited nature of cluster headache (15-180 minutes) indicates primary involvement of a system that has the intrinsic ability to limit or dampen the headache attack initiating physiological event. Such a system is highly unlikely to be purely vascular or neuronal. 2. Strict lateralization of headache indicates an idiosyncratic cranial structural or anatomical variation that localizes the headache. 3. Absence of vomiting despite a variant of headache that is frequently far more intense and distressing than migrainous headache indicates that vomiting – while frequently remitting migraine – might exacerbate the underlying pathophysiological mechanism in cluster headache. 4. Non-pulsatile nature of headache indicates occurrence of the maximum possible attack-related stretching of the cranial structure primarily involved in cluster headache. 5. Therapeutic effect of oxygen and ergotamine and aggravation / precipitation by alcohol or nitroglycerine (glyceryl trinitrate) strongly indicate primary involvement of peripheral non-neuronal mechanisms. 6. Prophylaxis with verapamil practically confirms a peripheral non- neuronal origin of cluster headache. 7. Long periods of remissions indicate operation of adaptive mechanisms, possibly involving tissue creep. It is illusionary to believe that advanced neuro-imaging or other laboratory advancements have unlocked the “biology” of cluster headache. All laboratory procedures have their limitations; nothing can supplant careful thinking about the research question(s). Technology is a tool of science, it is not science itself. Also, undirected epidemiological investigations and nosological or statistical-mathematical sophistication do not further our understanding of cluster headache. Vinod K Gupta, Physician. dr_vkgupta@yahoo.com References 1. van Vliet JA, Favier I, Helmerhorst FM, Haan J, Ferrari MD. Cluster headache in women – relation with menstruation, use of oral contraceptives, pregnancy and menopause. J Neurol Neurosurg Psychiatry published online 11 Jan 2006; doi:10.1136/jnnp.2005.081158 2. Gupta VK. Migraine: Migraine: “how” versus “what” of a disease process. BMJ (published online 8 February 2006). Available at: http://bmj.bmjjournals.com/cgi/eletters/332/7532/25 3. Skrabanek P. The poverty of epidemiology. Persp Biol Med 1992;35:182-185. 4. Gupta VK. Trigeminal autonomic cephalalgias: ‘noso-physiology’ or pathophysiology? J Neurology Neurosurgery & Psychiatry (22 February 2005). Available at: http://jnnp.bmjjournals.com/cgi/eletters/76/3/301 5. Gupta VK. Intractable cluster headache and therapeutic stimulation of the hypothalamus: pathophysiological and management insights from a rare experiment. Brain 2005;128: E26. [Extract] [Full Text] 6. Gupta V. Does the eye modulate the clinical expression of cluster headache? BMC Neurology (17 May 2005) Available at: http://www.biomedcentral.com/1471-2377/5/6/comments#201461 7. Gupta VK. Is verapamil-triptan combination for cluster headache therapy pharmacologically valid? Headache [In press]. 8. Gupta VK. Change in frequency pattern in cluster headache induced by subcutaneous sumatriptan. Headache [In press]. 9. Gupta VK. Neuroimaging in hemicrania continua: dissociation between technology and basic sciences? Headache [In press]. 10. Gupta VK. MRI imaging in primary headaches. Radiology 2006:238:754-755." The complete text of the above letter to the editor can be found at the following link: http://jnnp.bmj.com/cgi/eletters/jnnp.2005.081158v1 |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 8th, 2008, 2:37am on 05/07/08 at 23:56:03, Pinkfloyd wrote:
I never said I am smarter than the people of this board although I did spent 7 years going through medical school and another 12 years working in various hospitals and clinics and am exposed daily to scientific and medical terms which many here are not familiar with. I said that in the context of the responses Flo got 4 years ago trying to discuss the same topic. When he simply posted the medical findings on this board, here were the responses he got : on 10/13/04 at 13:10:43, nani wrote:
on 10/13/04 at 15:39:36, Woobie wrote:
on 10/21/04 at 10:43:57, Valerie wrote:
on 10/13/04 at 10:31:03, ozzy wrote:
When I read that I realised that if I just posted the studies without any comment or interpretation I most probably would get similar responses, people would say " interesting" and then not think twice about it. That was not the response I was hoping for. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 8th, 2008, 2:46am on 05/07/08 at 23:52:17, Pinkfloyd wrote:
Have you actually got concrete evidence of that ? Which medical professionals have looked at it and where did they publish their findings that stopping smoking does not make any beneficial difference to CH ? Can you please post these results ? I would love to see it as I have not found anything like that. |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 8th, 2008, 4:51am on 05/08/08 at 02:46:00, Annette wrote:
Goadsby et al have been saying it for donkey's years Annette, just pick up one of their articles which review TACs. There is this too, which was compiled by Arne May. I've posted the whole extract, because it's interesting in its own right, and is pertinent to the whole thread: Quote:
BTW Annette, careful when you quote Ozzy out of context. He is one of the most knowledgeable and smartest people here; I think that comment was somewhat tongue in cheek 8) I've been following Dr Gupta's missives too Batch. I don't agree with much he says, but he certainly provides an interesting perspective ;) -Lee |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 8th, 2008, 3:17pm on 05/08/08 at 04:51:18, LeeS wrote:
I could not find any work done by Goadsby on the effect of smoking on CH. Have you got anything on hand that you can share please Lee ? Or BobW ? From what BobW posted I thought he meant many medical professionals have actually done studies or trials on the effects of stopping smoking on CH specifically. I might have quoted Ozzy out of context but what else he posted in the thread did not make a lot of sense, at least to me. Ozzy, if you are here and read this please come correct me and share what you know on this topic. I would really appreciate it. Thank you. Your quote from the Lancet article is somewhat not accurate. " The medical history often reveals a high incidence of head trauma with brain concussion,23–25 but it is hard to prove a cause-and-effect relation. Interestingly, up to 85% of patients with chronic headache are also chronic cigarette smokers.23 Quitting smoking has no effect on the disease. The question arises whether chronic nicotine consumption is needed as a trigger to initiate the syndrome, possibly on the basis of some genetic background. " 1- The article must be old as it had no mention of the finding of the hypocretin receptor gene. The discovery of it and the fact that nicotine acts on it have shed new light on the topic. 2- It mentioned that medical history showed high incidence of head injury with concussion. I am not sure whether that statistic is still valid ? 3- It actually mentioned the possibility of chronic nicotine consumption required to trigger the gene for CH. 4- 85% chronic CHers are also chronic smokers. Therefore although it said stopping smoking may not change the course of CH but it sure raised the possibility that smoking could cause CH to start in the first place and that CH somehow links to chronicity. In effect, it said basically the same thing I did, which is that chronic nicotine consumption in some people "causes" or " triggers" the condition to happen, by acting on the CH gene, but for those whose damage has been done and became "fixed", stopping smoking later in life may not help anymore as it is too late. However, if this " triggering" effect on the gene can be proven, young people who test positive to this gene may be able to avoid triggering CH in themselves by not starting to smoke ? Finding this out may not be worthwhile for people of this generation but it can help their children , grandchildren, great grandchildren .... Wouldnt that be a good thing ? |
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Title: Re: CH history, genetic link and nicotine Post by nani on May 8th, 2008, 4:32pm on 05/08/08 at 15:17:13, Annette wrote:
Ozzy hasn't been around in a long time. I hope my ignorance didn't chase him away, too. :-[ Annette, Batch suggests your info here is publishable. Why not submit it somewhere? Once it's published, it should be easy to get a university, or even your own hospital to back a study, no? You could even be the lead researcher! / for spelling, LOL |
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Title: Re: CH history, genetic link and nicotine Post by purpleydog on May 8th, 2008, 6:08pm on 05/06/08 at 21:31:31, Redd wrote:
Annette, why don't you post the link on this thread? I would also like to read the study about hypothalamic cell abnormality, and how it relates to schizophrenia, and to see if there are any correlations to CH, or how it parallels with CH. Or, if you wish, feel free to pm it to me. I think there are others who would like to see it too, so they can draw their conclusions, as Pegg will, and as I would like to. |
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Title: Re: CH history, genetic link and nicotine Post by Bob P on May 8th, 2008, 6:57pm 50% of clusterheads smoke. 72% of clusterheads drink. Alcohol is a definite trigger. Maybe it's an alcohol gene instead of smoke gene? |
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Title: Re: CH history, genetic link and nicotine Post by Redd on May 8th, 2008, 7:23pm Quote:
This is the first link Annette, and I guess I'd want to see the conclusions to these postulations and speculations, and something much more recent than 1941. There is nothing conclusive in this. Quote:
It is my understanding that Goadsby and his tean found that there was an increace in cell volume in the inferior postierior region of the hypothalamus. I could be wrong but this is what I remember. http://books.google.com.au/books?id=6pyv4cWRkSIC&pg=PA133&lpg=PA133&dq=hypothalamus+schizophrenia&source=web&ots=defY6d4jy8&sig=jgD41JcrUrgg0czJ6N9DQBM_JOg&hl=en I can't copy the page so I'll post the link. Page 133. Third ventrical of the hypothalamus located in the antirior region and a tissue loss in this region. This reads to be the opposite of Goadsbys findings. Quote:
This one contradicts the previous ones but does give some information that is more in line with what the most recent findings in CH are. I'm not quite sure how it makes the leap to comparing schizophrenia with CH, but I hope you can clue me in. Quote:
Now I see the prefrontal cortex being the focus of this abridged article. Discussing the involvement of hypocretins/orexins and neuropsychiatric conditions would be very interesting indeed. Personally, I find there simply is not enough information presented for me to come to the conclusion that Hypothalamic abnormality is causal to the development of schizophrenia, especially when one very recent study shows, Quote:
I'm pretty adept at interpreting reports such as these, and maybe being out of college for 9 years has somethinng to do with my not being able to make the same connections bwteen this information as you are. Please tell me how you tied this information together to reach your hypothosis. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 8th, 2008, 8:46pm Pegg, you misunderstood something I said. I did not use the finding in the anatomical abnormality of schizophrenia to reach my hypothesis. My hypothesis is this 1- Hypocretin receptor gene has been found to be strongly associated with CH. 2- Hypocretin acts on the hypothalamus affecting the circadian clock via the sleep-wake cycle and on various neurotransmitters such as dopamine, noradrenaline,etc. 3- Nicotine has been found to bind to these same receptors. 4- CHers tend to be heavy smokers therefore would chronic or excessive exposure to nicotine play a causative or triggering role in the development of CH. Prior to arriving at this hypothesis I had the same notion as many here that it was CH that makes people more addicted to cigarettes. When I set out to research this angle I came across several stumbling blocks. I decided to study about the mechanism of addiction first. I learnt that addiction to anything ( chemicals or otherwise ) is caused by the release of dopamine. Dopamine is the chemical that makes a person feels rewarded. Whatever makes your brain releases more dopamine you will like it and potentially can become addicted to it. This is the same from chocolate to being in love to cigarette to cocaine. This can happen to ANYONE regardless of whether or not you have any existing condition, just to a different degree. Pathological addiction occurs in people where the dopamine pathway is malfunctioning. This has been extensively studied in schizophrenics. They have anatomical abnormalities in the hypothalamus as well as other areas of the brain which makes them MORE addictive than the normal person. The abnormalities that they have are obviously different from the ones seen in CH, otherwise they would be more likely to develop CH and not schizophrenia and vice versa. Since CHers dont seem to have the same abnormalities that cause pathological , more than normal addiction ( as seen in schizo ) the theory that CH makes people having more addictive trait was not standing very well, at least from my finding. Secondly it was observed that schizophrenics smoke more during the active phase of their illness makes it more indicative that it is their illness that makes them smoke, this again was not observed in CH. Lastly, researches done on the abnormal/pathological nicotine addiction in schizo showed that this leads to an unusual reactions of the body to nicotine, such as the worsening of symptoms when nicotine is withdrawn. This was not observed in CHers. That was the basis of my comparison between the two. If someone can help by finding articles and studies that show CH in a person causes that person to become MORE addicted to whatever or specifically nicotine, than otherwise normally, it would be wonderful and it would shed a lot more light on the topic. |
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Title: Re: CH history, genetic link and nicotine Post by Kevin_M on May 8th, 2008, 9:11pm on 05/08/08 at 20:46:13, Annette wrote:
Your own little survey of 25 popular website forums to see how many posters have thousands of posts like this site does might put us in perspective. ;) Not to mention the number of guests here at anytime. I've wouldn't know because I can't visit any other site, the addiction here doesn't allow time for another. :) |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 8th, 2008, 10:39pm on 05/08/08 at 21:11:29, Kevin_M wrote:
Good point Kevin ! I come here almost daily for 2 years now, does that qualify me a being addicted to this place ? I also go to work almost daily for 12 years now, I must be addicted to work too..... Uhmmm... somehow that last statement didnt sound right to me ! :P Just kidding! There are heaps of websites out there that have much much higher number of members and guests and number of posts than we do here. |
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Title: Re: CH history, genetic link and nicotine Post by Kevin_M on May 9th, 2008, 6:22am on 05/08/08 at 22:39:53, Annette wrote:
Oh wow, I didn't know. I've noticed a cell phone addiction being popular now, I mean where people do not go anywhere without it and walk around plugged in with ear attachments like cyborgs. Reminds me of this idea: http://www.funny-practical-jokes.com/images/BeerHelmet.jpg |
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Title: Re: CH history, genetic link and nicotine Post by seasonalboomer on May 9th, 2008, 9:29am on 05/08/08 at 02:37:42, Annette wrote:
The response you were hoping for? Annette, this is at the core of what takes you into the zone of having people begin to question your motivations. You got intelligent feedback, had excellent discussions from those with information that both complemented and at times refuted your theories, yet you don't seem to be able to let it go at that. I've PM'd you before on this same subject, wondering why, at times, you can't let well enough alone. This was a great thread. And then you started quoting people from a thread three years old, more or less denigrating what were probably just nice comments to Flo about the work he'd done. Jonathan's research threads were often above a lot of our heads - but he kept at it and even created his own website that compiled this information. I don't think he put them up and waited outside the trap for the "response". He contributed them to a group, some of which would understand, others may not, but may, by virtue of the thread, begin to absorb the information from other's input. Step back. Take a breather from this thread. Take a good look at that compulsion to respond to every single piece of data that appears on the thread you started. Sheesh. Scott |
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Title: Re: CH history, genetic link and nicotine Post by starlight on May 9th, 2008, 1:34pm Annette, Interesting theory. But, 2 things...I developed CH (at age 14) before I ever touched a cigarette or was in any environment with second hand smoke (I was lucky for that). I did smoke as a young adult--clusters continued. I did then quit smoking completely--clusters continued. I mentioned this to a neurologist and he said "Doesn't surprise me. I would not have expected them to stop. It is not good to smoke but it makes no difference with CH." So.....from (only from my personal experience) smoking or not smoking it really does make no difference for me. The headaches continue in the same way. As far as the hypothalamus being altered over the course of several generations, I think that is highly dubious. For an actual part of the brain to change over only a few generations...I really doubt it. Although, I do think it is possible that some aspect of modern life contributes to CH. Perhaps electric light, which contributes in many ways to altering sleep/wake cycles. |
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Title: Re: CH history, genetic link and nicotine Post by Paige_H. on May 9th, 2008, 1:42pm My CH started when I was 10 yrs old and it had nothing to do with smoking at all. However, I find it interesting how desperately I crave a ciggie when the hit is gone. Also, my grandmother has CH and she has never, ever smoked. Oh I know, it isn't hereditary either. |
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Title: Re: CH history, genetic link and nicotine Post by starlight on May 9th, 2008, 1:48pm One more comment wanted to add: As someone who has had CH for 20yrs., I would say I understand why people would think that smoking was perhaps a cause or an exacerbator of CH--smoking can cause regular old headaches or make a regular old headache worse--but unfortunately, and perhaps counterintuitively, I believe it really does not cause or influence CH. Alcohol, on the other hand--that is a different story--as alcohol is very detrimental to the sleep/wake cycle and also a powerful depressant--2 things not good for CH. But from my personal experience, I developed CH before I ever touched nicotine, alcohol or coffee, so....was it the early head injury, the longlasting case of mononucleosis, or stress? Won't ever know, but I don't drink, I don't think alcohol helps--although I definitely don't think a drink here or there will have any negative effect. |
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Title: Re: CH history, genetic link and nicotine Post by starlight on May 9th, 2008, 1:53pm Also, noticed a few people in this thread talking about how CHers more prone to addictions. If that's true, then start looking at conditions which often fuel addiction such as depression and anxiety, because if anything it would be imbalances such as those that fuel the addictions not "just being a CHer". My 2 cents. |
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Title: Re: CH history, genetic link and nicotine Post by Paige_H. on May 9th, 2008, 1:57pm on 05/09/08 at 13:53:22, starlight wrote:
I agree with this. If CHers are more prone to addictions, then why aren't we addicted to the opiates they attempt to give us when we are first getting diagnosed. Those narcotics can make you feel great, even when you know you can rebound. But we don't get addicted. |
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Title: Re: CH history, genetic link and nicotine Post by starlight on May 9th, 2008, 2:05pm Annette, Sorry--I am reading through this thread backwards. I read where you wrote to Paul98 that Kip 10s are rare in response to his suggesting that in the past some may have thought CHers were possessed b/c of headbanging behavior. For me, Kip 10s are not rare--I would describe every hit for many cycles previous that has broken through the O2 as being a Kip 8-10 and I can sense that the ones that thankfully do not break through which is the majority would be of the same caliber. Not saying that to elicity sympathy as my headaches when in cycle have been gotten under control, but just to clarify, CH is friggin' painful!!! |
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Title: Re: CH history, genetic link and nicotine Post by starlight on May 9th, 2008, 2:36pm Annette, I apologize profusely for posting so many times in a row. But you have me thinking about evolution here, and genetics. Since you talked about CH not being mentioned in the literature before 1641, and hence that it must have emerged in modernity, I have a thought....could it be the other way around? That CH did not emerge in modernity but perhaps was much more prevalent thousands and thousands and thousands of years ago and that only a few still carry the gene? What if, say, in the times of cavemen, CH was not uncommon? What if CH was some kind of seasonal signal, like, OK, the winter is coming, time to move and travel and seek shelter in a cave or something like that? I mean, I used to get CH on Nov. 9 of every year...which is truly astounding in a way, that type of regularity. So, anyway, that is my thought. |
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Title: Re: CH history, genetic link and nicotine Post by BMoneeTheMoneeMan on May 9th, 2008, 3:39pm I dont think Annette is saying if you smoke you will get clusters. I think she is saying the nicotine used by generations before us could have possibly "messed up" some receptor or nerve or something. This "messed up" receptor could then be handed down in the genes. So, even at 10 years old, you might have inherited the genetics with this messed up receptor. Is this sort of correct, Annette? From a person like me with an IQ of 67? Thanks, Brian |
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Title: Re: CH history, genetic link and nicotine Post by cluster on May 9th, 2008, 3:43pm There are 6 review articles about cluster headache research in the April 2008 issue of "Current Pain and Headache Reports": http://www.current-reports.com/home_journal.cfm?JournalID=PA No surprise, some of these articles focus on similar subjects as this thread does: Smoking, Endocrinology, orexin/hypocretin etc. Unfortunately these articles are not free and they are copyrighted, but perhaps some people have the chance to get a copy through a library or know somebody who owns a library or so. Here is a free open access article entitled " The primary headaches: genetics, epigenetics and a behavioural genetic model": http://www.springerlink.com/content/388m81878hr18124/ Giving up smoking has helped some CH patients I know, (or at least they think so) and for some others it did not make a change, they think. For myself I think I will not know if quitting helps unless I have tried it. Giving up smoking did help some people near Leicester U.K. back in ye' good old eighties, they think? Quote:
pf wishes Friedrich |
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Title: Re: CH history, genetic link and nicotine Post by LeLimey on May 10th, 2008, 5:56am The thing is - I've never smoked. Never. Not once. My ex didn't smoke either and Jasper doesn't but it didn't stop him from being diagnosed with it at 3. No one has ever smoked in my house either. If my friends smoke, they go outside... Who knows?! |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 10th, 2008, 7:53am Helen, I was hoping you would drop by this thread. I know they were doing some genetic testing for you and Jasper since he started from such a young age. Do you know if its the same gene they have found here?( the G allele for the Hypocretin receptor ) Or have they found something else ? |
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Title: Re: CH history, genetic link and nicotine Post by LeLimey on May 10th, 2008, 9:13am Annette in all honesty I can't remember now. We participated in 2005. The person doing the research is Professor Trembath at Leicester University here in the UK if that is any help. I only posted my info as it had been raised earlier in the thread. I don't know enough one way or another about tobacco etc to know anything sensible to add! As a further aside though, my mothers family were poor. They couldn't have afforded to smoke even if they wanted to and my own mother didn't start smoking until after my youngest brother was born and my dad started after her (how daft were THEY?!) It was stress though as my brother was very sickly. I had an uncle on my mothers side who had such terrible headaches he would go mad and have to be restrained. He died when he deliberately got in a car and drove it into a tree in one of these fits of pain induced madness. Was it CH? I'll never know for sure but I think so. |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 10th, 2008, 9:23am Professor Trembath's colleague (sorry – can't remember her name) presented an update on the genetic research at the last OUCH (UK) conference. I think you were powdering your nose at the time limey-bird ;) In summary, they're looking at loads of gene types (but it's very much like looking for a needle in a haystack) and they have yet to find anything conclusive. For some strange reason, my blood sample was rejected ::) -Lee |
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Title: Re: CH history, genetic link and nicotine Post by LeLimey on May 10th, 2008, 11:11am on 05/10/08 at 09:23:26, LeeS wrote:
Au contraire numbnut - you obviously didn't come back from the bar in the break the year before because it was 2005 when she presented that oh gormless one and I know - because I spoke to her afterwards so there! :P You're alcohol sample was probably ejected for trace elements of blood my sweet. 8) |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 10th, 2008, 6:57pm Thanks Helen and Lee ! I will go look for Prof Trembath's publication and see if there is anything interesting relating to CH genes. Lee, would you have a transcript of what his colleague talked about last year? I know you said they havent found anything concrete, but at least was there any info on what they were looking at ? or looking for ? the hypothesis they were working on ? Thanks guys. |
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Title: Re: CH history, genetic link and nicotine Post by Paul98 on May 10th, 2008, 7:34pm I have been enjoying this post and it has given me much to rhuminate upon. Looking back, I know my mother had devistating "migranins". She told me that she would be in agony on the floor writhing in pain. To this day I wonder if she had CH instead of migrain. This was back in the 50's when CH was "non existant" in wonen. I also know that my maternal grandfather had "headaches".......? I know that many genetic components of disease skip a generation, some don't. My grandparents on both sides did not smoke. My mother did not smoke. my father smoked cigars to which ALL the family was exposed. My thought is that some of the human (perhaps animal) population carries a mutation in a gene that predisposes us to CH. Tobacco smoke has hordes of chemical compounds in it...........SO DOES SMOKE FROM A FIRE. We came from living in caves, huts and close to fire and smoke for 50,000 years. Tobacco has been around for a long time in the Americias. More than 1,000 years. There are two things that have jumped out at me over the years....genetic link to (what was diagnosed as migrain) and head trauma. Unless tobacco can turn on genes in the gamates of parents (it is possible) than I would have to conclude we (the CH population) have a condition similar to epilepesy only very targeted to a specific (hypothalmus) region of the brain. Perhaps a component in tobacco can turn this gene on in adults. (or children) but my gut feeling is that it is similar to epilepesy. -P. |
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Title: Re: CH history, genetic link and nicotine Post by Brew on May 10th, 2008, 7:53pm on 05/10/08 at 19:34:03, Paul98 wrote:
Come now, Paul. We all know that the earth is only a little more than 6,000 years old. ;) |
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Title: Re: CH history, genetic link and nicotine Post by Paul98 on May 10th, 2008, 8:02pm on 05/10/08 at 19:53:21, Brew wrote:
Sorry brew, I was talking about the parrallel universe where folks live hundreds or years. ;) -P. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 10th, 2008, 9:46pm It seems certain that there is a genetic component to CH. There may even more than 1 gene associated with CH, or at least there are more than 1 allele associated with CH. This gene does not seem to be dominant or constantly active though due the fact that it seems to jump generations. Its possible that this gene gets passed on and then become activated some time along the line. What will activate this gene remains a mystery. It could be nicotine, it could be something else in the tobacco's myriads of chemicals, it could be diet, it could be stress or it could be trauma ? It would be very helpful to find out what can activate the gene as firstly we can prevent it from getting activated and secondly maybe then we can even do something to switch it off. I decided to look at nicotine and tobacco use as the hypocretin receptors gene is the only one confirmed so far to be strongly associated with CH and the fact that nicotine binds to this particular receptors, coupled with the observation that most CHers are heavy smokers, it just seems to be there must be some relevancy there between the 3 factors. On the other hand, CH maybe acquired too via head injury or other injuries to the hypothalamus. There had been case report where excessive emotional stress triggered a one off cycle of CH in some people and then nothing for up to 9 years afterwards. Are the ones with a genetic predisposition more likely to become chronic ? The fact that episodic can drink alcohol while in remission but doing so during a cycle would trigger a CH attack for sure is also interesting. Does that mean the gene can be temporarily switched off somehow ? Or is it more environmental like the variation in daylight due to seasonal change? I think this is why keeping a detailed headache diary is important , as it helps making any pattern more clearly visible. Please keep sharing your thoughts folks. Thank you very much :) |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 10th, 2008, 11:39pm Just noticing that there is another thread on the med board on smoking so I will link it here http://www.clusterheadaches.com/cgi-bin/yabb/YaBB.cgi?board=meds;action=display;num=1207935052 Its interesting that although many say stopping smoking does not seem to affect CH but one poster said when episodic cigarette smoke was a trigger and another said after quitting the number of kip10 decreased. No one seems to have found that starting smoking helps CH in any way though. While with schizophrenics, smoking actually helps reducing some of their symptoms. Has anyone noticed whether smoking more or starting to smoke helps CH at all ? Pegg and George mentioned something about smoking after a hit can help with the "after burn" effect but has anyone noticed smoking helps with the overal intensity or frequency of hits ? |
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Title: Re: CH history, genetic link and nicotine Post by MJ on May 11th, 2008, 3:31am Nicotine is the aide for CH. Not the cause. Nicotine enables and empowers the bodies natural pain killing endorphins. This is the cause and the reason many with CH seek solace in the drug and the smoke. If nicotine were to be causal why do episodic smokers exist? Half life of the drug was I think 2 hours wouldnt all be hit every 2 hours or so like me forever? Your cluster lump ideas do however make some sense when nicotine is researched as the drug tends to mass in that area. I have no cluster lump though. I think its easy to attempt to relate all things as being the cause of CH. Wether it be a bump on the head or a slightly different meter reading from a Cheads hypothalmic energy readings. Because of the difficulty in understanding this and some other research goadsby et al has studied we hear of deformed hypothalumus when its only a signal and reception that was noted. . Because a few individuals had shown a trite more gooey mass in the area of the brain that the hypothalumus lies near is not total and complete science as of yet either. This would not stand as fact but still theory. I believe there is some relationship but not yet proven beyond doubt. No doubt for all of us a rythmic factor exists. Maybe its due to the fact the first mechanical ticking timepiece was built around the time CH was first suspected as a singular affliction. (this holds up for me better then smoking through the ages being the cause as before timepieces we used only solar observations). Them old clocks had those big old gongs going off every hour on the hour. That gives anyone a headache. Going from memory I believe first mentions of CH like symptoms were given in and about 7000 BC by some egyptian dude. Mention has been made of similarities from the times of the ancient aztecs in stories told through the ages. Of course they may have smoked. (I have no citations) I also think its wrong to heavily suggest nicotine is causal to CH by a scientist with no proof that would stand up in any modern scientific publication or circle. As noted from another thread praises are being sung for total hooey to this point. It wont be long before this whole board begins to believe only oxygen users and nonsmokers can find relief. I do however think the discussion is good. I think also further research will show a larger relationship with the respiratory system. In fact there is a school of thought out there that all headaches may begin there or in parts of the digestive system. If smoking were to be a cluster cause it may just be found there and make much more sense. . carry on. I do not understand your relating of other mental illnesses is it just due to the fact that 90% of schizophrenics smoke. thus we also suffer dementia? Or is it something I missed. Does your husband still smoke. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 11th, 2008, 6:30am on 05/11/08 at 03:31:00, MJ wrote:
MJ I have given a more personal reply in a PM to you. On the thread though, since further information and discussion is good for the topic, would you be able to recall where you got that information ? Would you be able to find it again ? Thank you. |
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Title: Re: CH history, genetic link and nicotine Post by LeeS on May 12th, 2008, 11:54am on 05/10/08 at 18:57:34, Annette wrote:
I don't think a transcript exists, but this, I believe, is the latest published report in this respect: Quote:
Full text here: http://www.neurology.org/cgi/content/full/66/12/1888 -Lee |
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Title: Re: CH history, genetic link and nicotine Post by MJ on May 12th, 2008, 2:40pm The original leanings of this thread were based on an this article from 2004 "A polymorphism of the hypocretin receptor 2 gene is associated with cluster headache."http://www.ncbi.nlm.nih.gov/pubmed/15477554 I believe this was first noted in 1999. The theory seems to have been heavily contradicted in further reading on the same site. 2007 "The G1246A polymorphism in the hypocretin receptor 2 gene is not associated with treatment response in cluster headache." http://www.ncbi.nlm.nih.gov/pubmed/17376114?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=2&log$=relatedarticles&dbfrom=pubmed 2007 The 1246G-->A polymorphism of the HCRTR2 gene is not associated with migraine. or clusters http://www.ncbi.nlm.nih.gov/pubmed/17645762?ordinalpos=1&itool=EntrezSystem2.PEntrez.Pubmed.Pubmed_ResultsPanel.Pubmed_DiscoveryPanel.Pubmed_Discovery_RA&linkpos=5&log$=relatedarticles&dbfrom=pubmed From LeeS link 2006 "Association of the HCRTR2 gene was not replicated in this large dataset, even when the data were stratified into distinct populations" Goes to show what we think today may not be true tommorrow and what we want tommorrow we can find from yesterday. The science of the mind is an ever changing art. |
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Title: Re: CH history, genetic link and nicotine Post by Annette on May 12th, 2008, 4:43pm MJ, Please read the articles in full if you can. The 1st article about polymorphism for the gene not corresponding to treatment : the final result is that although people have the genes, they dont respond to the same meds the same way. It simply means there are other factors influencing their CH. It doesnt mean the gene is not associated with CH. The 2nd article says that the same gene that was found to be associated with CH is not found to be associated with migraine. Although migraine is very close to CH but genetically its a different entity all together. The 3rd article tested a larger population of CHers and found that the majority does not have this gene and still have CH. It simply means people can develop CH via other mechanisms. All in all, they do not discount the fact that the gene has been found to be associated with CH. They just showed that CH is much more complicated than one allele of the gene. |
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Title: Re: CH history, genetic link and nicotine Post by cluster on May 13th, 2008, 2:51am Quote:
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