Not All Severe Primary Headaches are Migraines - Tension Type Headaches are Far More Common Yet often Labelled as Migraines

Background: Tension-type headaches (TTH), together with migraines, are the most common primary headaches, affecting 80% of the general population. Stress is known to be a contributing factor to chronic tension-type headache (CTH), with research indicating that mental stress is the most commonly reported trigger and aggravating factor of a CTH episode. The study was conducted to find out the prevalence of TTH among youths of 18-25 age reporting frequent headache and to compare the perceived stress level among the diagnosed male and females of TTH. Methods: Perceived Stress Scale (PSS) rating and an IHS (International Headache Society) TTH Diagnostic questionnaire were used in this study. A sample of 150 students including 75 males and 75 females in the age group of 18-25 years complaining of frequent headache were taken from different colleges and universities located in Rewari district of Haryana. In the second phase, only the diagnosed cases of tension type headache participated in the study and fill the perceived stress scale questionnaire. After data collection, analysis of data using SPSS software was done which then further help in testing the hypothesis and extracting the result and inferences. Descriptive analysis of quantitative data expressed as mean and standard deviation. Mean and Chi square test were used for comparison of individual on quantitative parameters between groups. P value < 0.05 was considered statistically significant. Results: The mean age of subjects with TTH was 22.79 ±2.14. Prevalence of TTH among frequent headache sufferers is 68%. Out of 68% TTH cases 66.7% subjects have episodic TTH and 33.3% have chronic TTH. Value of PSS * Gender Pearson chi square is 5.151 at a significance value of .076 and it shows that there would be no significant differences exist between males and females on perceived stress score. Conclusion: TTH is more prevalent among females as compared to males. No significant differences exist between males and females on perceived stress scores.

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Headaches

Oxford Textbook of Pediatric Pain ◽

10.1093/med/9780198818762.003.0032 ◽

2021 ◽

pp. 329-342

Author(s):

Andrew D. Hershey

Keyword(s):

Early Recognition ◽

Primary Headache ◽

Primary Care Providers ◽

School Nurses ◽

Primary Headaches ◽

Care Providers ◽

Primary Headache Disorders ◽

Tension Type Headaches ◽

The Impact

This chapter discusses recurrent headaches, especially when episodic, which are much more likely to represent primary headache disorders. Primary headaches are intrinsic to the nervous system and are the disease itself. Early recognition of the primary headaches in patients should result in improved response and outcome, minimizing the impact of the primary headaches and disability. Primary headaches can be grouped into migraine, tension-type headaches, and trigeminal autonomic cephalalgia, and an additional grouping of rarer headaches without a secondary cause. The primary headache that has the greatest impact on a child’s quality of life and disability is migraine, and subsequently is the most frequent primary headache brought to the attention of parents, primary care providers, and school nurses.

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Prevalence and clinical characteristics of headache in adolescents: A Croatian epidemiological study

Cephalalgia ◽

10.1177/0333102413507636 ◽

2013 ◽

Vol 34 (4) ◽

pp. 289-297 ◽

Cited By ~ 7

Author(s):

Vlasta Vuković Cvetković ◽

Davor Plavec ◽

Arijana Lovrenčić-Huzjan ◽

Maja Strineka ◽

Dražen Ažman ◽

...

Keyword(s):

High School ◽

High School Students ◽

Clinical Characteristics ◽

Demographic Data ◽

Public Health Problem ◽

Primary Headaches ◽

School Students ◽

The Mean ◽

Tension Type Headaches ◽

Moderate Nausea

Background Headaches are often under-diagnosed in adolescents. The aim of this study was to examine the one-year prevalence of primary headaches among high school students in the city of Zagreb, the capital of Croatia. Methods This was a population-based, cross-sectional study. A total of 2350 questionnaires consisting of questions on demographic data, the presence and clinical characteristics of headaches were distributed among students in eight high schools; 2057 (87.5%) questionnaires were eligible for analysis. Results The mean age of the students was 17.2 ± 1.2 years; 50.2% were female. The prevalence of recurrent headache was 30.1% (620/2057), girls 35.1%, boys 25.2%. Among students with headache, 291 (46.9%) had migraine, and 329 (53.1%) had tension-type headaches (TTHs). The mean frequency of headaches was 5.66 per month in girls and 4.42 in boys; mean duration of a headache attack was 8.94 hours in girls and 8.37 hours in boys (NS). Unilateral headache was present in 31.6%, throbbing quality in 22.6%, dull in 34.4% of students; 22.4% had severe intensity and 70.3% moderate. Nausea was present in 4.0% always and in 14.7% frequently (girls 18.8%), photophobia in 41.3%, phonophobia in 63.2%, osmophobia in 23.9% (NS among genders). Almost 30% of students were disabled and stayed at home, more frequently boys. Girls (33.4%) were more likely to take drugs for every attack; number per month was 3.7. The results of this study showed that the prevalence of migraine among adolescents in Croatia was 16.5% for girls and 11.8% for boys; the prevalence of TTH was 18.4% for girls and 13.4% for boys. Conclusions The prevalence of self-reported headache among high school students in Zagreb is relatively high. Significant gender differences in frequency and clinical characteristics were observed. Primary headaches among adolescents are an important public health problem and should receive more attention from school and health authorities.

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DISORDERED PERSONALITY TRAITS IN PRIMARY HEADACHES

Social Behavior and Personality An International Journal ◽

10.2224/sbp.2005.33.5.495 ◽

2005 ◽

Vol 33 (5) ◽

pp. 495-502 ◽

Cited By ~ 2

Author(s):

Wei Wang ◽

Tingzhong Yang ◽

Huanqing Zhu ◽

Fuqiang Mao ◽

W. John Livesley ◽

...

Keyword(s):

Personality Traits ◽

Primary Headache ◽

Cognitive Distortion ◽

Self Report ◽

Primary Headaches ◽

Healthy Controls ◽

Social Avoidance ◽

Normal Personality ◽

Chronic Headaches ◽

Tension Type Headaches

Previous research has shown an association between primary headaches and some extreme features of normal personality traits, however, studies of the relationship between these headaches and the disordered or abnormal personality traits are still needed. This study sought to examine the disordered personality trait profiles in patients with migraine, tension-type headaches compared to healthy controls. Disordered personality traits were assessed using the Dimensional Assessment of Personality Pathology (DAPP; Livesley & Jackson, in press), a self-report measure of abnormal personality function that subsumes major models of normal personality, in 41 patients with chronic headaches (CTH), 34 frequent episodic tension-type headaches (FETH) and 48 migraine without aura, as well as 37 headache-free healthy control subjects. All patient groups scored significantly higher than healthy controls on Submissiveness, Cognitive Distortion, Identity Problems, Intimacy Problems, Social Avoidance, and Self-Harm. In addition, the migraine group scored higher on Submissiveness than did the FETH group. Our findings thus confirmed personality dysfunctions in primary headache sufferers.

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An Application of a Hybrid Intelligent System for Diagnosing Primary Headaches

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18041890 ◽

2021 ◽

Vol 18 (4) ◽

pp. 1890

Author(s):

Svetlana Simić ◽

José R. Villar ◽

José Luis Calvo-Rolle ◽

Slobodan R. Sekulić ◽

Svetislav D. Simić ◽

...

Keyword(s):

Intelligent System ◽

Primary Headache ◽

Primary Headaches ◽

Headache Disorders ◽

Data Set ◽

Primary Headache Disorders ◽

Hybrid Intelligent System ◽

Ihs Criteria ◽

Tension Type Headaches ◽

Quality Diagnosis

(1) Background: Modern medicine generates a great deal of information that stored in medical databases. Simultaneously, extracting useful knowledge and making scientific decisions for diagnosis and treatment of diseases becomes increasingly necessary. Headache disorders are the most prevalent of all the neurological conditions. Headaches have not only medical but also great socioeconomic significance. The aim of this research is to develop an intelligent system for diagnosing primary headache disorders. (2) Methods: This research applied various mathematical, statistical and artificial intelligence techniques, among which the most important are: Calinski-Harabasz index, Analytical Hierarchy Process, and Weighted Fuzzy C-means Clustering Algorithm. These methods, techniques and methodologies are used to create a hybrid intelligent system for diagnosing primary headache disorders. The proposed intelligent diagnostic system is tested with original real-world data set with different metrics. (3) Results: First at all, nine of 20 attributes – features from International Headache Society (IHS) criteria are selected, and then only five most important attributes from IHS criteria are selected. The calculation result based on the Calinski–Harabasz index value (178) for the optimal number of clusters is three, and they present three classes of headaches: (i) migraine, (ii) tension-type headaches (TTHs), and (iii) other primary headaches (OPHs). The proposed hybrid intelligent system shows the following quality metrics: Accuracy 75%; Precision 67% for migraine, 74% for TTHs, 86% for OPHs, and Average Precision 77%; Recall 86% for migraine, 73% for TTHs, 67% for OPHs, Average Recall 75%; F1 score 75% for migraine, 74% for TTHs, 75% for OPHs, and Average F1 score 75%. (4) Conclusions: The hybrid intelligent system presents qualitative and respectable experimental results. The implementation of existing diagnostics systems and the development of new diagnostics systems in medicine is necessary in order to help physicians make quality diagnosis and decide the best treatments for the patients.

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THE EFFECT OF AEROBIC EXERCISES ON PAIN, QUALITY OF LIFE IN PRIMARY HEADACHE

Journal of Experimental Biology and Agricultural Sciences ◽

10.18006/2021.9(spl-1-gcsgd_2020).s01.s09 ◽

2021 ◽

Vol 9 (Spl-1- GCSGD_2020) ◽

pp. S01-S09

Author(s):

Kiruthika Selvakumar ◽

Keyword(s):

Quality Of Life ◽

Aerobic Exercise ◽

Primary Headache ◽

World Health ◽

Primary Headaches ◽

Positive Effects ◽

Specific Protocol ◽

Tension Type Headaches ◽

Cluster Headaches

Headache disorders are among the most common disorders of the nervous system. According to World Health Organisation reports that almost half of all adults worldwide experience a headache in any given year. Based on research, headaches are classified into primary and secondary headaches. Depending on global prevalence the most common primary headaches are migraine, tension-type, and cluster headaches. If left untreated it can result in increased pain, decreased quality of life. The objective of this literature article is to analyze the effect of aerobic exercise on pain and quality of life among subjects with primary headaches like migraine, tension-type, and cluster headache and to discuss the current updates in the literature. In this article, relevant data available in PubMed, Cochrane, and Medline databases were retrieved from 2010 to February 2020 using the search terms aerobic exercise and tension-type headaches, aerobic exercise and migraine, aerobic exercise and cluster headaches, pain, and quality of life. The search strategy identified five articles that considered the effect of aerobic exercise on primary headaches like a migraine; tension-type and cluster. Results have positive effects for aerobic exercise on tension-type headache, migraine headache mainly on pain intensity, whereas the quality of life is less studied. On the other hand, these studies did not provide a specific protocol or parameter on exercise intensities. The availability of data on the influence of aerobic exercise on primary headaches though is limited, aerobic exercises are the best option for reducing pain and improving quality of life in primary headaches, especially for tension-type and migraine-type headaches.

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The Role of Vitamin D in Primary Headache–from Potential Mechanism to Treatment

Nutrients ◽

10.3390/nu12010243 ◽

2020 ◽

Vol 12 (1) ◽

pp. 243

Author(s):

Magdalena Nowaczewska ◽

Michał Wiciński ◽

Stanisław Osiński ◽

Henryk Kaźmierczak

Keyword(s):

Vitamin D ◽

Serum Vitamin ◽

Primary Headache ◽

Vitamin D Supplementation ◽

Cochrane Library ◽

Primary Headaches ◽

Serum Vitamin D ◽

Clinical Databases ◽

Vitamin D Levels ◽

Tension Type Headaches

Some studies have suggested a link between vitamin D and headache; however, the underlying physiological mechanisms are unclear. We aimed to summarize the available evidence on the relationship between vitamin D and the various subtypes of primary headaches, including migraines and tension-type headaches. All articles concerning the association between primary headache and vitamin D published up to October 2019 were retrieved by searching clinical databases, including: EMBASE, MEDLINE, PubMed, Google scholar, and the Cochrane library. All types of studies (i.e., observational, cross-sectional, case-control, and clinical trials) were included. We identified 22 studies investigating serum vitamin D levels in association with headaches. Eight studies also evaluated the effect of vitamin D supplementation on the various headache parameters. Among them, 18 studies showed a link between serum vitamin D levels and headaches, with the strongest connection reported between serum vitamin D levels and migraine. Overall, there is not enough evidence to recommend vitamin D supplementation to all headache patients, but the current literature indicates that it may be beneficial in some patients suffering headaches, mainly migraineurs, to reduce the frequency of headaches, especially in those with vitamin D deficiency.

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Headache in Children: Selected Factors of Vascular Changes Involved in Underlying Processes of Idiopathic Headaches

Children ◽

10.3390/children7100167 ◽

2020 ◽

Vol 7 (10) ◽

pp. 167

Author(s):

Joanna Sordyl ◽

Ewa Małecka-Tendera ◽

Beata Sarecka-Hujar ◽

Ilona Kopyta

Keyword(s):

Platelet Aggregation ◽

Current Knowledge ◽

Plasminogen Activator Inhibitor ◽

Cd40 Ligand ◽

Point Of View ◽

Primary Headaches ◽

Soluble Cd40 Ligand ◽

Potential Risk Factors ◽

Tension Type Headaches ◽

Endothelial Growth Factor

Headaches are common complaints in children. The International Classification of Headache Disorders, 3rd edition (beta version), defines more than 280 types of headaches. Primary headaches refer to independent conditions that cause pain and include migraine, tension-type headaches (TTH), and trigeminal autonomic cephalalgias (TACs). Several agents are involved in the pathogenesis of headaches. The factors associated with predisposition to atherosclerosis seem to be particularly important from the clinical point of view. The influence of obesity on the incidence of headaches has been well established. Moreover, idiopathic headaches, especially migraine, are thought to be one of the first signs of disorders in lipid metabolism and atherosclerosis. The risk of migraine increases with increasing obesity in children. Another factor that seems to be involved in both obesity and headaches is the adiponectin level. Recent data also suggest new potential risk factors for atherosclerosis and platelet aggregation such as brain-derived neurotrophic factor (BDNF), sCD40L (soluble CD40 ligand), serpin E1/PAI I (endothelial plasminogen activator inhibitor), and vascular endothelial growth factor (VEGF). However, their role is controversial because the results of clinical studies are often inconsistent. This review presents the current knowledge on the potential markers of atherosclerosis and platelet aggregation, which may be associated with primary headaches.

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Association of temporomandibular disorder-related pain with severe headaches—a Bayesian view

Clinical Oral Investigations ◽

10.1007/s00784-021-04051-y ◽

2021 ◽

Author(s):

Javed Ashraf ◽

Matti Närhi ◽

Anna Liisa Suominen ◽

Tuomas Saxlin

Keyword(s):

Regression Models ◽

Temporomandibular Disorder ◽

Credible Interval ◽

Research Impact ◽

Sensitivity Analyses ◽

Effect Estimate ◽

Primary Headaches ◽

Logistic Regression Models ◽

Tension Type Headaches

Abstract Objectives Association of temporomandibular disorders (TMD)-related pain with severe headaches (migraine and tension-type headaches [TTH]) was studied over a follow-up period of 11 years. Materials and methods The data used was from two nationally representative health surveys in Finland—the Health 2000 Survey (baseline) and the Health 2011 Survey (follow-up) (Bioresource Research Impact Factor [BRIF] 8901)—conducted by the Finnish Institute for Health and Welfare (THL). The primary dataset of the current study included a subset of the population undergoing a clinical oral examination, including TMD examination, at baseline, and answering the questions related to severe headaches, both at baseline and at follow-up (n = 530). From the primary dataset, two datasets were created to study the onset of migraine (dataset 1) and TTH (dataset 2) separately. Dataset 1 included participants healthy of migraine, but not other headaches, at baseline (n = 345), and dataset 2 participants healthy of TTH and other headaches, except migraine, at baseline (n = 464). Bayesian logistic regression models with weakly informative priors were utilized to assess the association of muscle-related TMD pain (mTMD) at baseline and temporomandibular joint-related TMD pain (jTMD) at baseline with the presence of migraine and TTH at follow-up. Results Neither of the baseline TMD-related pain variables were associated with the presence of migraine at follow-up (posterior effect estimates-0.12, 95% credible interval [CI] -0.49–0.24, and 0.11, 95% CI -0.38–0.59, for mTMD and jTMD, respectively), whereas mTMD at baseline (posterior effect estimate 0.36, 95% CI 0.02–0.69), but not jTMD at baseline (posterior effect estimate -0.32, 95% CI -0.94–0.25), was associated with the presence of TTH at follow-up. Bayesian sensitivity analyses revealed that the estimates of the regression models were stable, demonstrating sufficient validity and consistency of the estimates. Conclusion These results indicate that diverse mechanisms may exist behind the associations of TMD-related painful conditions with different types of severe headaches. Clinical relevance TMD-related pain is a frequent comorbidity of severe primary headaches. Therapy of severe primary headaches may thus benefit significantly with the incorporation of a multi-disciplinary clinical team.

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Headaches

Oxford Textbook of Paediatric Pain ◽

10.1093/med/9780199642656.003.0031 ◽

2013 ◽

pp. 307-318

Author(s):

Andrew D. Hershey

Keyword(s):

Early Recognition ◽

Primary Headache ◽

Primary Care Providers ◽

School Nurses ◽

Primary Headaches ◽

Care Providers ◽

Primary Headache Disorders ◽

Tension Type Headaches ◽

The Impact

Chapter 31 discusses recurrent headaches, especially when episodic, which are much more likely to represent primary headache disorders. Primary headaches are intrinsic to the nervous system and are the disease itself. Early recognition of the primary headaches in patients should result in improved response and outcome, minimizing the impact of the primary headaches and disability. Primary headaches can be grouped into migraine, tension-type headaches (TTHs), and trigeminal autonomic cephalalgia, and an additional grouping of rarer headaches without a secondary cause. The primary headache that has the greatest impact on a child’s quality of life and disability is migraine and subsequently is the most frequent primary headache brought to the attention of parents, primary care providers, and school nurses.

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