Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Cephalalgia ◽  
2021 ◽  
pp. 033310242110603
Author(s):  
Ignacio Elizagaray-García ◽  
Gabriela F Carvalho ◽  
Tibor M Szikszay ◽  
Waclaw M Adamczyk ◽  
Gonzalo Navarro-Fernández ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Headache Frequency ◽  
Chronic Tension Type Headache ◽  
Psychophysical Testing ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Neck Disability ◽  
Painful Area

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

A Prospective, Open-Label, Long-Term Study of the Efficacy and Tolerability of Topiramate in the Prophylaxis of Chronic Tension-Type Headache

Cephalalgia ◽  
2006 ◽  
Vol 26 (10) ◽  
pp. 1203-1208 ◽  
Author(s):  
C Lampl ◽  
S Marecek ◽  
A May ◽  
L Bendtsen
Keyword(s):  
Tension Type Headache ◽  
Headache Frequency ◽  
Open Label ◽  
Term Study ◽  
Chronic Tension Type Headache ◽  
Long Term Study ◽  
Efficacy Parameter ◽  
Type Headache

This open study evaluates the effectiveness and safety of topiramate for the prophylaxis of chronic tension-type headache. Fifty-one patients were enrolled, of whom 46 completed 24 weeks of treatment with topiramate. Daily dosing was titrated from 25 mg to 100 mg by treatment week 4. The primary efficacy parameter was headache frequency at weeks 13-24 compared with baseline. Headache frequency declined from 23.50 ± 5.32 days (baseline, mean, SD) to 12.58 ± 6.28 days at weeks 13-24 ( P < 0.0001), with frequency of severe headaches dropping from 8.18 to 3.14 days ( P < 0.0001). The average headache intensity dropped from 6.13 to 2.07 on the visual analogue scale ( P < 0.0001). These parameters were not significantly reduced at weeks 5-12. A 50% reduction in headache frequency was achieved in 73% of patients at weeks 13-24. Also improved were mood, sleep, quality of life (all parameters, P < 0.0001) as well as the Beck Depression Inventory-II ( P < 0.0001). In addition, a highly significant weight loss of 2.14 kg (mean) was observed between baseline (71.64 ± 10.65 kg) and week 24 [69.50 ± 10.04 kg (SD)] ( P < 0.0001). There were only few side-effects, none of these rated severe. The results provide preliminary confirmation of the efficacy and tolerability of topiramate in the prophylaxis of chronic tension-type headache.

scholarly journals Patient Profiling Based on Spectral Clustering for an Enhanced Classification of Patients with Tension-Type Headache

2020 ◽  
Vol 10 (24) ◽  
pp. 9109
Author(s):  
Oscar J. Pellicer-Valero ◽  
César Fernández-de-las-Peñas ◽  
José D. Martín-Guerrero ◽  
Esperanza Navarro-Pardo ◽  
Margarita I. Cigarán-Méndez ◽  
...  
Keyword(s):  
Spectral Clustering ◽  
Dynamic Pressure ◽  
Trigger Points ◽  
Tension Type Headache ◽  
Therapeutic Interventions ◽  
Headache Frequency ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Cluster 2

Profiling groups of patients in clusters can provide meaningful insights into the features of the population, thus helping to identify people at risk of chronification and the development of specific therapeutic strategies. Our aim was to determine if spectral clustering is able to distinguish subgroups (clusters) of tension-type headache (TTH) patients, identify the profile of each group, and argue about potential different therapeutic interventions. A total of 208 patients (n = 208) with TTH participated. Headache intensity, frequency, and duration were collected with a 4-week diary. Anxiety and depressive levels, headache-related burden, sleep quality, health-related quality of life, pressure pain thresholds (PPTs), dynamic pressure thresholds (DPT) and evoked-pain, and the number of trigger points (TrPs) were evaluated. Spectral clustering was used to identify clusters of patients without any previous assumption. A total of three clusters of patients based on a main difference on headache frequency were identified: one cluster including patients with chronic TTH (cluster 2) and two clusters including patients with episodic TTH (clusters 0–1). Patients in cluster 2 showed worse scores in all outcomes than those in clusters 0–1. A subgroup of patients with episodic TTH exhibited pressure pain hypersensitivity (cluster 0) similarly to those with chronic TTH (cluster 2). Spectral clustering was able to confirm subgrouping of patients with TTH by headache frequency and to identify a group of patients with episodic TTH with higher sensitization, which may need particular attention and specific therapeutic programs for avoiding potential chronification.

Generalized Neck-Shoulder Hyperalgesia in Chronic Tension-Type Headache and Unilateral Migraine Assessed by Pressure Pain Sensitivity Topographical Maps of the Trapezius Muscle

Cephalalgia ◽  
2009 ◽  
Vol 30 (1) ◽  
pp. 77-86 ◽  
Author(s):  
C Fernández-de-las-Peñas ◽  
P Madeleine ◽  
AB Caminero ◽  
ML Cuadrado ◽  
L Arendt-Nielsen ◽  
...  
Keyword(s):  
Pain Sensitivity ◽  
Trapezius Muscle ◽  
Tension Type Headache ◽  
Healthy Controls ◽  
Pressure Pain ◽  
Chronic Tension Type Headache ◽  
Pressure Pain Thresholds ◽  
Pressure Algometer ◽  
Type Headache ◽  
Topographical Maps

Spatial changes in pressure pain hypersensitivity are present throughout the cephalic region (temporalis muscle) in both chronic tension-type headache (CTTH) and unilateral migraine. The aim of this study was to assess pressure pain sensitivity topographical maps on the trapezius muscle in 20 patients with CTTH and 20 with unilateral migraine in comparison with 20 healthy controls in a blind design. For this purpose, a pressure algometer was used to assess pressure pain thresholds (PPT) over 11 points of the trapezius muscle: four points in the upper part of the muscle, two over the levator scapulae muscle, two in the middle part, and the remaining three points in the lower part of the muscle. Pressure pain sensitivity maps of both sides (dominant/non-dominant; symptomatic/non-symptomatic) were depicted for patients and controls. CTTH patients showed generalized lower PPT levels compared with both migraine patients ( P = 0.03) and controls ( P < 0.001). The migraine group had also lower PPT than healthy controls ( P < 0.001). The most sensitive location for the assessment of PPT was the neck portion of the upper trapezius muscle in both patient groups and healthy controls ( P < 0.001). PPT was negatively related to some clinical pain features in both CTTH and unilateral migraine patients (all P < 0.05). Side-to-side differences were found in strictly unilateral migraine, but not in those subjects with bilateral pain, i.e. CTTH. These data support the influence of muscle hyperalgesia in both CTTH and unilateral migraine patients and point towards a general pressure pain hyperalgesia of neck-shoulder muscles in headache patients, particularly in CTTH.

Tryptamine levels are low in plasma of chronic migraine and chronic tension-type headache

2014 ◽  
Vol 35 (12) ◽  
pp. 1941-1945 ◽  
Author(s):  
Giovanni D’Andrea ◽  
Domenico D’Amico ◽  
Gennaro Bussone ◽  
Andrea Bolner ◽  
Marco Aguggia ◽  
...  
Keyword(s):  
Chronic Migraine ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Type Headache

Interaction between anxiety, depression, quality of life and clinical parameters in chronic tension-type headache

2008 ◽  
Vol 12 (7) ◽  
pp. 886-894 ◽  
Author(s):  
Cecilia Peñacoba-Puente ◽  
César Fernández-de-las-Peñas ◽  
Jose L. González-Gutierrez ◽  
Juan C. Miangolarra-Page ◽  
Juan A. Pareja
Keyword(s):  
Quality Of Life ◽  
Tension Type Headache ◽  
Clinical Parameters ◽  
Chronic Tension Type Headache ◽  
Type Headache ◽  
Anxiety Depression

Stretch Reflex and Pressure Pain Thresholds in Chronic Tension-Type Headache Patients and Healthy Controls

Cephalalgia ◽  
2009 ◽  
Vol 29 (5) ◽  
pp. 556-565 ◽  
Author(s):  
A Peddireddy ◽  
K Wang ◽  
P Svensson ◽  
L Arendt-Nielsen
Keyword(s):  
Stretch Reflex ◽  
Tension Type Headache ◽  
Healthy Controls ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Chronic Tension Type Headache ◽  
Control Subjects ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Masseter Muscles

To compare the jaw-stretch reflex and pressure pain thresholds (PPT) in chronic tension-type headache (CTTH) patients and healthy controls, 30 patients (15 male and 15 female) and 30 age- and sex-matched healthy subjects were investigated. Stretch reflexes were recorded in the temporalis and masseter muscles and PPT was determined in the anterior temporalis, splenius capitis and masseter muscles. The results showed that the amplitude of the stretch reflex in CTTH patients was higher compared with control subjects ( P < 0.045), and higher in women compared with men in the right and left anterior temporalis muscles ( P < 0.009). There were no differences in the PPT value between CTTH and control subjects ( P > 0.509), whereas women showed significantly lower PPT measurements ( P < 0.046). The results demonstrated a facilitation of the stretch reflex pathways in CTTH patients that is unrelated to measures of pericranial sensitivity.

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