The sensitivity to change of the cluster headache quality of life scale assessed before and after deep brain stimulation of the ventral tegmental area

Davide Cappon; Agata Ryterska; Harith Akram; Susie Lagrata; Sanjay Cheema; Jonathan Hyam; Ludvic Zrinzo; Manjit Matharu; Marjan Jahanshahi

doi:10.1186/s10194-021-01251-5

The sensitivity to change of the cluster headache quality of life scale assessed before and after deep brain stimulation of the ventral tegmental area

J Headache Pain. 2021 Jun 6;22(1):52. doi: 10.1186/s10194-021-01251-5.

Authors

Davide Cappon^{1

2

3}, Agata Ryterska^{1

4}, Harith Akram¹, Susie Lagrata⁵, Sanjay Cheema⁴, Jonathan Hyam¹, Ludvic Zrinzo¹, Manjit Matharu⁴, Marjan Jahanshahi^{6

7}

Affiliations

¹ Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, University College London (UCL) Institute of Neurology, National Hospital for Neurology and Neurosurgery, 33 Queen Square, WC1N 3BG, London, UK.
² Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife, Harvard Medical School, Boston, MA, USA.
³ Deanna and Sidney Wolk Center for Memory Health, Hebrew SeniorLife, Boston, MA, USA.
⁴ Department of Psychology, Queen Mary University of London, London, UK.
⁵ Headache and Facial Pain Group, UCL Queen Square Institute of Neurology, The National Hospital for Neurology and Neurosurgery, London, UK.
⁶ Unit of Functional Neurosurgery, Department of Clinical and Movement Neurosciences, University College London (UCL) Institute of Neurology, National Hospital for Neurology and Neurosurgery, 33 Queen Square, WC1N 3BG, London, UK. m.jahanshahi@ucl.ac.uk.
⁷ MOE Key Lab for Neuroinformation, The Clinical Hospital of Chengdu Brain Science Institute, University of Electronic Science and Technology of China, Chengdu, China. m.jahanshahi@ucl.ac.uk.

Abstract

Background: Cluster headache (CH) is a trigeminal autonomic cephalalgia (TAC) characterized by a highly disabling headache that negatively impacts quality of life and causes limitations in daily functioning as well as social functioning and family life. Since specific measures to assess the quality of life (QoL) in TACs are lacking, we recently developed and validated the cluster headache quality of life scale (CH-QoL). The sensitivity of CH-QoL to change after a medical intervention has not been evaluated yet.

Methods: This study aimed to test the sensitivity to change of the CH-QoL in CH. Specifically we aimed to (i) assess the sensitivity of CH-QoL to change before and following deep brain stimulation of the ventral tegmental area (VTA-DBS), (ii) evaluate the relationship of changes on CH-QoL with changes in other generic measures of quality of life, as well as indices of mood and pain. Ten consecutive CH patients completed the CH-QoL and underwent neuropsychological assessment before and after VTA-DBS. The patients were evaluated on headache frequency, severity, and load (HAL) as well as on tests of generic quality of life (Short Form-36 (SF-36)), mood (Beck Depression Inventory, Hospital Anxiety and Depression Rating Scale), and pain (McGill Pain Questionnaire, Headache Impact Test, Pain Behaviour Checklist).

Results: The CH-QoL total score was significantly reduced after compared to before VTA-DBS. Changes in the CH-QoL total score correlated significantly and negatively with changes in HAL, the SF-36, and positively and significantly with depression and the evaluative domain on the McGill Pain Questionnaire.

Conclusions: Our findings demonstrate that changes after VTA-DBS in CH-QoL total scores are associated with the reduction of frequency, duration, and severity of headache attacks after surgery. Moreover, post VTA-DBS improvement in CH-QoL scores is associated with an amelioration in quality of life assessed with generic measures, a reduction of depressive symptoms, and evaluative pain experience after VTA-DBS. These results support the sensitivity to change of the CH-QoL and further demonstrate the validity and applicability of CH-QoL as a disease specific measure of quality of life for CH.

Keywords: Cluster headache; Deep brain stimulation; Quality of life scale; Trigeminal autonomic cephalalgias.

MeSH terms

Cluster Headache* / therapy
Deep Brain Stimulation*
Humans
Pain
Quality of Life
Ventral Tegmental Area