Quote:Neurology 2001;56:1233-1236
Increased familial risk of cluster headache
M. Leone, MD;, M.B. Russell, MD, PhD, DrMedSci;, A. Rigamonti, MD;, A. Attanasio, MD;, L. Grazzi, MD;, D. D’Amico, MD;,
S. Usai, MD; and G. Bussone, MD
From the Carlo Besta National Neurological Institute (Drs. Leone, Rigamonti, Attanasio, Grazzi, D’Amico, Usai, and Bussone), Milan, Italy; and Department of Neurology (Dr. Russell), Copenhagen University Hospital, University of Copenhagen, Denmark.
The authors studied the occurrence of cluster headache in the families of 220 Italian patients with cluster headache. A positive family history was found in 20% (44/220) of the families. Compared with the general population, first-degree relatives had a 39-fold significantly increased risk of cluster headache. Second-degree relatives had an eightfold significantly increased risk. The increased familial risk strongly supports the hypothesis that cluster headache has a genetic component in some families.
Increased familial risk of cluster headache -- Leone et al. 56 (9) 1233 -- Neurology
Bob, don't wish to get off to a bad start, or have an argument with the Alumni here. Just my 2 cents worth...
You probably, fully realise that the study is only statistical evidence, not conclusive scientific proof of a carried gene in "hereditary" cases of CH.
The study raises a few questions for me.
Where is the control group for this study?
Families that arrive for clinical trials already suspect hereditary involvement, which in my view, shows significant bias within the study group. Where study participants are sourced often plays a major role in the outcome(s). I cannot obtain a full copy of the study to research it, perhaps to my peril here, in posting about it...
The quote does not suggest whether or not trial participants, or their offspring met IHS criteria for CH.
To answer Tammygue's original question - My Grandmother had Migraine all her adult life, no CH.
I have had CH from birth, first presenting at age 4, also experiencing Migraine myself. So yes it can happen young. As a contributor/moderator on the Aussie CH site, I have seen perhaps 3 or 4 cases of childhood CH, confirmed by a specialist using IHS diagnostic criteria, none of which had any family members with any other reported headache type.
I am not doubting the study results, the scientists know more than I and I defer to their expertise. I can only go with what I have found in my research on familial CH and my experience in dealing with CH patients online. If genetic in origin, the gene responsible for CH is yet to be identified. When identified, it has to be established that it is in fact, hereditary. This has not yet been validated in genetic studies. It is still a target in genetic studies, but I await (with interest) the outcomes of genetic studies into hereditary CH and whether a specific gene can be named and/or carried from parent to offspring.
As I posted when asked about this in Oz:
Hereditary CH (My summary):
Firstly, although there are a small group of families that suspect hereditary involvement in their CH conditions, the evidence for inheritance is strictly statistical, anecdotal or at best, strongly suspected. No single hereditary gene has yet been implicated in CH.
In layman's terms; the jury is still out on hereditary cluster headache, more studies are needed. If you do the maths, the incidence (or prevalence) of CH occurring within families is statistically about the same (very marginally higher) as would be the occurrence of CH in the general population. The difference in reported familial CH and CH occurring in the general population purely by chance, is a small one. At least 2 genes have been identified as hereditary in Migraine headache, specifically, not cluster headache at this stage. These 2 genes do not specifically show up in CH patients.
A selection from the current literature on genes sought in CH conditions:
We have established a large cohort of CH families in which we have previously reported a genome-wide linkage scan, isolating a number of putative linkage loci. Despite this, a single causative gene is yet to be identified, largely due to substantial genetic heterogeneity. The significance of these variants in CH pathogenesis remains to be determined; however these results provide further evidence for a potential genetic predisposition to this debilitating disorder. Potential linkage was identified at four possible disease loci in Danish kindreds, yet no single chromosome location generated a lod or NPL score of recognized significance. No deleterious sequence variants of the HCRTR2 gene were detected by comparison to wild-type sequence. Association of the HCRTR2 gene was not replicated in this large dataset, even when the data were stratified into distinct populations.
CONCLUSIONS: Cluster headache is a complex genetic disorder, with possible phenotypic and genetic heterogeneity compounding attempts at gene identification.
thejournalofheadacheandpain.com/conten/pdf/1129-2377-1-
S1-P34.pdf
ncbi.nlm.nih.gov/pubmed/16801656
The jury is still out on that one, I reckon.
Cheers, Ben.