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CNS & Neurological Disorders Drug... Aug 2007The pathophysiology of tension-type headache is still far from clear, although recent advances in basic and clinical research have increased our knowledge about... (Review)
Review
The pathophysiology of tension-type headache is still far from clear, although recent advances in basic and clinical research have increased our knowledge about mechanisms underlying this disorder. Experimental studies suggest that increased excitability of the CNS generated by repetitive and sustained pericranial myofascial input may be responsible for transformation of episodic tension-type headache into chronic form. Future studies should focus on the identification of the source of peripheral nociception in patients with tension-type headache and the development of more effective and specific treatment modalities.
Topics: Animals; Central Nervous System; Humans; Peripheral Nervous System; Tension-Type Headache
PubMed: 17691978
DOI: 10.2174/187152707781387297 -
Current Pain and Headache Reports Jun 2010Cervicogenic headache (CEH) is a well-recognized syndrome. Proposed diagnostic criteria differentiate CEH from migraine and tension-type headache (TTH) in most of the... (Comparative Study)
Comparative Study Review
Cervicogenic headache (CEH) is a well-recognized syndrome. Proposed diagnostic criteria differentiate CEH from migraine and tension-type headache (TTH) in most of the cases. The best differentiating factors include side-locked unilateral pain irradiating from the back and evidence of neck involvement--attacks may be precipitated by digital pressure over trigger spots in the cervical/nuchal areas or sustained awkward neck positions. Migrainous traits may be present in some cases. Cervical lesions are not necessarily seen, and most common cervical lesions do not produce CEH. Whiplash may occasionally induce headaches. This is suspected when the pain onset and the whiplash trauma are close in time. Whiplash-related headaches tend to be short-lasting, admitting mostly a TTH or a CEH-like phenotype. Neuroimaging abnormalities are not necessarily expected in CEH. Whiplash patients must undergo cervical imaging mostly in connection with the trauma, as no abnormalities are pathognomonic in chronic cases.
Topics: Humans; Migraine Disorders; Post-Traumatic Headache; Tension-Type Headache; Whiplash Injuries
PubMed: 20428974
DOI: 10.1007/s11916-010-0114-x -
Cephalalgia : An International Journal... Mar 2004
Review
Topics: Headache Disorders; Humans; Muscle, Skeletal; Neuropeptides; Nitric Oxide; Tension-Type Headache
PubMed: 15009009
DOI: 10.1111/j.1468-2982.2003.00644.x -
Current Pain and Headache Reports Oct 2001Tension-type headache (TTH) is the most prevalent form of headache. Although it is not the most severe form of headache, it has a significant impact on society. In spite... (Review)
Review
Tension-type headache (TTH) is the most prevalent form of headache. Although it is not the most severe form of headache, it has a significant impact on society. In spite of this, little is known about its pathophysiology. Current International Headache Society classification has been called into question, and new classification approaches have been suggested. With reference to chronic TTH, the issue of analgesic rebound may confound the diagnosis. Transformed migraine and new persistent daily headaches are clarified and differentiated from chronic TTHs (CTTHs). The best documented abnormality found in TTHs is the presence of pericranial tenderness. It is generally believed that pain is initiated by a peripheral mechanism, most likely increased input from the myofascial nociceptors. In CTTH, there may be an impaired supraspinal modulation of the incoming stimuli. Whether there is an overlap in the continuum between TTH and migraine is controversial. Abortive and prophylactic treatments are discussed and wellness and adjunct therapy are also emphasized. Lastly, special attention is paid to the doctor-patient relationship in patients with difficult headaches.
Topics: Humans; Tension-Type Headache
PubMed: 11560811
DOI: 10.1007/s11916-001-0057-3 -
Arquivos de Neuro-psiquiatria May 2015
Topics: Humans; Nerve Growth Factors; Protein Kinases; Tension-Type Headache
PubMed: 26017200
DOI: 10.1590/0004-282X20150055 -
Genes Oct 2022Nitric oxide (NO) is an important autocrine and paracrine signaling molecule that plays a crucial role in cardiovascular physiology and pathology regulation. NO is an...
BACKGROUND
Nitric oxide (NO) is an important autocrine and paracrine signaling molecule that plays a crucial role in cardiovascular physiology and pathology regulation. NO is an important molecule involved in regulation of cerebral and extra cerebral cranial blood flow and arterial diameters. Reduced bioavailability of NO in the endothelium is an important precursor for impaired vasodilation and arterial hypertension (AH). Furthermore, NO is involved in nociceptive processing. A NO-induced biphasic response with immediate and a delayed headache is typical for chronic tension-type headaches (TTH) in humans. The aim was to study the association of allelic variants and genotypes of the single nucleotide variant (SNV) rs3782218 of the gene with the TTH and AH overlap syndrome development in middle age adults.
MATERIALS AND METHODS
We observed 91 Caucasian participants who resided in Krasnoyarsk city: group 1 (TTH and AH overlap syndrome)-30 patients; group 2 (AH without headache)-30 patients; group 3 (control)-31 healthy volunteers. The diagnosis of AH was based on criteria of the European Society of Cardiology and the European Society of Hypertension (2018) и criteria of the Russian Society of Cardiology (2020). Diagnosis of TTH was based on criteria of the International Classification of Headache Disorders (2018). Real-time polymerase chain reaction was used for the determination of allelic variants and genotypes of the SNV rs3782218 of the gene in all groups of participants.
RESULTS
The frequency of the minor allele T of rs3782218 was statistically significantly higher by 16.7 times in group 1 (TTH and AH) compared to group 3 (control): 26.7% versus 1.6%, respectively (-value = 0.000065) and 3.2 times higher in group 1 (TTH and AH) compared to group 2 (AH without headache): 26.7% versus 8.3%, respectively (-value = 0.008). The frequency of the heterozygous (CT) genotype was statistically significantly higher in group 1 (TTH and AH) compared to group 3 (control): 40.0% versus 3.2% (-value = 0.000454) and in group 1 (TTH and AH) compared to group 2 (AH without headache): 40.0% versus 16.7% (-value = 0.045). The minor allele T was statistically significantly associated with a high risk of developing the TTH and AH overlap syndrome compared with the controls (odds ratio (OR) = 22.2 (95% confidential interval (CI): 2.8-173.5)) and compared with AH without headache (OR = 4.0 (95% CI: 1.4-11.8)). Although the frequency of the minor allele T was 5.2 times higher in group 2 (AH without headache) compared with group 3 (control), there were not statistically significantly differences (-value = 0.086).
CONCLUSION
Thus, the minor allele T of rs3782218 of the gene is an important genetic biomarker for a high risk of developing the TTH and AH overlap syndrome in hypertensive patients.
Topics: Adult; Middle Aged; Humans; Tension-Type Headache; Nitric Oxide; Headache; Hypertension; Syndrome; Nucleotides; Biomarkers
PubMed: 36292708
DOI: 10.3390/genes13101823 -
Cephalalgia : An International Journal... Dec 2015Manual therapies are generally requested by patients with tension type headache. (Comparative Study)
Comparative Study Meta-Analysis Review
BACKGROUND
Manual therapies are generally requested by patients with tension type headache.
OBJECTIVE
To compare the efficacy of multimodal manual therapy vs. pharmacological care for the management of tension type headache pain by conducting a meta-analysis of randomized controlled trials.
METHODS
PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, PEDro and SCOPUS were searched from their inception until June 2014. All randomized controlled trials comparing any manual therapy vs. medication care for treating tension type headache adults were included. Data were extracted and methodological quality assessed independently by two reviewers. We pooled headache frequency as the main outcome and also intensity and duration. The weighted mean difference between manual therapy and pharmacological care was used to determine effect sizes.
RESULTS
Five randomized controlled trials met our inclusion criteria and were included in the meta-analysis. Pooled analyses found that manual therapies were more effective than pharmacological care in reducing frequency (weighted mean difference -0.8036, 95% confidence interval -1.66 to -0.44; three trials), intensity (weighted mean difference -0.5974, 95% confidence interval -0.8875 to -0.3073; five trials) and duration (weighted mean difference -0.5558, 95% confidence interval -0.9124 to -0.1992; three trials) of the headache immediately after treatment. No differences were found at longer follow-up for headache intensity (weighted mean difference -0.3498, 95% confidence interval -1.106 to 0.407; three trials).
CONCLUSION
Manual therapies were associated with moderate effectiveness at short term, but similar effectiveness at longer follow-up for reducing headache frequency, intensity and duration in tension type headache than pharmacological medical drug care. However, due to the heterogeneity of the interventions, these results should be considered with caution at this stage.
Topics: Analgesics; Combined Modality Therapy; Disease Management; Humans; Musculoskeletal Manipulations; Randomized Controlled Trials as Topic; Tension-Type Headache
PubMed: 25748428
DOI: 10.1177/0333102415576226 -
Clinical Evidence Jun 2003
Review
Topics: Acupuncture Therapy; Amitriptyline; Antidepressive Agents, Tricyclic; Cognitive Behavioral Therapy; Humans; Tension-Type Headache
PubMed: 15366194
DOI: No ID Found -
Current Opinion in Neurology Jun 2000Tension-type headache represents one of the most costly diseases in modern society because of its very high prevalence. Very little research on this disease has actually... (Review)
Review
Tension-type headache represents one of the most costly diseases in modern society because of its very high prevalence. Very little research on this disease has actually been carried out, and knowledge about key pathophysiological issues such as the nature and site of the noxious stimulus is surprisingly limited. As a result of this and the lack of scientific interest from the medical field, treatment is widely non-specific, very often ineffective and consists mainly of simple analgesics. The only new strategy is the pericranial injection of botulinum toxin. If current progress in our understanding of the mechanisms of tension-type headache continues, this may lead to greater scientific interest and the development of more specific and more effective drugs in the future.
Topics: Analgesics; Humans; Tension-Type Headache
PubMed: 10871252
DOI: 10.1097/00019052-200006000-00009 -
Disability and Rehabilitation 2012To review the pacing literature; describe the use of pacing in a specialty headache clinic; and provide client feedback regarding the effectiveness of pacing in headache... (Review)
Review
PURPOSE
To review the pacing literature; describe the use of pacing in a specialty headache clinic; and provide client feedback regarding the effectiveness of pacing in headache self-management.
METHOD
The evidence for this report was derived from a structured literature review, an established pacing intervention program for patients with headache, and patient self-report questionnaire.
RESULTS
There are frequent references to pacing in the chronic pain and rheumatic disease literature, but no universal definition and, until recently, few outcome studies. References to pacing in the headache literature are limited. For a small sub-group of clients at a specialty headache clinic (n = 20), pacing principles taught by occupational therapists were reported to prevent increases in headache intensity (70%); decrease headache intensity (65%), and shorten the duration of a headache (40%). Additionally, 70% of respondents used pacing to prevent headache onset. Pacing was seen to contribute to increased quality of life, headache self-efficacy, function, and independence. There were a variety of opinions regarding the most helpful pacing components. The most frequently endorsed were identify and prioritize responsibilities; balance activity and rest; schedule regular rest breaks; and delegate or eliminate tasks.
CONCLUSIONS
Pacing appears to play an important role in headache self-management. More pacing research is required in both headache and chronic pain populations.
Topics: Activities of Daily Living; Adaptation, Psychological; Disease Management; Humans; Migraine Disorders; Self Care; Tension-Type Headache; Treatment Outcome
PubMed: 21980991
DOI: 10.3109/09638288.2011.610496