scholarly journals Has the Phase of the Menstrual Cycle Been Considered in Studies Investigating Pressure Pain Sensitivity in Migraine and Tension-Type Headache: A Scoping Review

2021 ◽  
Vol 11 (9) ◽  
pp. 1251
Author(s):  
Francisca Curiel-Montero ◽  
Francisco Alburquerque-Sendín ◽  
César Fernández-de-las-Peñas ◽  
Daiana P. Rodrigues-de-Souza
Keyword(s):  
Menstrual Cycle ◽  
Scoping Review ◽  
Observational Studies ◽  
Pain Sensitivity ◽  
Tension Type Headache ◽  
Risk Of Bias ◽  
Primary Headaches ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Type Headache

Objective: The aim of this scoping review was to identify if the phase of the menstrual cycle was considered in observational studies comparing pressure pain sensitivity between women with migraine or tension-type headache (TTH) and headache-free women. Methods: A systematic electronic literature search in PubMed, Medline, Web of Science, Scopus, and CINAHL databases was conducted. Observational studies including one or more groups with TTH and/or migraine comparing pressure pain thresholds (PPTs) were included. The methodological quality (risk of bias) was assessed with the Newcastle-Ottawa Scale. Authors, objectives, inclusion/exclusion criteria, size sample, female sample, tool to assess PPTs, mean age, and the use of any medication were extracted and analyzed independently by two authors. Results: From a total of 1404 and 1832 identified articles for TTH and migraine, 30 and 18 studies satisfied the criteria and were included. Nineteen (63.4%) studies assessing TTH patients and eleven (61.1%) assessing migraine patients showed a high risk of bias. The most common flaws were attributed to improper selection of control and control over other additional factors. Based on the systematic review, just one study including TTH and one including migraine patients considered the menstrual cycle. Conclusion: The results of this scoping review identified that the phase of the menstrual cycle has been rarely considered in studies investigating sensitivity to pressure pain in primary headaches, such as TTH or migraine, although there is evidence showing the relevance of the phase of the menstrual cycle in pain perception.

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.

Trigger points are associated with widespread pressure pain sensitivity in people with tension-type headache

Cephalalgia ◽  
2016 ◽  
Vol 38 (2) ◽  
pp. 237-245 ◽  
Author(s):  
María Palacios-Ceña ◽  
Kelun Wang ◽  
Matteo Castaldo ◽  
Amparo Guillem-Mesado ◽  
Carlos Ordás-Bandera ◽  
...  
Keyword(s):  
Pain Sensitivity ◽  
Tibialis Anterior Muscle ◽  
Trigger Points ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Cross Sectional ◽  
Pressure Pain ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Type Headache

Objective To investigate the association between trigger points (TrPs) and widespread pressure pain sensitivity in people with tension-type headache (TTH) and to determine if this association is different between frequent episodic (FETTH) or chronic (CTTH) headache. Design A cross-sectional study. Methods One hundred and fifty-seven individuals (29% male) with TTH participated. Clinical features of headache, i.e., intensity, duration, and frequency, were recorded in a headache diary. Active and latent TrPs were bilaterally explored in the temporalis, masseter, suboccipital, upper trapezius, sternocleidomastoid, and splenius capitis muscles. Pressure pain thresholds (PPT) were assessed over the trigeminal area (i.e., temporalis muscle), extra-trigeminal (i.e., C5/C6 zygapophyseal joint), and two distant pain-free points (i.e., second metacarpal and tibialis anterior muscle). Results Eighty (51%) patients were classified as FETTH, whereas 77 (49%) were classified as CTTH. No differences in the number of either active or latent TrPs (all p > 0.171) or widespread pressure pain sensitivity (all p > 0.351) were observed between FETTH and CTTH groups. The number of active and latent TrPs was significantly and negatively associated with PPTs: The higher the number of active or latent TrPs, the lower the widespread PPT, and the more generalized sensitization. This association was stronger within the FETTH group than the CTTH group. Conclusions This study found that the number of TrPs in head and neck/shoulder muscles was associated with widespread pressure hypersensitivity independently of the frequency of 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.

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.

Bilateral, wide-spread, mechanical pain sensitivity in children with frequent episodic tension-type headache suggesting impairment in central nociceptive processing

Cephalalgia ◽  
2010 ◽  
Vol 30 (9) ◽  
pp. 1049-1055 ◽  
Author(s):  
César Fernández-de-las-Peñas ◽  
Daniel M Fernández-Mayoralas ◽  
Ricardo Ortega-Santiago ◽  
Silvia Ambite-Quesada ◽  
Antonio Gil-Crujera ◽  
...  
Keyword(s):  
Tibialis Anterior ◽  
Trapezius Muscle ◽  
Tension Type Headache ◽  
Healthy Children ◽  
Wide Spread ◽  
Pressure Pain ◽  
Upper Trapezius ◽  
Pressure Pain Thresholds ◽  
Upper Trapezius Muscle ◽  
Type Headache

Introduction: The aim was to investigate bilateral, wide-spread pressure pain hyperalgesia in symptomatic (trigeminocervical) and non-symptomatic (pain-free distant) regions in children with frequent episodic tension-type headache (FETTH). Methods: Twenty-five children, 6 boys and 19 girls (mean age, 8.9 ± 1.8 years) with FETTH and 50 age- and sex-matched healthy children (12 boys, 38 girls; mean age: 8.8 ± 1.7 years) were recruited. Pressure pain thresholds (PPTs) were bilaterally assessed over temporalis muscle, upper trapezius muscle, second metacarpal and tibialis anterior muscles in a blinded design. Results: The results showed that PPT levels were significantly decreased bilaterally over the temporalis, upper trapezius and tibialis muscles, and the second metacarpal in children with FETTH as compared to controls (all sites, P < 0.001). No significant differences in the magnitude of PPT decrease between the upper trapezius muscle, second metacarpal and tibialis anterior muscles were found. PPT over both upper trapezius muscles were negatively correlated with the history and intensity of headache (rs = −0.415; P = 0.045). Conclusions: The findings revealed bilateral, wide-spread pressure pain hypersensitivity in children with FETTH suggesting that wide-spread central sensitisation is involved in children with this headache pain condition.

scholarly journals Widespread Pressure Pain Sensitivity over Nerve Trunk Areas in Women with Frequent Episodic Tension-Type Headache as a Sign of Central Sensitization

Pain Medicine ◽  
2019 ◽  
Vol 21 (7) ◽  
pp. 1408-1414
Author(s):  
Leandro H Caamaño-Barrios ◽  
Fernando Galán-del-Río ◽  
César Fernández-de-las-Peñas ◽  
Gustavo Plaza-Manzano ◽  
Lars Arendt-Nielsen ◽  
...  
Keyword(s):  
Central Sensitization ◽  
Pain Sensitivity ◽  
Pressure Pain Threshold ◽  
Depression Scale ◽  
Tension Type Headache ◽  
Analysis Of Covariance ◽  
Tibialis Posterior ◽  
Temporalis Muscle ◽  
Pressure Pain ◽  
Type Headache

Abstract Objective Previous studies reported the presence of widespread pressure pain sensitivity in patients with tension-type headache. However, most of the studies assessed pressure pain sensitivity over muscle tissue. Our aim was to investigate the difference in pressure pain sensitivity over musculoskeletal and nerve symptomatic and distant areas between women with frequent episodic tension-type headache (FETTH) and healthy subjects. Methods Thirty-two women with FETTH and 32 matched healthy women participated. Pressure pain threshold (PPT) was bilaterally assessed over several nerve trunks (greater occipital, median, radial, ulnar, common peroneal, tibialis posterior) and musculoskeletal structures (temporalis muscle, C5/C6 joint, tibialis anterior) by an assessor blinded to the subject’s condition. A four-week headache diary was used to collect the intensity, frequency, and duration of headache. The Hospital Anxiety and Depression Scale was used to determine anxiety and depressive levels. Results Analysis of covariance found lower widespread and bilateral PPTs over all nerve trunks and musculoskeletal structures in women with FETTH pain (P &lt; 0.001). No significant effect of anxiety and depressive levels on PPTs was found (all P &gt; 0.222). PPT over the temporalis muscle was significantly negatively correlated with headache intensity. Conclusions This study found widespread pressure pain hypersensitivity over both nerve trunks and musculoskeletal structures in women with FETTH, suggesting that the presence of central altered nociceptive processing is not just restricted to musculoskeletal areas, for example, muscles, but also pain evoked from directly provoking the nerve trunks by pressure. It is also possible that nerve tissue treatment could lead to a decrease in central sensitization and headache features.

Pressure pain thresholds and thermal nociceptive thresholds in chronic tension-type headache

Pain ◽  
1989 ◽  
Vol 38 (2) ◽  
pp. 203-210 ◽  
Author(s):  
Michael Langemark ◽  
Kai Jensen ◽  
Troels S. Jensen ◽  
Jes Olesen
Keyword(s):  
Tension Type Headache ◽  
Pain Thresholds ◽  
Pressure Pain ◽  
Chronic Tension Type Headache ◽  
Pressure Pain Thresholds ◽  
Type Headache

Pressure Pain Threshold and Pain Tolerance in Episodic Tension-Type Headache Do Not Depend on the Presence of Headache

Cephalalgia ◽  
1999 ◽  
Vol 19 (3) ◽  
pp. 174-178 ◽  
Author(s):  
GM Bove ◽  
N Nilsson
Keyword(s):  
Pain Threshold ◽  
Pressure Pain Threshold ◽  
Underlying Mechanism ◽  
Tension Type Headache ◽  
Pain Tolerance ◽  
Mechanical Stimuli ◽  
Pressure Pain ◽  
Pressure Pain Thresholds ◽  
Type Headache ◽  
Tension Type Headaches

Pressure pain thresholds and responses to painful mechanical stimuli were obtained from 20 subjects with episodic tension-type headaches (TTH). Tender points in the temporalis and trapezius muscles were studied, along with two nontender points, one in the temporalis and one on the Achilles tendon. Two examinations were performed, one during and one without a headache, and results were compared. No significant differences were found in either variable for any tested points. The data demonstrate that the sensitivity level of these points does not differ based on the presence or absence of TTH. This suggests that the muscle sensitivity in TTH is constant. The observation that the sensitivity levels of both tender and nontender points did not vary suggests that the underlying mechanism or effect of TTH is not restricted to tender muscles.

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