Cervical impairments in subjects with migraine or tension type headache: an observational study
The aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine an...
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| Vydáno v: | Frontiers in neurology Ročník 15; s. 1373912 |
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Frontiers Media S.A
11.03.2024
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| ISSN: | 1664-2295, 1664-2295 |
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| Abstract | The aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine and TTH share similar pathophysiological pathways. Nevertheless, there may be some anatomical and functional differences which would explain why clinicians may obtain variable results when treating both pathological entities with similar or equal approaches.
An observational study was conducted in accordance with STROBE guidelines. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, tibialis anterior, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments.
Ninety participants were enrolled in the study. All subjects were equally divided into TTH, migraine and control groups. The PPT values exhibited lower thresholds in patients with TTH than both migraine and healthy participants. Specifically, in the temporal muscle on both sides, patients with TTH exhibited a significantly lower threshold (
< 0.001)than both migraine and healthy participants. Patients with TTH displayed significantly lower thresholds in both upper trapezius muscles (right:
< 0.001; left:
= 0.001). Similar results were obtained for the tibialis anterior PPTs from both sides (
= 0.001 in both). However, both clinical groups exhibited lower thresholds than the healthy subjects (
< 0.001). In multifidus muscle cross-sectional area (CSA), no statistically significant differences were found between migraine patients and healthy subjects, both in relaxation and contraction (right;
> 0.05 and
> 0.05; left:
> 0.05 and
> 0.05). However, patients with TTH exhibited a smaller CSA than both migraine patients and healthy controls in multifidus relaxed and contracted state (right:
< 0.001 in both relaxed and contracted multifidus; left:
= 0.001 and
< 0.001, respectively). Similar results were obtained for the left longus colli muscle in both relaxation and contraction for patients with TTH and migraine compared with healthy subjects (
= 0.001 and
< 0.001, respectively, for muscle relaxation and
< 0.001 for muscle contraction). However, no significant differences were observed between patients with TTH and migraine (
< 0.05 in both relaxation and contraction). In the right longus colli, TTH and migraine patients had a significantly smaller CSA during contraction than healthy subjects (
< 0.001 in both comparisons). In the craniocervical flexion test, both groups of patients with TTH and migraine showed significantly lower values than healthy subjects (
< 0.001 in both comparisons). However, no significant differences were found between patients with TTH and migraineurs (
> 0.05).
The findings provide a significant message for clinicians since anatomical and functional impairments were shown in patients with TTH and migraine. This study corroborates a lack of strength and smaller CSA in both clinical groups compared to controls. Therefore, strengthening programs may be addressed successfully for people with these pathological entities. To be more accurate, according to PPTs and CSA lower values in patients with TTH compared to migraine and controls, manual therapy approaches to desensitize craniocervical soft tissues and exercise therapy to increase endurance of deep cervical muscles may become meaningful especially in subjects with TTH. Nevertheless, in order to distinguish precisely between patients with TTH and migraine, different diagnostic strategies may be used in the future to describe these populations in further detail, which will assist health professionals in a more accurate treatment selection. |
|---|---|
| AbstractList | The aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine and TTH share similar pathophysiological pathways. Nevertheless, there may be some anatomical and functional differences which would explain why clinicians may obtain variable results when treating both pathological entities with similar or equal approaches.
An observational study was conducted in accordance with STROBE guidelines. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, tibialis anterior, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments.
Ninety participants were enrolled in the study. All subjects were equally divided into TTH, migraine and control groups. The PPT values exhibited lower thresholds in patients with TTH than both migraine and healthy participants. Specifically, in the temporal muscle on both sides, patients with TTH exhibited a significantly lower threshold (
< 0.001)than both migraine and healthy participants. Patients with TTH displayed significantly lower thresholds in both upper trapezius muscles (right:
< 0.001; left:
= 0.001). Similar results were obtained for the tibialis anterior PPTs from both sides (
= 0.001 in both). However, both clinical groups exhibited lower thresholds than the healthy subjects (
< 0.001). In multifidus muscle cross-sectional area (CSA), no statistically significant differences were found between migraine patients and healthy subjects, both in relaxation and contraction (right;
> 0.05 and
> 0.05; left:
> 0.05 and
> 0.05). However, patients with TTH exhibited a smaller CSA than both migraine patients and healthy controls in multifidus relaxed and contracted state (right:
< 0.001 in both relaxed and contracted multifidus; left:
= 0.001 and
< 0.001, respectively). Similar results were obtained for the left longus colli muscle in both relaxation and contraction for patients with TTH and migraine compared with healthy subjects (
= 0.001 and
< 0.001, respectively, for muscle relaxation and
< 0.001 for muscle contraction). However, no significant differences were observed between patients with TTH and migraine (
< 0.05 in both relaxation and contraction). In the right longus colli, TTH and migraine patients had a significantly smaller CSA during contraction than healthy subjects (
< 0.001 in both comparisons). In the craniocervical flexion test, both groups of patients with TTH and migraine showed significantly lower values than healthy subjects (
< 0.001 in both comparisons). However, no significant differences were found between patients with TTH and migraineurs (
> 0.05).
The findings provide a significant message for clinicians since anatomical and functional impairments were shown in patients with TTH and migraine. This study corroborates a lack of strength and smaller CSA in both clinical groups compared to controls. Therefore, strengthening programs may be addressed successfully for people with these pathological entities. To be more accurate, according to PPTs and CSA lower values in patients with TTH compared to migraine and controls, manual therapy approaches to desensitize craniocervical soft tissues and exercise therapy to increase endurance of deep cervical muscles may become meaningful especially in subjects with TTH. Nevertheless, in order to distinguish precisely between patients with TTH and migraine, different diagnostic strategies may be used in the future to describe these populations in further detail, which will assist health professionals in a more accurate treatment selection. The aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine and TTH share similar pathophysiological pathways. Nevertheless, there may be some anatomical and functional differences which would explain why clinicians may obtain variable results when treating both pathological entities with similar or equal approaches.ObjectiveThe aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine and TTH share similar pathophysiological pathways. Nevertheless, there may be some anatomical and functional differences which would explain why clinicians may obtain variable results when treating both pathological entities with similar or equal approaches.An observational study was conducted in accordance with STROBE guidelines. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, tibialis anterior, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments.MethodsAn observational study was conducted in accordance with STROBE guidelines. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, tibialis anterior, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments.Ninety participants were enrolled in the study. All subjects were equally divided into TTH, migraine and control groups. The PPT values exhibited lower thresholds in patients with TTH than both migraine and healthy participants. Specifically, in the temporal muscle on both sides, patients with TTH exhibited a significantly lower threshold (p < 0.001)than both migraine and healthy participants. Patients with TTH displayed significantly lower thresholds in both upper trapezius muscles (right: p < 0.001; left: p = 0.001). Similar results were obtained for the tibialis anterior PPTs from both sides (p = 0.001 in both). However, both clinical groups exhibited lower thresholds than the healthy subjects (p < 0.001). In multifidus muscle cross-sectional area (CSA), no statistically significant differences were found between migraine patients and healthy subjects, both in relaxation and contraction (right; p > 0.05 and p > 0.05; left: p > 0.05 and p > 0.05). However, patients with TTH exhibited a smaller CSA than both migraine patients and healthy controls in multifidus relaxed and contracted state (right: p < 0.001 in both relaxed and contracted multifidus; left: p = 0.001 and p < 0.001, respectively). Similar results were obtained for the left longus colli muscle in both relaxation and contraction for patients with TTH and migraine compared with healthy subjects (p = 0.001 and p < 0.001, respectively, for muscle relaxation and p < 0.001 for muscle contraction). However, no significant differences were observed between patients with TTH and migraine (p < 0.05 in both relaxation and contraction). In the right longus colli, TTH and migraine patients had a significantly smaller CSA during contraction than healthy subjects (p < 0.001 in both comparisons). In the craniocervical flexion test, both groups of patients with TTH and migraine showed significantly lower values than healthy subjects (p < 0.001 in both comparisons). However, no significant differences were found between patients with TTH and migraineurs (p > 0.05).ResultsNinety participants were enrolled in the study. All subjects were equally divided into TTH, migraine and control groups. The PPT values exhibited lower thresholds in patients with TTH than both migraine and healthy participants. Specifically, in the temporal muscle on both sides, patients with TTH exhibited a significantly lower threshold (p < 0.001)than both migraine and healthy participants. Patients with TTH displayed significantly lower thresholds in both upper trapezius muscles (right: p < 0.001; left: p = 0.001). Similar results were obtained for the tibialis anterior PPTs from both sides (p = 0.001 in both). However, both clinical groups exhibited lower thresholds than the healthy subjects (p < 0.001). In multifidus muscle cross-sectional area (CSA), no statistically significant differences were found between migraine patients and healthy subjects, both in relaxation and contraction (right; p > 0.05 and p > 0.05; left: p > 0.05 and p > 0.05). However, patients with TTH exhibited a smaller CSA than both migraine patients and healthy controls in multifidus relaxed and contracted state (right: p < 0.001 in both relaxed and contracted multifidus; left: p = 0.001 and p < 0.001, respectively). Similar results were obtained for the left longus colli muscle in both relaxation and contraction for patients with TTH and migraine compared with healthy subjects (p = 0.001 and p < 0.001, respectively, for muscle relaxation and p < 0.001 for muscle contraction). However, no significant differences were observed between patients with TTH and migraine (p < 0.05 in both relaxation and contraction). In the right longus colli, TTH and migraine patients had a significantly smaller CSA during contraction than healthy subjects (p < 0.001 in both comparisons). In the craniocervical flexion test, both groups of patients with TTH and migraine showed significantly lower values than healthy subjects (p < 0.001 in both comparisons). However, no significant differences were found between patients with TTH and migraineurs (p > 0.05).The findings provide a significant message for clinicians since anatomical and functional impairments were shown in patients with TTH and migraine. This study corroborates a lack of strength and smaller CSA in both clinical groups compared to controls. Therefore, strengthening programs may be addressed successfully for people with these pathological entities. To be more accurate, according to PPTs and CSA lower values in patients with TTH compared to migraine and controls, manual therapy approaches to desensitize craniocervical soft tissues and exercise therapy to increase endurance of deep cervical muscles may become meaningful especially in subjects with TTH. Nevertheless, in order to distinguish precisely between patients with TTH and migraine, different diagnostic strategies may be used in the future to describe these populations in further detail, which will assist health professionals in a more accurate treatment selection.ConclusionThe findings provide a significant message for clinicians since anatomical and functional impairments were shown in patients with TTH and migraine. This study corroborates a lack of strength and smaller CSA in both clinical groups compared to controls. Therefore, strengthening programs may be addressed successfully for people with these pathological entities. To be more accurate, according to PPTs and CSA lower values in patients with TTH compared to migraine and controls, manual therapy approaches to desensitize craniocervical soft tissues and exercise therapy to increase endurance of deep cervical muscles may become meaningful especially in subjects with TTH. Nevertheless, in order to distinguish precisely between patients with TTH and migraine, different diagnostic strategies may be used in the future to describe these populations in further detail, which will assist health professionals in a more accurate treatment selection. ObjectiveThe aim of this investigation was to compare the thickness of the deep local muscles in the neck region, as well as local and widespread sensitivity and functionality, between individuals with migraine, Tension-Type Headache (TTH), and healthy controls. To date, we know that the onset of migraine and TTH share similar pathophysiological pathways. Nevertheless, there may be some anatomical and functional differences which would explain why clinicians may obtain variable results when treating both pathological entities with similar or equal approaches.MethodsAn observational study was conducted in accordance with STROBE guidelines. The flexor longus colli and multifidus, two neck-stabilizing muscles, were measured using B-mode ultrasound imaging. The upper trapezius, masseter, temporalis, tibialis anterior, and median nerve all underwent bilateral pressure-pain threshold (PPT) assessments.ResultsNinety participants were enrolled in the study. All subjects were equally divided into TTH, migraine and control groups. The PPT values exhibited lower thresholds in patients with TTH than both migraine and healthy participants. Specifically, in the temporal muscle on both sides, patients with TTH exhibited a significantly lower threshold (p < 0.001)than both migraine and healthy participants. Patients with TTH displayed significantly lower thresholds in both upper trapezius muscles (right: p < 0.001; left: p = 0.001). Similar results were obtained for the tibialis anterior PPTs from both sides (p = 0.001 in both). However, both clinical groups exhibited lower thresholds than the healthy subjects (p < 0.001). In multifidus muscle cross-sectional area (CSA), no statistically significant differences were found between migraine patients and healthy subjects, both in relaxation and contraction (right; p > 0.05 and p > 0.05; left: p > 0.05 and p > 0.05). However, patients with TTH exhibited a smaller CSA than both migraine patients and healthy controls in multifidus relaxed and contracted state (right: p < 0.001 in both relaxed and contracted multifidus; left: p = 0.001 and p < 0.001, respectively). Similar results were obtained for the left longus colli muscle in both relaxation and contraction for patients with TTH and migraine compared with healthy subjects (p = 0.001 and p < 0.001, respectively, for muscle relaxation and p < 0.001 for muscle contraction). However, no significant differences were observed between patients with TTH and migraine (p < 0.05 in both relaxation and contraction). In the right longus colli, TTH and migraine patients had a significantly smaller CSA during contraction than healthy subjects (p < 0.001 in both comparisons). In the craniocervical flexion test, both groups of patients with TTH and migraine showed significantly lower values than healthy subjects (p < 0.001 in both comparisons). However, no significant differences were found between patients with TTH and migraineurs (p > 0.05).ConclusionThe findings provide a significant message for clinicians since anatomical and functional impairments were shown in patients with TTH and migraine. This study corroborates a lack of strength and smaller CSA in both clinical groups compared to controls. Therefore, strengthening programs may be addressed successfully for people with these pathological entities. To be more accurate, according to PPTs and CSA lower values in patients with TTH compared to migraine and controls, manual therapy approaches to desensitize craniocervical soft tissues and exercise therapy to increase endurance of deep cervical muscles may become meaningful especially in subjects with TTH. Nevertheless, in order to distinguish precisely between patients with TTH and migraine, different diagnostic strategies may be used in the future to describe these populations in further detail, which will assist health professionals in a more accurate treatment selection. |
| Author | Ucero Lozano, Roberto Martín Vera, Daniel Ladriñán Maestro, Arturo Sosa-Reina, María Dolores del Blanco Muñiz, Jose Ángel Sánchez Sierra, Alberto |
| AuthorAffiliation | 1 Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid , Villaviciosa de Odón, Madrid , Spain 4 Physiotherapy Research Group of Toledo (GIFTO), Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha , Toledo , Spain 2 Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Health Sciences, Universidad Europea de Madrid , Madrid , Spain 3 Faculty of Physiotherapy and Nursing, University of Castilla La Mancha , Toledo , Spain |
| AuthorAffiliation_xml | – name: 3 Faculty of Physiotherapy and Nursing, University of Castilla La Mancha , Toledo , Spain – name: 4 Physiotherapy Research Group of Toledo (GIFTO), Faculty of Physiotherapy and Nursing, Universidad de Castilla-La Mancha , Toledo , Spain – name: 2 Research Group on Exercise Therapy and Functional Rehabilitation, Faculty of Health Sciences, Universidad Europea de Madrid , Madrid , Spain – name: 1 Department of Physiotherapy, Faculty of Sport Sciences, Universidad Europea de Madrid , Villaviciosa de Odón, Madrid , Spain |
| Author_xml | – sequence: 1 givenname: Jose Ángel surname: del Blanco Muñiz fullname: del Blanco Muñiz, Jose Ángel – sequence: 2 givenname: Alberto surname: Sánchez Sierra fullname: Sánchez Sierra, Alberto – sequence: 3 givenname: Arturo surname: Ladriñán Maestro fullname: Ladriñán Maestro, Arturo – sequence: 4 givenname: Roberto surname: Ucero Lozano fullname: Ucero Lozano, Roberto – sequence: 5 givenname: María Dolores surname: Sosa-Reina fullname: Sosa-Reina, María Dolores – sequence: 6 givenname: Daniel surname: Martín Vera fullname: Martín Vera, Daniel |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/38529031$$D View this record in MEDLINE/PubMed |
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| CitedBy_id | crossref_primary_10_3390_jcm14051740 crossref_primary_10_62087_hpr_2024_0025 crossref_primary_10_1016_j_jbmt_2025_04_030 crossref_primary_10_1016_j_msksp_2024_103185 crossref_primary_10_1515_jcim_2024_0283 |
| Cites_doi | 10.1123/jpah.2013 10.1080/10669817.2018.1560946 10.2147/JPR.S146050 10.1136/bmj.39335.541782.AD 10.3390/medicina58070917 10.1186/s12998-016-0132- 10.1016/S1474-4422(18)30322-3 10.1016/S1474-4422(17)30435-0 10.1016/j.ncl.2019.06.001 10.1590/1806-9282.20230841 10.1177/0333102417716934 10.1186/s10194-022-01402-2 10.1007/s11916-002-0082- 10.1016/S0140-6736(17)32154-2 10.21474/IJAR01/12748 10.1016/j.msksp.2019.04.007 10.1016/j.apmr.2019.10.194 10.4103/jfmpc.jfmpc_68_18 10.1186/1129-2377-15-58 10.1097/j.pain.0000000000000243 10.1097/AJP.0b013e318154b6ae 10.1016/j.jmpt.2018.04.003 10.1177/0333102415597889 10.1177/0333102417738202 10.1055/s-0038-1646946 10.1111/ijcp.14248 10.1097/j.pain.0000000000000219 10.1186/s10194-018-0834-6 10.1111/j.1468-2982.2008.01584.x 10.1093/ptj/pzac054 10.1186/s10194-023-01614-0 10.1136/bmjopen-2019-034926 10.1007/s00586-019-06097-9 10.1007/s10072-013-1387- 10.1177/0333102414535110 |
| ContentType | Journal Article |
| Copyright | Copyright © 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera. Copyright © 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera. 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera |
| Copyright_xml | – notice: Copyright © 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera. – notice: Copyright © 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera. 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera |
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| Keywords | pain migraine functionality tension type headache ultrasound |
| Language | English |
| License | Copyright © 2024 Del Blanco Muñiz, Sánchez Sierra, Ladriñán Maestro, Ucero Lozano, Sosa-Reina and Martín Vera. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
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| Notes | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Zhen Leo Yang, KU Leuven, Belgium Reviewed by: Eric Chun-Pu Chu, EC Healthcare, Hong Kong SAR, China Edited by: Parisa Gazerani, Oslo Metropolitan University, Norway |
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