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A retrospective cohort study: is COVID-19 BNT162b2 mRNA vaccination a trigger factor for cluster headache?

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Abstract

Objectıve

Cluster headache (CH) is a coronavirus 2019 (COVID-19) vaccination-related adverse event. There are a few case reports of relapses or de novo cluster episodes following the vaccine. The disease's pathophysiology is still not clear. The most widely accepted mechanism is activation of the trigeminocervical complex (TCC). However, the correlation between vaccination and CH is unexplainable. Its goal is to compare the CH bouts of patients before and after the vaccine.

Methods

Patients with a history of CH and who had never experienced COVID-19 illness during the pandemic were included in this retrospective cohort analysis. The semi-structured survey was administered face to face to 24 CH patients (16 male). The headache features before and after vaccination were detailed in this survey.

Results

18 patients got vaccinated twice, and 6 of them had no vaccination. After the first vaccination, 83.3% of them had CH bout; after the second vaccination, 72.2% of them had CH bout. We divided headache episodes into three groups: (1) before vaccination, (2) after the first vaccination, and (3) after the second vaccination. The third group had a higher pain intensity (9.30 ± 0.630, p = 0.047) and remitting longer (20.00 ± 5.40 days, p = 0.019) than the other groups. The management of the 53.3% bouts after vaccinations was less effective than the usual episodes.

Conclusion

Most ECH patients experienced new bouts more intense and longer duration after vaccinations than their previous bouts, the mechanism, and pathogenesis of the bouts are the subject of future research. The new studies can be a light for understanding the CH pathophysiology more deeply.

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Availability of data and materials

The data and materials are available from the corresponding author upon reasonable request and are subject to ethical review.

Abbreviations

COVID-19:

Coronavirus disease-2019

CH:

Cluster headache

CCH:

Chronic cluster headache

ECH:

Episodic cluster headache

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

ICHD-3:

The International Classification of Headache Disorders, Third Edition

NRS:

Numeric Rating Scale

SPSS:

Statistical Package for Social Science

TVS:

Trigeminovascular complex

TCC:

Trigeminocervical complex

cGRP:

Calcitonin gene-related peptide

NO:

Nitric oxide

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Author information

Author notes

  1. Şenay Aydın

    Present address: Department of Neurology, Yedikule Chest Disease and Surgery Training and Research Hospital, University of Health Sciences, İstanbul, Türkiye

Authors and Affiliations

  1. Pain Department, Mersin City Training and Research Hospital, University of Health Sciences, 33240, Korukent Mah. 96015 Sok. Mersin Entegre Sağlık Kampüsü, Toroslar/Mersin, Türkiye

    Suna Aşkın Turan

Authors
  1. Suna Aşkın Turan
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Contributions

SAT: design of the work; acquisition, analysis, and interpretation of data; drafting and substantial review of the manuscript, review of the manuscript. ŞA: drafting and substantial review of the manuscript, review of the manuscript, supervision.

Corresponding author

Correspondence to Suna Aşkın Turan.

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Conflict of interest

All authors state that they have no financial or personal interests that could pose a conflict of interest concerning this study's findings. We are grateful to the participants.

Ethical approval

Clinical Research Ethics Committee of University of Health Sciences, Yedikule Chest Disease and Surgery Training and Research Hospital; 370/2023–13.07.2023.

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This research did not receive any specific grants from public, commercial, or non-profit funding bodies.

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Aşkın Turan, S., Aydın, Ş. A retrospective cohort study: is COVID-19 BNT162b2 mRNA vaccination a trigger factor for cluster headache?. Acta Neurol Belg (2024). https://doi.org/10.1007/s13760-024-02536-7

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