Central mechanisms in tension-type headaches

Vandenheede, Michel; Schoenen, Jean

doi:10.1007/s11916-002-0082-x

Cited by 50 publications

(35 citation statements)

References 85 publications

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“…This may be attributed partly to the fact that the understanding of TTH pathophysiology is less complete than that of migraine. Fortunately, we have gained a significant amount of new knowledge on pathophysiological aspects of TTH within the past decade, and we now are beginning to understand some of the complex mechanisms leading to this prevalent disease [2][3][4][5][6][7][8][9][10][11]. This is the first step toward the development of more effective treatments.…”

Section: Introductionmentioning

confidence: 99%

The Role of Muscles in Tension-Type Headache

Bendtsen

Fernández-de-la-Peñas

2011

Curr Pain Headache Rep

122

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The tenderness of pericranial myofascial tissues and number of myofascial trigger points are considerably increased in patients with tension-type headache (TTH). Mechanisms responsible for the increased myofascial pain sensitivity have been studied extensively. Peripheral activation or sensitization of myofascial nociceptors could play a role in causing increased pain sensitivity, but firm evidence for a peripheral abnormality still is lacking. Peripheral mechanisms are most likely of major importance in episodic TTH. Sensitization of pain pathways in the central nervous system due to prolonged nociceptive stimuli from pericranial myofascial tissues seem to be responsible for the conversion of episodic to chronic TTH. Treatment directed toward muscular factors include electromyography biofeedback, which has a documented effect in patients with TTH, as well as physiotherapy and muscle relaxation therapy, which are most likely effective. Future studies should aim to identify the source of peripheral nociception.

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Section: Introductionmentioning

confidence: 99%

The Role of Muscles in Tension-Type Headache

Bendtsen

Fernández-de-la-Peñas

2011

Curr Pain Headache Rep

122

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“…In particular, it would be interesting if there is any correlation between tensiontype headache with a muscular contraction and the central nervous system diseases characterized by increased muscle tone. Studies of the therapeutic effect of pericranial botulinum toxin type A injections, which reduce muscle tone, yielded different results [28]. Schmitt et al [29] demonstrated some improvement in affective variables, but the pain intensity, the number of pain-free days, and the consumption of analgesics, were not statistically different between the groups of patients who received botulinum toxin and placebo.…”

Section: Pathophysiological Hypothesesmentioning

confidence: 99%

“…The general lowering of pressure pain detection and tolerance thresholds indicates that both allodynia (pain elicited by stimuli which are normally not perceived as painful and are generated by low threshold Aβ) and hyperalgesia (increased sensitivity to painful stimuli with activation of high-threshold afferents) are present in patients with chronic tension-type headache [4,28].…”

Section: Neurophysiological Evidencementioning

confidence: 99%

“…The central sensitization could theoretically also be secondary to the chronic pain condition itself, but this is most unlikely, because the central nervous system is not sensitized in patients with chronic tension-type headache who are not tender to palpation [4]. Thus, the peripheral mechanisms in episodic tension-type headache lead to a central mechanism in chronic tensiontype headache [1,4,28].…”

Section: Neurophysiological Evidencementioning

confidence: 99%

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Pain and tension-type headache: a review of the possible pathophysiological mechanisms

Milanov

Богданова

2004

J Headache Pain

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Tension-type headache represents a considerable health problem and is one of the most costly diseases in the modern society. However, the knowledge about the pathophysiological mechanisms leading to this disorder is limited. The review presents a summary of available research and experimental data on the pathophysiological mechanisms and the recent pathophysiological models. Although the pain in tension-type headache clinically resembles pain from myofascial tissues, both peripheral and central mechanisms are believed to be involved. It is likely that myofascial nociception is important in episodic tension-type headache and that central mechanisms are involved in the pathophysiology of the chronic form. Neurophysiological investigations are introduced to be the most suitable to confirm an involvement of trigeminal pathways, to substantiate recent theories on sensitization phenomena, and to disclose the exact pain-control mechanisms. More studies are needed to elucidate the mechanisms leading to central sensitization and to develop new therapeutic strategies.

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“…Embora seja reconhecida como a forma mais comum de dor cefálica, é ainda muito pouco estudada. Escassos são os conhecimentos acerca de seus mecanismos fisiopatológicos 3 , seus dados epidemiológicos, suas formas de apresentação e seu tratamento farmacológico 4 . Em diversos estudos clínicos e epidemiológicos, duas comorbidades são especialmente enfocadas entre pacientes com CTT: depressão e ansiedade.…”

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Sintomas depressivos e ansiedade em pacientes com cefaléia do tipo tensional crônica e episódica

Matta

Filho

2003

Arq. Neuro-Psiquiatr.

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RESUMO -Introdução:A cefaléia do tipo tensional (CTT), dor cefálica mais comum, tem mecanismos fisiopatológicos, epidemiologia e apresentação clínica pouco estudados. Depressão e ansiedade são comorbidades especialmente enfocadas entre seus portadores. Objetivo: Estudar a ocorrência de sintomas depressivos e ansiedade entre portadores de CTT episódica (CTTE) e crônica (CTTC). Metodologia: Cinqüenta pacientes com CTTE e cinqüenta com CTTC preencheram os inventários de depressão e de ansiedade de Beck. Somente foram considerados aqueles com escores moderado ou grave. Resultados: Entre portadores de CTTE, ansiedade e sintomas depressivos foram encontrados em 60 e 32 % dos pacientes, respectivamente. Em pacientes com CTTC, ansiedade foi detectada em 44 % e sintomas depressivos foram observados em 40 % da amostra. Conclusão: ambas as comorbidades são importantes em pacientes com CTT. Negligenciá-las significa risco de falência no tratamento, contribuindo para queda na qualidade de vida .PALAVRAS-CHAVE: cefaléia do tipo tensional episódica, cefaléia do tipo tensional crônica, depressão, ansiedade. Depressive symptoms and anxiety in patients with chronic and episodic tension-type headacheABSTRACT -Background: Tension-type headache (TTH) is recognized as the most prevalent type of headache. Despite this, there is a limited understanding of the entity's physiology, epidemiology, and clinical presentation. Anxiety and depression are recognized comorbidities present among patients with TTH. Objective: To quantify the prevalence of anxiety and depression among patients with episodic and chronic TTH. Method: fifty patients with episodic TTH and fifty patients with chronic TTH completed Beck's anxiety and depression surveys. Only patients presenting with moderate to severe scores were considered. Results: among the patients with episodic TTH, anxiety and depression were observed in 30 (60%) and 16 (32%) patients respectively. Among the patients with chronic TTH, anxiety was observed in 22 (44%) patients, and depression was observed in 20 (40%). Conclusion: both comorbidities are important among patients with episodic and chronic TTH. Neglecting this association may result in failure of symptomatic and prophylactic treatment ultimately leading to lost quality of life.

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Central mechanisms in tension-type headaches

Cited by 50 publications

References 85 publications

The Role of Muscles in Tension-Type Headache

The Role of Muscles in Tension-Type Headache

Pain and tension-type headache: a review of the possible pathophysiological mechanisms

Sintomas depressivos e ansiedade em pacientes com cefaléia do tipo tensional crônica e episódica

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