Psychophysical testing in chronic migraine and chronic tension type headache: An observational study

Abstract

Background Clinical presentation is the key to the diagnosis of patients with migraine and tension-type headache, but features may overlap when both become chronic. Psychophysical parameters may distinguish both conditions. We aimed to compare psychophysical aspects of patients with chronic migraine, chronic tension-type headache and headache-free controls, and to determine whether these can predict headache frequency. Methods An examiner blinded to the diagnosis assessed 100 participants (chronic migraine (n = 38), chronic tension-type headache (n = 31) and controls (n = 31)). Assessed variables included painful area, pressure pain thresholds, temporal summation, cervical range of motion, neck posture, headache and neck impact, quality of life, and kinesiophobia. Comparison between groups was performed with one-way ANOVA and multiple linear regression was used to assess the headache frequency predictors. Results We found differences of both headache groups compared to controls ( p < 0.01), but not between headache groups. Neck disability was a significant predictor of headache frequency for chronic tension-type headache (adjusted R2 = 0.14; β = 0.43; p = 0.03) and chronic migraine (adjusted R2 = 0.18; β = 0.51; p < 0.01). Conclusions Chronic tension-type headache and chronic migraine showed similar psychophysical results, but were significantly worse when compared to controls. The psychophysical examination did not discriminate between headache types. The variable best explaining headache frequency for both headache types was neck disability.

Relationship between Self-Efficacy and Headache Impact, Anxiety, and Physical Activity Levels in Patients with Chronic Tension-Type Headache: An Observational Study

“…Several studies in head-referred symptoms like migraine [ 57 ], temporomandibular disorders [ 58 ], and TTH [ 59 ] are inconsistent with our findings. Recently, one study reported that patients with chronic TTH and chronic migraine showed similar kinesiophobia scores but were significantly worse when compared to controls [ 13 ]. However, findings from the present study did not support that patients' perception and their fear of movement influence their pain experience or headache impact.…”

“…Some studies evaluated kinesophobia as a factor associated with TTH, although no clear data has been drawn regarding this issue [11][12][13]. Kinesiophobia refers to excessive, irrational, and debilitating fear a person may suffer from physical movement and/or activity due to a vulnerability perception to experience a painful injury or reinjury [14].…”

“…This fact often leads to physical inactivity as well as an increase in pain intensity in subjects with musculoskeletal pain conditions [15]. However, no significant associations between pain intensity and decreased physical activity have been reported in patients with TTH [11][12][13].…”