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Evaluation of premonitory spontaneous and nitroglycerin triggered symptoms among patients with cluster headache and migraine

A. González-Martínez, Diana Y. Wei, N. Karsan, K. Nagaraj, Helin Gosalia, P. Goadsby

Cephalalgia, 2025

164 participants · 2 citations

Abstract

Background Our knowledge of the presence and type of premonitory symptoms in patients with cluster headache is limited. Methods Premonitory symptom presence and type in a clinical cohort of cluster headache and migraine was collated retrospectively from clinical notes, alongside a cluster headache nitroglycerin triggered experimental group and an age-matched migraine nitroglycerin experimental group. Demographic data and premonitory symptoms in cluster headache and migraine patients were analysed. The primary focus was on premonitory symptom presence and phenotype in cluster headache patients, with secondary analysis exploring associated factors and comparing spontaneous and nitroglycerin-triggered symptoms in cluster headache and migraine cohorts. Results Among 164 cluster headache patients, 122/164 (74%) males, aged 45.9 ± 13.8 years (mean ± SD), 66/164 (40%) had chronic cluster headache and 32/164 (20%) had also comorbid migraine. Among them, 85% exhibited premonitory symptoms for which the presence was associated with oxygen treatment. No significant differences were found in symptom frequency between cluster headache and migraine cohorts or within spontaneous and nitroglycerin-triggered symptoms. Conclusions This study highlights recognizable spontaneous and nitroglycerin-triggered premonitory symptoms in cluster headache and factors potentially impacting cluster headache management, which may aid in tailoring treatment strategies for both conditions through the use of…

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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence. Reported size: 164 participants or records.

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