Morphology of muscular function in chronic tension-type headache: a pilot study

Abstract

Chronic pain has been thought to induce muscular changes in chronic tension-type headache (CTTH) patients. As the knowledge of muscular responses in CTTH is inconsistent, we decided to introduce new electromyogram signal shape descriptors. We also wanted to compare the discriminatory power of proposed indices with classical measures to establish their potential to act as markers for CTTH. Thirty-eight headache patients with twenty healthy volunteers were recruited. Twenty patients had CTTH, while 18 had migraine without aura. Surface electromyogram data were recorded from right sternocleidomastoid and left temporalis muscles during rest and in a headache-free situation. Besides conventional root mean square (RMS) and median frequency (MDF), two morphological-based indices, skewness and kurtosis, were proposed to quantify the shape variations of signal distribution. Results demonstrated that the skewness outperformed RMS and MDF in terms of discriminatory power (p < 0.00). Kurtosis values for both muscles differed considerably among study groups (p < 0.04). RMS for both muscles was noticeably higher in CTTH group (p < 0.00). Regarding MDF, migraineurs revealed highest (p < 0.05), while CTTH patients represented the lowest values. Skewness was the most relevant predictor for headache diagnosis, especially in temporalis muscle (migraine, odds ratio = 21.1, p = 0.01; Ctension-type headache, odds ratio = 78.8, p = 0.00). There are detectable distinct muscular responses in chronic headache sufferers. This finding could be due to adaptation to muscle underuse or sustained contraction, leading to impaired recruitment and muscle fiber-type conversion with dominant type I fibers in CTTH.

Comparing neck extensor muscle function in asymptomatic Canadian adults and adults with tension-type headache: a cross-sectional study

“…The combination of data obtained from surface EMG for muscle fatigue (RMS and MDF mean slopes) and the endurance time which was similar in both our TTH and asymptomatic participants suggests that there is no morphological difference in neck extensor muscle fibre types between the two groups. These results are in accordance with the findings from the study by Biyouki et al which reported minimal differences in muscle activity between CTTH and controls at rest 40…”

Chronic Tension-Type Headache: Muscle Overactivity Versus Deficient Pain Controls

“…There are detectable distinct muscular responses in chronic headache sufferers. This finding could be due to adaptation to muscle underuse or sustained contraction, leading to impaired recruitment, and muscle fiber-type conversion with dominant type I fibers in CTTH [17].…”

“…Although the activity was not significantly different, it is probable that such an effect may be there during active headache episodes. A different muscle firing pattern or some muscle modifications in patients with CTTH may reflect the reorganization of the motor control strategy [17,18]. There are detectable distinct muscular responses in chronic headache sufferers.…”