Abstract：
BACKGROUND: Cluster headache presents in an episodic and chronic form, between which patients can convert during the course of disease. We aimed to quantify the rate of cluster headache patients changing phenotype within one and five years and investigate the earlier proposed association between chronification and having side-shifting attacks.
METHODS: In total, 430 cluster headache patients well-characterized according to current International Classification of Headache Disorders criteria, who were all participants in a prior transition-study, were re-interviewed in an observational, retrospective, cross-sectional follow-up study design at the Danish Headache Center.
RESULTS: The transition rate for the whole cohort was 6.5% within one year and 19.8% within five years. The risk of becoming chronic if episodic was 4.0% within one year and 12.3% within five years. For conversion from chronic to episodic, the corresponding risk was 11.1% and 25.0%, respectively. Alterations in attack-side were reported in 32% of all chronic patients, generating an odds ratio of 2.24 of being chronic as opposed to episodic if experiencing side-shifting attacks.
CONCLUSIONS: A higher transition rate since the original cross-sectional study demonstrates cluster headache as a non-static condition. Identifying a risk of transition within one and five years, based on current phenotype along with high odds of being chronic when experiencing a shift of attack-side, offers a valuable clinical compass in the dialogue with the patient.
METHODS: In total, 430 cluster headache patients well-characterized according to current International Classification of Headache Disorders criteria, who were all participants in a prior transition-study, were re-interviewed in an observational, retrospective, cross-sectional follow-up study design at the Danish Headache Center.
RESULTS: The transition rate for the whole cohort was 6.5% within one year and 19.8% within five years. The risk of becoming chronic if episodic was 4.0% within one year and 12.3% within five years. For conversion from chronic to episodic, the corresponding risk was 11.1% and 25.0%, respectively. Alterations in attack-side were reported in 32% of all chronic patients, generating an odds ratio of 2.24 of being chronic as opposed to episodic if experiencing side-shifting attacks.
CONCLUSIONS: A higher transition rate since the original cross-sectional study demonstrates cluster headache as a non-static condition. Identifying a risk of transition within one and five years, based on current phenotype along with high odds of being chronic when experiencing a shift of attack-side, offers a valuable clinical compass in the dialogue with the patient.
摘要：
背景：丛集性头痛表现为发作性和慢性形式，患者可以在疾病过程中转换。我们旨在量化丛集性头痛患者在一年和五年内改变表型的比率，并研究较早提出的时间化与侧移发作之间的关联。
方法：总共，根据现行国际头痛疾病分类标准，430名丛集性头痛患者特征良好，他们都是先前过渡研究的参与者，在一次观察中被重新采访，回顾性,丹麦头痛中心的横断面随访研究设计。
结果：整个队列的过渡率在一年内为6.5％，在五年内为19.8％。如果发生偶发性，则成为慢性的风险在一年内为4.0％，在五年内为12.3％。从慢性转变为情节，相应的风险为11.1%和25.0%，分别。据报道，在所有慢性患者中，有32％的患者出现了发作侧的改变，如果经历侧移攻击，则产生2.24的慢性优势比，而不是发作性。
结论：自原始横断面研究以来，更高的过渡率表明丛集性头痛是一种非静态疾病。确定在一年和五年内过渡的风险，基于当前的表型以及在经历攻击侧转移时慢性的高几率，在与患者的对话中提供了一个有价值的临床指南针。
方法：总共，根据现行国际头痛疾病分类标准，430名丛集性头痛患者特征良好，他们都是先前过渡研究的参与者，在一次观察中被重新采访，回顾性,丹麦头痛中心的横断面随访研究设计。
结果：整个队列的过渡率在一年内为6.5％，在五年内为19.8％。如果发生偶发性，则成为慢性的风险在一年内为4.0％，在五年内为12.3％。从慢性转变为情节，相应的风险为11.1%和25.0%，分别。据报道，在所有慢性患者中，有32％的患者出现了发作侧的改变，如果经历侧移攻击，则产生2.24的慢性优势比，而不是发作性。
结论：自原始横断面研究以来，更高的过渡率表明丛集性头痛是一种非静态疾病。确定在一年和五年内过渡的风险，基于当前的表型以及在经历攻击侧转移时慢性的高几率，在与患者的对话中提供了一个有价值的临床指南针。
