Dysfunction of the Central Nervous System in Chronic Whiplash and Tension-Type Headache

2020 ◽  
Author(s):  
Jens Astrup ◽  
Finn Gyntelberg ◽  
Anne-Marie Johansen ◽  
Anders Lei ◽  
Jacob Louis Marott
2021 ◽  
Author(s):  
Jens Astrup ◽  
Finn Gyntelberg ◽  
Anne-Marie Johansen ◽  
Anders Lei ◽  
Jacob Louis Marott

Abstract BackgroundThe purpose of this study is to support the hypothesis that the neuro-motor control of the neck muscles is impaired in the diseases of chronic whiplash and tension-type headache. This hypothesis is based on a previous study, and if confirmed, it indicates that the central nervous system may be part of the pathophysiology of these diseases. For further verification, we designed a laser tracking method for standardized and quantitative measurements of movements of head and hand. The hand was included as a presumed normal reference to the head movements.MethodsA new laser tracking instrument was designed to monitor the ability of a test-person to track a reference point on the wall by a laser fixed to the forehead or held in the hand. The reference point moves in runs of a circle or a square at three different speeds 10, 20 or 30 cm/sec thus providing 6 runs for both head and hand per test-person. We used a 1x1x1 m set-up geometry. The data of each run was processed on-line. Groups of 22 patients diagnosed with chronic whiplash associated disorder, 19 patients diagnosed with chronic tension-type headache and 37 control persons were compared.FindingsA small but highly significant dyscoordination of head movements was observed in both patients groups, and in whiplash also of the hand. InterpretationOur study confirms the hypothesis that the neuro-motor control of the neck muscles is impaired in both chronic whiplash and tension-type headache. In our view this observation implicates that the central nervous system may be involved in the primary pathology of both these diseases. Accordingly, we suggest a provisional term 'cervical dyssynergia' for these diseases, and suggest further studies along this paradigm.


Cephalalgia ◽  
2010 ◽  
Vol 30 (10) ◽  
pp. 1250-1267 ◽  
Author(s):  
Stuart Cathcart ◽  
Anthony H Winefield ◽  
Kurt Lushington ◽  
Paul Rolan

Stress is widely demonstrated as a contributing factor in tension-type headache (TTH). The mechanisms underlying this remain unclear at present. Recent research indicates the importance of central pain processes in tension-type headache (TTH) pathophysiology. Concurrently, research with animals and healthy humans has begun to elucidate the relationship between stress and pain processing in the central nervous system, including central pain processes putatively dysfunctional in TTH. Combined, these two fields of research present new insights and hypotheses into possible mechanisms by which stress may contribute to TTH. To date, however, there has been no comprehensive review of this literature. The present paper provides such a review, which may be valuable in facilitating a broader understanding of the central mechanisms by which stress may contribute to TTH.


Cephalalgia ◽  
2006 ◽  
Vol 26 (8) ◽  
pp. 940-948 ◽  
Author(s):  
S Ashina ◽  
L Bendtsen ◽  
M Ashina ◽  
W Magerl ◽  
R Jensen

Increased pain sensitivity in the central nervous system may play an important role in the pathophysiology of chronic tension-type headache (CTTH). Previous studies using pain thresholds as a measure of central pain sensitivity have yielded inconsistent results and only a few studies have examined perception of muscle pain without involvement of adjacent tissues. It has been suggested that suprathreshold testing might be more sensitive than threshold measurements in evaluation of central hyperexcitability in CTTH. The aim of the study was to compare pain ratings to suprathreshold single and repetitive (2 Hz) electrical stimulation of muscle and skin in cephalic (temporal and trapezius) and extracephalic (anterior tibial) regions between patients with CTTH and healthy subjects. In addition, we aimed to examine gender differences in pain ratings to suprathreshold stimulation and degree of temporal summation of pain between patients and controls. Pain ratings to both single and repetitive suprathreshold stimulation were higher in patients than in controls in both skin and muscle in all examined cephalic and extracephalic regions ( P < 0.04). Pain ratings to both single and repetitive suprathreshold electrical stimulation were significantly higher in female compared with male patients ( P < 0.001) and in female compared with male controls ( P ≤ 0.001). The degree of temporal summation of muscular and cutaneous pain tended to be higher in patients than in controls but the differences were not statistically different. This study provides evidence for generalized increased pain sensitivity in CTTH and strongly suggests that pain processing in the central nervous system is abnormal in this disorder. Furthermore, it indicates that suprathreshold stimulation is more sensitive than recording of pain thresholds for evaluation of generalized pain perception.


Author(s):  
Gladys Harrison

With the advent of the space age and the need to determine the requirements for a space cabin atmosphere, oxygen effects came into increased importance, even though these effects have been the subject of continuous research for many years. In fact, Priestly initiated oxygen research when in 1775 he published his results of isolating oxygen and described the effects of breathing it on himself and two mice, the only creatures to have had the “privilege” of breathing this “pure air”.Early studies had demonstrated the central nervous system effects at pressures above one atmosphere. Light microscopy revealed extensive damage to the lungs at one atmosphere. These changes which included perivascular and peribronchial edema, focal hemorrhage, rupture of the alveolar septa, and widespread edema, resulted in death of the animal in less than one week. The severity of the symptoms differed between species and was age dependent, with young animals being more resistant.


Author(s):  
John L.Beggs ◽  
John D. Waggener ◽  
Wanda Miller ◽  
Jane Watkins

Studies using mesenteric and ear chamber preparations have shown that interendothelial junctions provide the route for neutrophil emigration during inflammation. The term emigration refers to the passage of white blood cells across the endothelium from the vascular lumen. Although the precise pathway of transendo- thelial emigration in the central nervous system (CNS) has not been resolved, the presence of different physiological and morphological (tight junctions) properties of CNS endothelium may dictate alternate emigration pathways.To study neutrophil emigration in the CNS, we induced meningitis in guinea pigs by intracisternal injection of E. coli bacteria.In this model, leptomeningeal inflammation is well developed by 3 hr. After 3 1/2 hr, animals were sacrificed by arterial perfusion with 3% phosphate buffered glutaraldehyde. Tissues from brain and spinal cord were post-fixed in 1% osmium tetroxide, dehydrated in alcohols and propylene oxide, and embedded in Epon. Thin serial sections were cut with diamond knives and examined in a Philips 300 electron microscope.


Author(s):  
Ezzatollah Keyhani

Acetylcholinesterase (EC 3.1.1.7) (ACHE) has been localized at cholinergic junctions both in the central nervous system and at the periphery and it functions in neurotransmission. ACHE was also found in other tissues without involvement in neurotransmission, but exhibiting the common property of transporting water and ions. This communication describes intracellular ACHE in mammalian bone marrow and its secretion into the extracellular medium.


Author(s):  
S.S. Spicer ◽  
B.A. Schulte

Generation of monoclonal antibodies (MAbs) against tissue antigens has yielded several (VC1.1, HNK- 1, L2, 4F4 and anti-leu 7) which recognize the unique sugar epitope, glucuronyl 3-sulfate (Glc A3- SO4). In the central nervous system, these MAbs have demonstrated Glc A3-SO4 at the surface of neurons in the cerebral cortex, the cerebellum, the retina and other widespread regions of the brain.Here we describe the distribution of Glc A3-SO4 in the peripheral nervous system as determined by immunostaining with a MAb (VC 1.1) developed against antigen in the cat visual cortex. Outside the central nervous system, immunoreactivity was observed only in peripheral terminals of selected sensory nerves conducting transduction signals for touch, hearing, balance and taste. On the glassy membrane of the sinus hair in murine nasal skin, just deep to the ringwurt, VC 1.1 delineated an intensely stained, plaque-like area (Fig. 1). This previously unrecognized structure of the nasal vibrissae presumably serves as a tactile end organ and to our knowledge is not demonstrable by means other than its selective immunopositivity with VC1.1 and its appearance as a densely fibrillar area in H&E stained sections.


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