A cross-sectional study conducted by researchers at the University of Granada's Institute of Neurosciences has revealed significant comorbidity patterns between cluster headache, fibromyalgia, and migraine, highlighting the complex interplay between these chronic pain conditions.
The observational study, carried out between 2020 and 2021, analyzed data from 91 cluster headache patients through a comprehensive survey distributed via the Spanish Association of Cluster Headache and Other Primary Headaches. The findings revealed that 57.1% of participants experienced cluster headache alongside at least one comorbid condition.
Distribution of Comorbidities
The study population showed distinct patterns of disease overlap:
- 42.9% experienced cluster headache alone
- 16.5% had both cluster headache and migraine
- 11% suffered from cluster headache and fibromyalgia
- 29.7% experienced all three conditions: cluster headache, fibromyalgia, and migraine
Gender Patterns and Clinical Impact
Notable gender differences emerged across the subgroups. While cluster headache alone was more common in males (61.5%), the presence of comorbidities showed a strong female predominance. Particularly striking was the 100% female representation in the cluster headache with fibromyalgia group.
The research team, led by Elena P. Calandre, found that patients with comorbid conditions, especially those with fibromyalgia, faced significantly greater challenges:
- Higher numbers of additional medical conditions
- More severe depression scores
- Increased sleep disturbances
- Lower health-related quality of life scores
Mental Health Concerns
A particularly alarming finding was the prevalence of suicidal ideation across all patient groups:
- 41% in cluster headache alone
- 33% in cluster headache with migraine
- 90% in cluster headache with fibromyalgia
- 37% in patients with all three conditions
Associated Medical Conditions
The study identified several common comorbidities across patient groups:
- Osteoarticular conditions (particularly osteoarthritis)
- Anxiety and depression
- Gastrointestinal disorders
- Cardiovascular conditions
- Chronic fatigue syndrome
- Multiple chemical sensitivity
- Food intolerance
Clinical Implications
The findings underscore the need for comprehensive patient assessment and management strategies. The research team emphasized the importance of careful screening and monitoring for suicide risk in clinical practice, particularly given the high rates of suicidal ideation observed.
The investigators called for additional population-based studies to further investigate the frequency and clinical relevance of these comorbidities, particularly focusing on suicide risk assessment with more robust outcome measures such as attempted suicide rates and mortality data.
