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        Cluster Headache Help and Support >> Medications, Treatments, Therapies >> Might CH be an aspect of a larger disorder?
        
(Message started by: georgej on Feb 10^th, 2007, 12:05pm)

Title: Might CH be an aspect of a larger disorder?
Post by georgej on Feb 10^th, 2007, 12:05pm

This link was provided by starlight in another thread. I'd hate to see it get lost, since I think it's interesting, and deserves some discussion:

http://www.neurologyreviews.com/jun06/headache.html

Not all of it is concerned with CH, specifically, but to quote in part:

"In hypnic "alarm clock headaches," which are most commonly observed in elderly women and produce bilateral pain and nausea, evidence of the benefit of lithium has produced interest in the pathways of neurologic signaling on which this drug acts to identify etiologic events. "Mutations at the presumptive site of action of lithium are associated with disrupted circadian rhythmicity in animal models," Dr. Shapiro observed. He indicated that these may also have a relation to the often-observed circadian regularity of cluster headache attacks and that they may also respond to lithium therapy. Moreover, cluster headache periods often have a perisolstitial pattern, signifying greater activity near solstices, which are times in the year of "maximum discordance between internal and external clocks."

As one last example, Dr. Shapiro identified a relationship between cluster headaches and narcolepsy. Evidence that both are mediated by hypocretin, an orexin precursor, provides an important potential link that may explain both.
"I would propose that narcolepsy and cluster headache are reciprocal disorders," Dr. Shapiro said. He listed several parallels, including the fact that orexinergic neurons and CSF orexin A are diminished in human narcolepsy while orexinergic neurons are located in brain regions of increased metabolic activity and tissue density in cluster headache patients. Also, some mutations in the gene for the orexin-2 receptor increase the susceptibility to cluster headache. Dr. Shapiro speculates that orexin B may be increased in the brain during cluster headache attacks. If this is the case, he suggests that this disorder may be a result of hyperactivity of orexinergic systems and that there may be a potential for the therapeutic use of selective orexin-2 receptor antagonists in cluster headache, an approach that requires testing.

While much of the support for the importance of biorhythms in defining the risk of migraine and headache has been drawn from disparate sources, the point emphasized by Dr. Shapiro is that a reorientation might be warranted to reconsider headache in a broader context. While the risk of headache in any given individual may be mediated by some combination of environmental factors, genetics, and disturbances in biorhythms, headache may not be best evaluated in many patients as an isolated phenomenon but as just one manifestation of a syndrome in which symptoms share an etiology."

Thoughts?

Best,

George

Title: Re: Might CH be an aspect of a larger disorder?
Post by georgej on Feb 10^th, 2007, 2:28pm

Hypocretins are produced by the hypothalamus. I see that GSK is attempting to develop the first and only hypocretin antagonist. Might this be of interest to us at some point?

Best,

George

Title: Re: Might CH be an aspect of a larger disorder?
Post by BB on Feb 10^th, 2007, 3:45pm

The observation makes a lot of sense. I have always thought that there are many different aspects to CH and many people although all have CH exhibit fairly different symptoms and responses to various meds.

In a way it may be compared to diabetes. Every diabetic has problems with insulin but the problems range from not enough, to too much, to insulin resistance to irregular levels being produced. There are also different types of diabetes, such as type I insulin dependent, type II non insulin dependent, syndrome X insulin resistant, and diabetes insipidus,etc. The symptoms are different requiring different treatments .

CH, SUNCT, migraines, Hemicrania, Narcolepsy, Schizophrenia etc ... may all share the same aetiology with different sets of symptoms depending on which pathways/neurotransmittors are effected ?

The great search continues. One of these days we will achieve a more complete understanding of CH and with it much better control of it than now.

Annette

Title: Re: Might CH be an aspect of a larger disorder?
Post by starlight on Feb 10^th, 2007, 10:21pm

George,

Thanks for posting this article so other people can read it. This article somehow "clicked" with me. I told a good friend of mine about it today and mentioned to her that I have always felt that there was something "wrong" with my sleep overall (and I understand that not everyone will relate)--recalling several dreams everynight in complete detail is only one thing I will mention when anyone and everyone I have ever asked says they don't. And I get these headaches real frequently at night, so anyway, I don't know, somehow it gives me a different perspective.

Title: Re: Might CH be an aspect of a larger disorder?
Post by TonyG1 on Feb 11^th, 2007, 7:07pm

on 02/10/07 at 22:21:51, starlight wrote:

George,

...recalling several dreams everynight in complete detail is only one thing I will mention when anyone and everyone I have ever asked says they don't....

Starlight - When I'm in cycle, my dreams are the most vivid and I recall them in great detail.... In cycle, I'm always a night hit person. When I'm not in cycle I rarely recall my dreams ... [smiley=huh.gif]

Title: Re: Might CH be an aspect of a larger disorder?
Post by starlight on Feb 11^th, 2007, 9:53pm

Tony,

I have read on here before other CHers saying that they don't dream much generally. I'm not sure what it means that I do dream a lot (or if it means anything but I definitely haven't met anyone that remembers their dreams as much as I do). That is interesting that you dream a lot in cycle. Maybe something
changes with your sleep quality (other than the headaches themselves) while in cycle.
The part of that article linked above that blew my mind is where Dr. Shapiro says "I would propose that narcolepsy and cluster headache are reciprocal disorders", and "list(s) several parallels".
Maybe there is something different about sleep structure of CHers (at least while in cycle)--I feel like there must be or why these crazy headaches that awaken so many of us from sleep.
All best, STar

Title: Re: Might CH be an aspect of a larger disorder?
Post by Derrick on Feb 13^th, 2007, 1:40am

on 02/11/07 at 19:07:14, TonyG1 wrote:

That's pretty cool, I though I was the only one who noticed that about dreaming while in cycle.

Title: Re: Might CH be an aspect of a larger disorder?
Post by alienspacebabe on Feb 18^th, 2007, 1:53am

on 02/11/07 at 19:07:14, TonyG1 wrote:

The same is true for me....

Lizzie