Theory of mind: a new perspective on cluster headache-a cross-sectional study.

INTRODUCTION: Theory of mind (ToM) is the ability to attribute mental states of self and others, such as beliefs (cognitive ToM) and feelings (affective ToM). Based on the role of the hypothalamus in pain and social cognition, our aim is to determine whether ToM is impaired in patients with cluster headache (CH). METHODS: Cross-sectional study in which 31 episodic cluster headache (ECH) patients outside the bout and 20 matched controls carried out social cognition and executive function tasks. Patients were recruited from an outpatient Headache Unit. RESULTS: Patients performed worse than healthy controls at cognitive ToM (t = 4.2, p < 0.001) task but not at affective ToM. Executive function was also impaired (t = 4.8, p < 0.001) and higher scores at anxiety and depression questionnaires (t = - 2.9, p = 0.006; t = - 3.6, p = 0.001) were reported. There was no correlation between ToM scores and executive function, anxiety and depression symptoms, or disease duration and severity. DISCUSSION: Our results suggest that ECH patients can perceive other people's or selves' feelings (affective ToM) but have more difficulties than healthy subjects at recognizing beliefs (cognitive ToM).

Cognitive Performance in Episodic Cluster Headache.

BACKGROUND: Cluster headache is one of the most disabling of all headache conditions. Although some studies have investigated the psychological profile of patients with cluster headache, research on its impact on cognitive function in patients with episodic cluster headache outside the cluster bout is scant. METHODS: Cross-sectional study to evaluate various aspects of neuropsychological assessment and cognitive function including working memory, selective attention, verbal fluency, and executive function in 40 patients with episodic cluster headache. The patients were compared with 40 age-, gender-, and level of education-matched healthy controls. RESULTS: Episodic cluster headache patients performed significantly worse than healthy controls on all cognitive tests, except for the Interference Score (P = 0.281). They had significantly higher Hospital Anxiety Scale scores (P = 0.002). However, we found no significant association between cognitive performance, anxiety, sleep quality, and disease duration. CONCLUSIONS: Patients with episodic cluster headache outside the bout showed worse executive functioning, working memory, language, and selective attention compared with healthy controls, regardless of the duration of disease or sleep quality.