A

Cluster Headache Genomewide Association Study and Meta‐Analysis Identifies Eight Loci and Implicates Smoking as Causal Risk Factor

Annals of Neurology, vol. 94, pp. 713–726

Abstract

OBJECTIVE: The objective of this study was to aggregate data for the first genomewide association study meta-analysis of cluster headache, to identify genetic risk variants, and gain biological insights. METHODS: A total of 4,777 cases (3,348 men and 1,429 women) with clinically diagnosed cluster headache were recruited from 10 European and 1 East Asian cohorts. We first performed an inverse-variance genomewide association meta-analysis of 4,043 cases and 21,729 controls of European ancestry. In a secondary trans-ancestry meta-analysis, we included 734 cases and 9,846 controls of East Asian ancestry. Candidate causal genes were prioritized by 5 complementary methods: expression quantitative trait loci, transcriptome-wide association, fine-mapping of causal gene sets, genetically driven DNA methylation, and effects on protein structure. Gene set and tissue enrichment analyses, genetic correlation, genetic risk score analysis, and Mendelian randomization were part of the downstream analyses. RESULTS: The estimated single nucleotide polymorphism (SNP)-based heritability of cluster headache was 14.5%. We identified 9 independent signals in 7 genomewide significant loci in the primary meta-analysis, and one additional locus in the trans-ethnic meta-analysis. Five of the loci were previously known. The 20 genes prioritized as potentially causal for cluster headache showed enrichment to artery and brain tissue. Cluster headache was genetically correlated with cigarette smoking, risk-taking behavior, attention deficit hyperactivity disorder (ADHD), depression, and musculoskeletal pain. Mendelian randomization analysis indicated a causal effect of cigarette smoking intensity on cluster headache. Three of the identified loci were shared with migraine. INTERPRETATION: This first genomewide association study meta-analysis gives clues to the biological basis of cluster headache and indicates that smoking is a causal risk factor. ANN NEUROL 2023;94:713-726.

Authors 93

  1. Oslo University Hospital · Norwegian University of Science and Technology

    Affiliation as printed

    Department of Neurology Oslo University Hospital Oslo Norway

    Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital Oslo Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of Neurology, Oslo University Hospital, Oslo, Norway

    Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  2. Leiden University Medical Center

    Affiliation as printed

    Department of Human Genetics Leiden University Medical Center Leiden The Netherlands

    Department of Neurology Leiden University Medical Center Leiden The Netherlands

    Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

  3. Karolinska Institutet

    Affiliation as printed

    Centre for Cluster Headache, Department of Neuroscience Karolinska Institutet Stockholm Sweden

    Centre for Cluster Headache, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden

  4. University of Copenhagen · Glostrup Hospital · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Neurology, Danish Headache Center, Rigshospitalet‐Glostrup University of Copenhagen University Hospital Glostrup Denmark

    Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen University Hospital, Glostrup, Denmark

  5. Consejo Nacional de Investigaciones Científicas y Técnicas · University of Cologne · Universidad Nacional Arturo Jauretche · Hospital El Cruce · University Hospital Cologne

    Affiliation as printed

    Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany

    Neurosciences and Complex Systems Unit (EnyS), CONICET, Hospital El Cruce 'N. Kirchner' National University A. Jauretche (UNAJ) Florencio Varela Argentina

    Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany

    Neurosciences and Complex Systems Unit (EnyS), CONICET, Hospital El Cruce 'N. Kirchner', National University A. Jauretche (UNAJ), Florencio Varela, Argentina

  6. deCODE Genetics (Iceland)

    Affiliation as printed

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  7. University Hospital Cologne

    Affiliation as printed

    Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry Uniklinik Köln Cologne Germany

  8. University of Bologna

    Affiliation as printed

    Department of Pharmacy and Biotechnology University of Bologna Bologna Italy

    Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy

  9. Oslo University Hospital · Norwegian University of Science and Technology

    Affiliation as printed

    Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital Oslo Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  10. Karolinska Institutet

    Affiliation as printed

    Centre for Cluster Headache, Department of Neuroscience Karolinska Institutet Stockholm Sweden

    Centre for Cluster Headache, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden

  11. University of Copenhagen · Glostrup Hospital · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Neurology, Danish Headache Center, Rigshospitalet‐Glostrup University of Copenhagen University Hospital Glostrup Denmark

    Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen University Hospital, Glostrup, Denmark

  12. Leiden University Medical Center

    Affiliation as printed

    Department of Human Genetics Leiden University Medical Center Leiden The Netherlands

    Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands

  13. deCODE Genetics (Iceland)

    Affiliation as printed

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  14. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  15. deCODE Genetics (Iceland)

    Affiliation as printed

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  16. University of Helsinki · Institute for Molecular Medicine Finland · HiLIFE – Elämäntieteiden Instituutti

    Affiliation as printed

    Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki Helsinki Finland

    Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland

  17. National Yang Ming Chiao Tung University · Taipei Veterans General Hospital

    Affiliation as printed

    Brain Research Center National Yang Ming Chiao Tung University Taipei Taiwan

    Department of Neurology Taipei Veterans General Hospital Taipei Taiwan

    Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Neurology, Taipei Veterans General Hospital, Taipei, Taiwan

  18. University of Copenhagen · Glostrup Hospital · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Neurology, Danish Headache Center, Rigshospitalet‐Glostrup University of Copenhagen University Hospital Glostrup Denmark

    Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen University Hospital, Glostrup, Denmark

  19. Ghent University Hospital

    Affiliation as printed

    Department of Neurology Ghent University Hospital Ghent Belgium

    Department of Neurology, Ghent University Hospital, Ghent, Belgium

  20. Universitat Autònoma de Barcelona · Vall d'Hebron Institut de Recerca

    Affiliation as printed

    Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

  21. Leiden University Medical Center

    Affiliation as printed

    Department of Neurology Leiden University Medical Center Leiden The Netherlands

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

  22. Karolinska Institutet

    Affiliation as printed

    Centre for Cluster Headache, Department of Neuroscience Karolinska Institutet Stockholm Sweden

    Centre for Cluster Headache, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden

  23. Affiliation as printed

    Kiel Migraine and Headache Centre Kiel Germany

    Kiel Migraine and Headache Centre, Kiel, Germany

  24. University of Copenhagen · Glostrup Hospital · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Neurology, Danish Headache Center, Rigshospitalet‐Glostrup University of Copenhagen University Hospital Glostrup Denmark

    Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen University Hospital, Glostrup, Denmark

  25. Norwegian University of Science and Technology · St Olav's University Hospital

    Affiliation as printed

    BioCore–Bioinformatics Core Facility Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Clinic of Laboratory Medicine St. Olavs Hospital, Trondheim University Hospital Trondheim Norway

    Department of Clinical and Molecular Medicine Norwegian University of Science and Technology (NTNU) Trondheim Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    BioCore–Bioinformatics Core Facility Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  26. Institute of Biomedical Sciences, Academia Sinica · Academia Sinica

    Affiliation as printed

    Institute of Biomedical Sciences, Academia Sinica Taipei Taiwan

    Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan

  27. University of Helsinki · Institute for Molecular Medicine Finland · HiLIFE – Elämäntieteiden Instituutti

    Affiliation as printed

    Department of Mathematics and Statistics University of Helsinki Helsinki Finland

    Department of Public Health University of Helsinki Helsinki Finland

    Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki Helsinki Finland

    Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland

    Department of Public Health, University of Helsinki, Helsinki, Finland

    Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland

  28. University of Helsinki · Institute for Molecular Medicine Finland · HiLIFE – Elämäntieteiden Instituutti

    Affiliation as printed

    Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki Helsinki Finland

    Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland

  29. Universitat Autònoma de Barcelona · Instituto de Salud Carlos III · Centro de Investigación Biomédica en Red de Salud Mental · Vall d'Hebron Institut de Recerca · Vall d'Hebron Hospital Universitari · Universitat de Barcelona

    Affiliation as printed

    Biomedical Network Research Centre on Mental Health (CIBERSAM) Instituto de Salud Carlos III Madrid Spain

    Department of Genetics, Microbiology, and Statistics, Faculty of Biology Universitat de Barcelona Barcelona Spain

    Department of Psychiatry Vall d'Hebron University Hospital Barcelona Spain

    Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

    Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain

    Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain

    Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

  30. Azienda Ospedaliero-Universitaria di Modena

    Affiliation as printed

    AOU Policlinico Modena Modena University Hospital Modena Italy

    AOU Policlinico Modena, Modena University Hospital, Modena, Italy

  31. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  32. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  33. Affiliation as printed

    Kiel Migraine and Headache Centre Kiel Germany

    Kiel Migraine and Headache Centre, Kiel, Germany

  34. University of Antwerp · VIB-UAntwerp Center for Molecular Neurology

    Affiliation as printed

    Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIB Antwerp Belgium

    Department of Biomedical Sciences University of Antwerp Antwerp Belgium

    Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIB, Antwerp, Belgium

    Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium

  35. University of Copenhagen · Rigshospitalet

    Affiliation as printed

    Department of Clinical Immunology, Centre of Diagnostic Investigation Rigshospitalet Copenhagen Denmark

    Department of Clinical Medicine University of Copenhagen Copenhagen Denmark

    Department of Clinical Immunology, Centre of Diagnostic Investigation, Rigshospitalet, Copenhagen, Denmark

    Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark

  36. Zealand University Hospital Køge

    Affiliation as printed

    Department of Clinical Immunology Zealand University Hospital Køge Denmark

  37. Oslo University Hospital · University of Oslo · Norwegian University of Science and Technology · Akershus University Hospital

    Affiliation as printed

    Department of General Practice University of Oslo Oslo Norway

    Department of Neurology Akershus University Hospital Lørenskog Norway

    Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital Oslo Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of General Practice, University of Oslo, Oslo, Norway

    Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  38. Oslo University Hospital · University of Oslo · Norwegian University of Science and Technology

    Affiliation as printed

    Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital Oslo Norway

    Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway

    Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  39. Universitat Autònoma de Barcelona · Instituto de Salud Carlos III · Centro de Investigación Biomédica en Red de Salud Mental · Vall d'Hebron Institut de Recerca · Vall d'Hebron Hospital Universitari · Universitat de Barcelona

    Affiliation as printed

    Biomedical Network Research Centre on Mental Health (CIBERSAM) Instituto de Salud Carlos III Madrid Spain

    Department of Genetics, Microbiology, and Statistics, Faculty of Biology Universitat de Barcelona Barcelona Spain

    Department of Psychiatry Vall d'Hebron University Hospital Barcelona Spain

    Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

    Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain

    Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain

    Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

  40. National Hospital for Neurology and Neurosurgery · UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Headache and Facial Pain Group University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery London UK

    Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK

  41. Azienda Ospedaliero-Universitaria di Modena

    Affiliation as printed

    AOU Policlinico Modena Modena University Hospital Modena Italy

    AOU Policlinico Modena, Modena University Hospital, Modena, Italy

  42. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  43. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  44. University Hospital Schleswig-Holstein · University of Lübeck

    Affiliation as printed

    Department of Neurology University Hospital Schleswig‐Holstein Lübeck Germany

    Kiel Migraine and Headache Centre Kiel Germany

    Kiel Migraine and Headache Centre, Kiel, Germany

  45. University Hospital Schleswig-Holstein · University of Lübeck

    Affiliation as printed

    Department of Neurology University Hospital Schleswig‐Holstein Lübeck Germany

    Kiel Migraine and Headache Centre Kiel Germany

    Kiel Migraine and Headache Centre, Kiel, Germany

  46. University Medical Center Hamburg-Eppendorf

    Affiliation as printed

    Institute of Human Genetics University Medical Center Hamburg‐Eppendorf Hamburg Germany

    Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  47. University of Bonn · University Hospital Bonn

    Affiliation as printed

    Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn Bonn Germany

    Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn Bonn Germany

  48. Norwegian University of Science and Technology

    Affiliation as printed

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  49. Norwegian University of Science and Technology

    Affiliation as printed

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  50. Zuyderland Medisch Centrum

    Affiliation as printed

    Department of Neurology Zuyderland Hospital Heerlen The Netherlands

    Department of Neurology, Zuyderland Hospital, Heerlen, The Netherlands

  51. National Hospital for Neurology and Neurosurgery · UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Headache and Facial Pain Group University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery London UK

    Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK

  52. National Hospital for Neurology and Neurosurgery · UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Headache and Facial Pain Group University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery London UK

    Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK

  53. deCODE Genetics (Iceland)

    Affiliation as printed

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  54. Leiden University Medical Center

    Affiliation as printed

    Department of Clinical Epidemiology Leiden University Medical Center Leiden The Netherlands

    Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands

  55. Leiden University Medical Center

    Affiliation as printed

    Department of Human Genetics Leiden University Medical Center Leiden The Netherlands

    Department of Internal Medicine, Division of Endocrinology Leiden University Medical Center Leiden The Netherlands

    Einthoven Laboratory for Experimental Vascular Medicine Leiden University Medical Center Leiden The Netherlands

    Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands

    Department of Internal Medicine, Division of Endocrinology, Leiden University Medical Center, Leiden, The Netherlands

    Einthoven Laboratory for Experimental Vascular Medicine, Leiden University Medical Center, Leiden, The Netherlands

  56. Leiden University Medical Center

    Affiliation as printed

    Department of Neurology Leiden University Medical Center Leiden The Netherlands

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

  57. University Hospital Bonn · German Center for Neurodegenerative Diseases

    Affiliation as printed

    Department of Neurodegenerative Diseases and Geriatric Psychiatry University Hospital Bonn Bonn Germany

    German Center for Neurodegenerative Diseases (DZNE Bonn) Bonn Germany

    Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany

    German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn, Germany

  58. University Medical Center Hamburg-Eppendorf

    Affiliation as printed

    Department of Primary Medical Care University Medical Center Hamburg‐Eppendorf Hamburg Germany

    Department of Primary Medical Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  59. Affiliation as printed

    Kiel Migraine and Headache Centre Kiel Germany

    Kiel Migraine and Headache Centre, Kiel, Germany

  60. University of Antwerp · VIB-UAntwerp Center for Molecular Neurology

    Affiliation as printed

    Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIB Antwerp Belgium

    Department of Biomedical Sciences University of Antwerp Antwerp Belgium

    Complex Genetics of Alzheimer's Disease Group, Center for Molecular Neurology, VIB, Antwerp, Belgium

    Department of Biomedical Sciences, University of Antwerp, Antwerp, Belgium

  61. University of Iceland

    Affiliation as printed

    Faculty of Medicine, School of Health Sciences University of Iceland Reykjavik Iceland

    Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland

  62. University of Modena and Reggio Emilia · University of Miami

    Affiliation as printed

    Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy

    Department of Psychiatry and Behavioral Sciences University of Miami Miami FL

    Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

    Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL

  63. University of Modena and Reggio Emilia

    Affiliation as printed

    Department of Biomedical, Metabolic and Neural Sciences University of Modena and Reggio Emilia Modena Italy

    Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy

  64. Universitat Autònoma de Barcelona · Instituto de Salud Carlos III · Centro de Investigación Biomédica en Red de Salud Mental · Vall d'Hebron Institut de Recerca · Vall d'Hebron Hospital Universitari

    Affiliation as printed

    Biomedical Network Research Centre on Mental Health (CIBERSAM) Instituto de Salud Carlos III Madrid Spain

    Department of Psychiatry Vall d'Hebron University Hospital Barcelona Spain

    Department of Psychiatry and Forensic Medicine Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

    Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

    Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain

    Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

  65. University of Thessaly

    Affiliation as printed

    Department of Neurology, Faculty of Medicine University of Thessaly Volos Greece

    Department of Neurology, Faculty of Medicine, University of Thessaly, Volos, Greece

  66. Karolinska University Hospital · Karolinska Institutet

    Affiliation as printed

    Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden

    Department of Neurology Karolinska University Hospital Stockholm Sweden

    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Department of Neurology, Karolinska University Hospital, Stockholm, Sweden

  67. Leipzig University

    Affiliation as printed

    Institute of Social Medicine, Occupational Health and Public Health University of Leipzig Leipzig Germany

    Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany

  68. Danderyds sjukhus · Karolinska Institutet

    Affiliation as printed

    Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden

    Department of Neurology Danderyd Hospital Stockholm Sweden

    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Department of Neurology, Danderyd Hospital, Stockholm, Sweden

  69. deCODE Genetics (Iceland)

    Affiliation as printed

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  70. deCODE Genetics (Iceland)

    Affiliation as printed

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  71. St George's, University of London · King's College London

    Affiliation as printed

    Department of Medical & Molecular Genetics, Faculty of Life Sciences & Medicine King's College London London UK

    Molecular and Clinical Sciences Research Institute St. George's, University of London London UK

    Department of Medical & Molecular Genetics, Faculty of Life Sciences & Medicine King's College London London UK

    Molecular and Clinical Sciences Research Institute, St. George's, University of London, London, UK

  72. King's College London

    Affiliation as printed

    Department of Medical & Molecular Genetics, Faculty of Life Sciences & Medicine King's College London London UK

    Department of Medical & Molecular Genetics, Faculty of Life Sciences & Medicine King's College London London UK

  73. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  74. Leiden University Medical Center

    Affiliation as printed

    Department of Internal Medicine, Section of Gerontology and Geriatrics Leiden University Medical Center Leiden The Netherlands

    Department of Internal Medicine, Section of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands

  75. Ghent University Hospital

    Affiliation as printed

    Department of Neurology Ghent University Hospital Ghent Belgium

    Department of Neurology, Ghent University Hospital, Ghent, Belgium

  76. deCODE Genetics (Iceland) · University of Iceland

    Affiliation as printed

    Faculty of Medicine, School of Health Sciences University of Iceland Reykjavik Iceland

    deCODE genetics/Amgen Inc. Reykjavik Iceland

    Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland

    deCODE genetics/Amgen Inc., Reykjavik, Iceland

  77. Institute of Biomedical Sciences, Academia Sinica · Academia Sinica

    Affiliation as printed

    Institute of Biomedical Sciences, Academia Sinica Taipei Taiwan

    Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan

  78. Karolinska University Hospital · Karolinska Institutet

    Affiliation as printed

    Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden

    Department of Neurology Karolinska University Hospital Stockholm Sweden

    Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden

    Department of Neurology, Karolinska University Hospital, Stockholm, Sweden

  79. Norwegian University of Science and Technology · St Olav's University Hospital

    Affiliation as printed

    Department of Neurology and Clinical Neurophysiology St. Olavs Hospital, Trondheim University Hospital Trondheim Norway

    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway

    Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

  80. University of Copenhagen · Glostrup Hospital · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Neurology, Danish Headache Center, Rigshospitalet‐Glostrup University of Copenhagen University Hospital Glostrup Denmark

    Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen University Hospital, Glostrup, Denmark

  81. National Yang Ming Chiao Tung University · Taipei Veterans General Hospital

    Affiliation as printed

    Brain Research Center National Yang Ming Chiao Tung University Taipei Taiwan

    Department of Medical Research, Division of Translational Research Taipei Veterans General Hospital Taipei Taiwan

    Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Department of Medical Research, Division of Translational Research, Taipei Veterans General Hospital, Taipei, Taiwan

  82. UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Department of Neuromuscular Diseases, Institute of Neurology University College London London UK

    Department of Neuromuscular Diseases, Institute of Neurology, University College London, London, UK

  83. Leiden University Medical Center

    Affiliation as printed

    Department of Neurology Leiden University Medical Center Leiden The Netherlands

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

  84. University Medical Center Hamburg-Eppendorf

    Affiliation as printed

    Institute of Human Genetics University Medical Center Hamburg‐Eppendorf Hamburg Germany

    Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

  85. University of Bologna

    Affiliation as printed

    Department of Pharmacy and Biotechnology University of Bologna Bologna Italy

    Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy

  86. Affiliation as printed

    Glyfada Headache Center Glyfada Greece

    Glyfada Headache Center, Glyfada, Greece

  87. Universitat Autònoma de Barcelona · Vall d'Hebron Institut de Recerca · Vall d'Hebron Hospital Universitari

    Affiliation as printed

    Headache Unit, Neurology Department Vall d'Hebron University Hospital Barcelona Spain

    Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

    Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Departament de Medicina Universitat Autònoma de Barcelona, Vall d'Hebron Research Institute (VHIR) Barcelona Spain

  88. Karolinska Institutet

    Affiliation as printed

    Centre for Cluster Headache, Department of Neuroscience Karolinska Institutet Stockholm Sweden

    Centre for Cluster Headache, Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden

  89. National Hospital for Neurology and Neurosurgery · UCL Queen Square Institute of Neurology · University College London

    Affiliation as printed

    Headache and Facial Pain Group University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery London UK

    Headache and Facial Pain Group, University College London Queen Square Institute of Neurology and National Hospital for Neurology and Neurosurgery, London, UK

  90. Leiden University Medical Center

    Affiliation as printed

    Department of Human Genetics Leiden University Medical Center Leiden The Netherlands

    Department of Neurology Leiden University Medical Center Leiden The Netherlands

    Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands

    Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands

  91. University of Copenhagen · Glostrup Hospital · Copenhagen University Hospital · Rigshospitalet

    Affiliation as printed

    Department of Neurology, Danish Headache Center, Rigshospitalet‐Glostrup University of Copenhagen University Hospital Glostrup Denmark

    Novo Nordic Foundation Center for Protein Research University of Copenhagen Copenhagen Denmark

    Department of Neurology, Danish Headache Center, Rigshospitalet-Glostrup, University of Copenhagen University Hospital, Glostrup, Denmark

    Novo Nordic Foundation Center for Protein Research, University of Copenhagen, Copenhagen, Denmark

  92. The University of Texas at San Antonio Health Science Center · University of Cologne · University Hospital Bonn · German Center for Neurodegenerative Diseases · Cologne Excellence Cluster on Cellular Stress Responses in Aging Associated Diseases · University Hospital Cologne

    Affiliation as printed

    Cluster of Excellence Cellular Stress Responses in Aging‐associated Diseases (CECAD) University of Cologne Cologne Germany

    Department of Neurodegenerative Diseases and Geriatric Psychiatry University Hospital Bonn Bonn Germany

    Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne University of Cologne Cologne Germany

    German Center for Neurodegenerative Diseases (DZNE Bonn) Bonn Germany

    Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases University of Texas Health Sciences Center San Antonio TX

    Cluster of Excellence Cellular Stress Responses in Aging-associated Diseases (CECAD), University of Cologne, Cologne, Germany

    Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany

    Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany

    German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn, Germany

    Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases University of Texas Health Sciences Center San Antonio TX

  93. John‐Anker Zwart corresponding

    Oslo University Hospital · University of Oslo · Norwegian University of Science and Technology

    Affiliation as printed

    Department of Research and Innovation, Division of Clinical Neuroscience Oslo University Hospital Oslo Norway

    Institute of Clinical Medicine, Faculty of Medicine University of Oslo Oslo Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science Norwegian University of Science and Technology (NTNU) Trondheim Norway

    Department of Research and Innovation, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway

    Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway

    K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Norwegian Centre for Headache Research (NorHEAD), Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

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References 53