Tension-type headache (TTH) is the most prevalent headache and is associated with a high socioeconomical impact 1 . It has been suggested that episodic TTH (ETTH) is mainly due to peripheral mechanisms such as muscle tenderness. Central mechanisms leading to reduced pain threshold and sensitization in the trigeminal nucleus, thalamus, or somatosensory cortex are probably related with chronic TTH (CTTH) 2 . However, the precise mechanisms determining ETTH and the conversion of ETTH to CTTH remain largely unknown.Neurotrophic factors (NF) are a unique group of polypeptides responsible for neuron survival, axon growth, dendrite prunning, and the expression of essential proteins for the neuronal functioning. NF are classified in different families according to functional and structural characteristics, such as the glial cell line-derived neurotrophic factor (GNDF) family and the neurotrophin super-family that includes the brainderived neurotrophic factor (BDNF), the nerve-growth factor (NGF), the neurotrophin-3 (NT-3), and the neurotrophin-4/5 (NT-4/5) 3 . NF may play a role in nociception by regulating peripheral sensitivity of nociceptors and by modulating the central processing of nociceptive information 4 . Considering that peripheral nociceptors and central processing of nociceptive information are both potentially involved in the pathophysiology of TTH, it is reasonable to hypothetize that NF may be involved in TTH pathogenesis.The association between NF and primary headaches has already been investigated. Reduced BDNF and NGF platelet levels have been described in patients with migraine and chronic daily headache (CDH) 5 . BDNF was shown to be increased during migraine and cluster headache attacks 6,7 . Increased cerebrospinal fluid (CSF) levels of NGF and BDNF,
ABSTRACTNeurotrophic factors (NF) are involved in pain regulation and a few studies have suggested that they may play a pathophysiological role in primary headaches. The aim of this study was to investigate NF levels in patients with tension type headache (TTH). We carried out a cross sectional study including 48 TTH patients and 48 age and gender matched controls. Beck Depression and Anxiety Inventories, and Headache Impact Test were recorded. Serum levels of NF were determined by ELISA. There were not significant differences between NF levels between TTH patients and controls. Patients with chronic and episodic TTH had not significant differences in NF levels. The presence of headache at the time of evaluation did not significantly alter the levels of NF. Depression and anxiety scores as well as headache impact did not correlate with NF levels. Our study suggest that the serum levels of NF are not altered in TTH.Keywords: tension-type headache, neurotrophic factors, depression, anxiety.
RESUMOOs fatores neurotróficos (FN) participam da regulação da dor e podem ter um papel na fisiopatologia das cefaleias peimárias. O objetivo do presente estudo foi avaliar os níveis séricos de FN em pacientes com cefaleia do tipo tensional (CTT). Foi realizado cort...