• Emer O'Connor, Benjamin S Simpson, Henry Houlden, Jana Vandrovcova, and Manjit Matharu.
• Department of Neuromuscular Disorders, UCL Institute of Neurology, DMN, Institute of Neurology, Queen Square, London, WC1N 3BG, UK. e.oconnor@ucl.ac.uk.
• J Headache Pain. 2020 Apr 25; 21 (1): 37.

IntroductionThe population rate of familial cluster headache (CH) has been reported to be as high as 20% however this varies considerably across studies. To obtain a true estimate of family history in CH, we conducted a systematic review and meta-analysis of previously published data.MethodsOur systematic review involved a search of electronic databases (Medline, EMBASE, PubMed, CINAHL) to identify and appraise studies of interest utilising the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. To further ameliorate the accuracy of our analysis we included an additional unpublished cohort of CH patients recruited at a tertiary referral centre for headache, who underwent detailed family history with diagnostic verification in relatives. Data was extracted and meta-analysis conducted to provide a true estimation of family history.ResultsIn total, we identified 7 studies which fulfilled our inclusion criteria. The estimated true prevalence of CH patients with a positive family history was 6.27% (95% CI:4.65-8.40%) with an overall I2 of 73%. Fitted models for gender subgroups showed higher estimates 9.26% (95% CI: 6.29-13.43%) in females. However the I2 for the female model was 58.42% and significant (p = 0.047).ConclusionOur findings estimate a rate of family history in CH to be approximately 6.27% (95% CI: 4.65-8.40%). While estimates were larger for female probands, we demonstrated high heterogeneity in this subgroup. These findings further support a genetic role in the aetiology of CH.

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