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Frontiers in Neurology 2022Tension-type headache (TTH) is the most prevalent headache in the clinical practice, leading to impaired social activities, work-related disability, and heavy financial...
BACKGROUND
Tension-type headache (TTH) is the most prevalent headache in the clinical practice, leading to impaired social activities, work-related disability, and heavy financial burdens. Previous studies have described possible inducement, potential pathophysiology, and clinical management of TTH; however, due to the lack of attention, literature involving bibliometric analysis is sporadic. Therefore, this study aimed to explore the current hotspots and future directions of the TTH field by bibliometric analysis.
METHODS
By using CiteSpace and VOSviewer, literature regarding TTH between 2002 and 2021 from the Web of Science database was summarized and extracted. Annual publication trend, the most productive countries/regions and institutions, distribution of categories, co-citation of journals and references, and co-occurrence of keywords were analyzed.
RESULTS
A total of 3,379 publications were included in the final visualization, indicating a stable trend in current research and a lack of breakthroughs over the past decades. These studies were mainly conducted in 120 countries/regions led by the United States and more than 600 institutions. Four eternal core themes were identified in TTH, including neurosciences, nursing, developmental psychology, and general/internal medicine. ranked first, with the highest number of literature, and is the most influential journal in this area. Keyword analysis demonstrated that the similarities and differences between migraine and TTH, epidemiological studies, clinical double-blind trials, and potential populations have become key issues in the TTH field.
CONCLUSION
TTH has received less attention and breakthroughs in the past 20 years. To promote coordinated development between regions to fight headaches, cooperation and exchanges between countries and institutions are essential in the future. Relevant studies about headaches in children and adolescents, inducing factors such as emotional triggers and sleep disorders, concomitant diseases, possible pathogenesis, and headache treatments, are in the spotlight in recent years. This study offers a powerful roadmap for further research in this field.
PubMed: 36119709
DOI: 10.3389/fneur.2022.980096 -
BMC Public Health Aug 2022Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Headache accompanying ischemic stroke is considered an independent predictor of neurological deterioration. This meta-analysis aims to estimate the prevalence of ischemic stroke-related headaches and identify its risk factors in China.
METHODS
PubMed, Embase, Cochrane Library database, Web of Science, PsycINFO, and four Chinese databases for the related publications were searched. Two researchers independently selected the literature, extracted the relevant data, and assessed its methodological quality. The meta-analysis applied a random-effects model with R software to calculate the pooled prevalence of ischemic stroke-related headaches in Chinese patients, and to merge the odds ratio (OR) of risk factors. Subgroup analysis, sensitivity analysis, and meta-regression analysis were conducted. Publication bias was assessed by a funnel plot and Egger test.
RESULTS
Ninety-eight studies were eligible for inclusion. The overall pooled prevalence of ischemic stroke-related headache was 18.9%. Subgroup analysis showed that the prevalence of ischemic stroke related-headaches was higher among studies using self-report to diagnosis headache (18.9%; 95%CI, 8.9% to 40.2%), and those focused on age ≥ 55 years (19.7%; 95%CI, 14.9% to 25.9%), rural settings (24.9%; 95%CI, 19.7% to 31.6%). There were no significant differences in the headache prevalence between studies in the south and north, and inland and coastal studies. The prevalence of pre onset headache (13.9%) and tension-type headache (15.5%) and was higher compared with other types. History of headache (OR = 3.24; 95%CI, 2.26 to 4.65.), female gender (OR = 2.06; 95%CI, 1.44 to 2.96.), midbrain lesions (OR = 3.56; 95%CI, 1.86 to 6.83.), and posterior circulation stroke (OR = 2.13; 95%CI, 1.14 to 4.32) were major risk factors.
CONCLUSION
The prevalence of ischemic stroke-associated headache is high in China. In addition, women, presence of midbrain lesions, posterior circulation stroke and a history of migraine were high-risk factors for ischemic stroke-related headaches. Designing effective interventions to prevent or alleviated headaches is necessary to promote patients' neurological recovery and quality of life.
Topics: Female; Headache; Humans; Ischemic Stroke; Middle Aged; Prevalence; Quality of Life; Risk Factors; Stroke
PubMed: 35953857
DOI: 10.1186/s12889-022-13917-z -
Headache Jul 2022We conducted a systematic review and dose-response meta-analysis to investigate the association between body mass index (BMI) and primary headache disorder subtypes and... (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
We conducted a systematic review and dose-response meta-analysis to investigate the association between body mass index (BMI) and primary headache disorder subtypes and to clarify the shape of this relationship.
METHODS
PubMed and Scopus were searched from inception to September 2020. Observational studies reporting the risk estimates of primary headache disorders across categories of BMI were included. We restricted our systematic search to articles published in English. Meta-analyses, reviews, letters to editor, case reports/case series, and abstracts with inadequate data were excluded. We used the Joanna Briggs Institute's critical appraisal tool to assess the quality of the studies included in the meta-analyses. One author extracted data from each study by using prespecified data extraction forms.
RESULTS
In total, 41 observational studies investigating the association between BMI and different primary headache disorders with 154,044 cases and 792,500 participants were included. Among subtypes of headache disorders, the risk of migraine significantly increased in subjects who were either underweight or had obesity compared to those with normal BMI (odds ratio [OR] = 1.21, 95% confidence interval [CI]: 1.09-1.34, I = 6.2%; OR = 1.28, 95% CI: 1.15-1.43, I = 89.7%, respectively). However, there was limited evidence to support the association between BMI and the risk of other subtypes of primary headache disorders. A nonlinear association was found between BMI and migraine (p nonlinearity <0.0001), and the lowest risk was observed in BMI around 20 and increased at BMI values >29.
CONCLUSION
This meta-analysis suggests through a nonlinear association an increased risk of migraine among individuals who are either underweight or obese. These results support the recommendation that headache disorders' prevention will benefit from weight control.
Topics: Body Mass Index; Headache; Humans; Migraine Disorders; Obesity; Thinness
PubMed: 35851952
DOI: 10.1111/head.14356 -
Annals of Medicine and Surgery (2012) Jun 2022Mindfulness-based stress reduction/cognitive therapy has attained popularity as an adjunctive treatment for a plethora of medical and psychiatric conditions, however,... (Review)
Review
BACKGROUND
Mindfulness-based stress reduction/cognitive therapy has attained popularity as an adjunctive treatment for a plethora of medical and psychiatric conditions, however, its impact on chronic headaches is inconclusive. This review aims to assess the impact of MBSR/MBCT in alleviating the symptoms of chronic headaches.
DATA SOURCES AND DATA SELECTION
PubMed and Cochrane CENTRAL were searched from inception till 1st May 2021. Randomized Control Trials evaluating mindfulness-based stress reduction/cognitive therapy with either passive comparators (usual care) or active comparators (e.g., Health education or cognitive behavioral therapy) for chronic headaches (Migraine, Tension-type, or cluster headaches), which evaluated either headache frequency, pain intensity or headache duration as primary outcome were eligible for inclusion. The Risk of Bias was evaluated using the Cochrane Collaboration's Risk of Bias Tool.
RESULTS
A total of ten Randomized Controlled Trials (five on migraine; three on tension-type; two with mixed samples) were evaluated. In comparison to usual care, mindfulness-based stress reduction/cognitive therapy did not illustrate significant changes in headache frequency (MD = -0.14; 95% CI -1.26 to 0.97; P = 0.80; Moderate Certainty), headache duration (MD = -0.27; 95% CI -3.51 to 2.97, P = 0.87; Low Certainty) or pain intensity (MD = -0.19; 95% CI -0.46 to 0.07; P = 0.15; Moderate Certainty).
CONCLUSION
The results found are insignificant for the three primary outcomes, which may be due to the low number of participants and often a high or unclear risk of bias in the randomized control trials included. Perhaps more aggressive clinical trials with a larger sample size effectively demonstrate differences in outcomes before and after therapy for MBSR/MBCT could provide a more significant change.
PubMed: 35734718
DOI: 10.1016/j.amsu.2022.103862 -
Neurologia 2022Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological... (Review)
Review
INTRODUCTION
Non-pharmacological treatment of patients with headache, such as dry needling (DN), is associated with less morbidity and mortality and lower costs than pharmacological treatment. Some of these techniques are useful in clinical practice. The aim of this study was to review the level of evidence for DN in patients with headache.
METHODS
We performed a systematic review of randomised clinical trials on headache and DN on the PubMed, Web of Science, Scopus, and PEDro databases. Methodological quality was evaluated with the Spanish version of the PEDro scale by 2 independent reviewers.
RESULTS
Of a total of 136 studies, we selected 8 randomised clinical trials published between 1994 and 2019, including a total of 577 patients. Two studies evaluated patients with cervicogenic headache, 2 evaluated patients with tension-type headache, one study assessed patients with migraine, and the remaining 3 evaluated patients with mixed-type headache (tension-type headache/migraine). Quality ratings ranged from low (3/10) to high (7/10). The effectiveness of DN was similar to that of the other interventions. DN was associated with significant improvements in functional and sensory outcomes.
CONCLUSIONS
Dry needling should be considered for the treatment of headache, and may be applied either alone or in combination with pharmacological treatments.
Topics: Humans; Tension-Type Headache; Dry Needling; Headache; Post-Traumatic Headache; Migraine Disorders
PubMed: 35659858
DOI: 10.1016/j.nrleng.2019.09.010 -
Journal of Clinical Pharmacology Oct 2022The nature and magnitude of nocebo responses in primary headache disorders are still unknown. To assess the distribution and possible predictors of nocebo responses in... (Meta-Analysis)
Meta-Analysis
The nature and magnitude of nocebo responses in primary headache disorders are still unknown. To assess the distribution and possible predictors of nocebo responses in primary headache treatments, databases, including PubMed, EMBASE, and Cochrane Library were searched from 1988 to December 31, 2020, for parallel-group, double-blind, randomized placebo-controlled trials of pharmacologic treatments of primary headaches. The nocebo responses were calculated using a random effects meta-analysis model. Subgroup and metaregression analyses were performed to determine the associations of study design and demographic characteristics with nocebo responses. A total of 178 randomized controlled trials that satisfied the inclusion criteria were included. Prophylactic treatments elicited stronger nocebo responses than acute treatments. The majority of nocebo adverse events were mild to moderate in severity, with the nervous and digestive systems being the most commonly affected. There was a strong correlation between the active medication and control groups in terms of adverse events, both quantitatively and qualitatively. Long treatment duration, a high proportion of subjects receiving active medications, multicenter design, North America, high body mass index, women, previous treatment experiences, and a high proportion of patients with migraine headache with aura were all found to be significant positive predictors of nocebo responses, whereas the year of publication was found to be inversely related to them. Nocebo effects should be noticed for their contribution to discontinuation of or lack of adherence to active treatments. Clarifying these nocebo-related risk factors can aid in their clinical prevention and management.
Topics: Double-Blind Method; Female; Headache; Humans; Migraine Disorders; Multicenter Studies as Topic; Nocebo Effect; Randomized Controlled Trials as Topic; Risk Factors
PubMed: 35532312
DOI: 10.1002/jcph.2072 -
Headache Mar 2022To summarize the evidence regarding static and dynamic balance alterations among patients with headache. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To summarize the evidence regarding static and dynamic balance alterations among patients with headache.
METHODS
Electronic databases (PubMed, CINAHL, and Web of Science) were searched by two researchers independently up to September 2021. Two reviewers selected eligible studies, extracted the data, and assessed the quality of evidence using the Downs and Black checklist. Case-control studies were included if they involved balance assessment of any kind of headache, including objective outcome measures of dynamic and static tests such as body sway displacement, limits of stability (LOS), gait, and tandem walk tests. A meta-analysis and post hoc sensitivity analyses were performed when possible.
RESULTS
Twenty-two studies (1202 patients with headache and 597 controls) were included in this review and 16 of them in the meta-analysis. Risk of bias ranged from low to moderate among all studies. Greater sway area in static posturography was shown by patients with migraine in comparison to controls, with more consistent differences in more challenging test conditions, such as over a foam surface with eyes closed (difference of 4.8 cm , 95% CI: 3.8-5.9). Lower performance of patients with migraine during the tandem walk test (difference of -7.8 cm/s, 95% CI: -9.0 to -6.5) and slower reaction time in the LOS test (difference of 0.3 s, 95% CI: 0.2-0.4) were also verified. There is no evidence of altered sway velocity and length in static posturography among patients with migraine (p > 0.05). The level of evidence is very low for balance alteration of any kind among patients with tension-type and cervicogenic headache owing to the limited number of studies and high heterogeneity.
CONCLUSION
This review confirmed the presence of static and dynamic balance alterations among patients with migraine. Future studies with low risk of bias are needed to decrease heterogeneity in methodology and explore the role of subdiagnosis on the balance of patients with headache.
Topics: Case-Control Studies; Headache; Humans; Migraine Disorders; Post-Traumatic Headache; Postural Balance
PubMed: 35315066
DOI: 10.1111/head.14281 -
Headache Mar 2022The aim of this study was to identify the manual therapy (MT) methods and techniques that have been evaluated for the treatment of cervicogenic headache (CH) and their... (Review)
Review
OBJECTIVE
The aim of this study was to identify the manual therapy (MT) methods and techniques that have been evaluated for the treatment of cervicogenic headache (CH) and their effectiveness.
BACKGROUND
MT seems to be one of the options with the greatest potential for the treatment of CH, but the techniques to be applied are varied and there is no consensus on which are the most indicated.
METHODS
A systematic search in Scopus, Medline, PubMed, Cinahl, PEDro, and Web of Science with the terms: secondary headache disorders, physical therapy modalities, musculoskeletal manipulations, cervicogenic headache, manual therapy, and physical therapy. We included articles published from 2015 to the present that studied interventions with MT techniques in patients with CH. Two reviewers independently screened 365 articles for demographic information, characteristics of study design, study-specific intervention, and results. The Oxford 2011 Levels of Evidence and the Jadad scale were used.
RESULTS
Of a total of 14 articles selected, 11 were randomized control trials and three were quasi-experimental studies. The techniques studied were: spinal manipulative therapy, Mulligan's Sustained Natural Apophyseal Glides, muscle techniques, and translatory vertebral mobilization. In the short-term, the Jones technique on the trapezius and ischemic compression on the sternocleidomastoid achieved immediate improvements, whereas adding spinal manipulative therapy to the treatment can maintain long-term results.
CONCLUSIONS
The manual therapy techniques could be effective in the treatment of patients with CH. The combined use of MT techniques improved the results compared with using them separately. This review has methodological limitations, such as the inclusion of quasi-experimental studies and studies with small sample sizes that reduced the generalizability of the results obtained.
Topics: Humans; Manipulation, Spinal; Neck Muscles; Post-Traumatic Headache; Research Design; Tension-Type Headache
PubMed: 35294051
DOI: 10.1111/head.14278 -
Cephalalgia : An International Journal... Aug 2022This systematic review assesses the effectiveness of physiotherapy on headache parameters and quality of life of patients with tension-type headache using network... (Meta-Analysis)
Meta-Analysis
Effectiveness of physiotherapy interventions on headache intensity, frequency, duration and quality of life of patients with tension-type headache. A systematic review and network meta-analysis.
BACKGROUND
This systematic review assesses the effectiveness of physiotherapy on headache parameters and quality of life of patients with tension-type headache using network meta-analysis.
METHODS
A systematic search was conducted in the databases Web of Science, Medline, Cochrane Library and Physiotherapy Evidence Database up to August 2021. Randomised controlled trials investigating the effect of physiotherapy on tension-type headache were included. Risk of bias assessment was performed using the Risk of bias tool 2.0. Results were presented according to the Cochrane handbook and the PRISMA statement.
RESULTS
Twenty reports were eligible and 15 were included in network meta-analysis for pain intensity and frequency. Transcutaneous electrical stimulation combined with physiotherapy was the most effective approach to reduce pain intensity compared to control (mean difference (MD): -4.18, moderate confidence) and usual care (MD: -3.8, moderate confidence) Manual therapy (joint mobilisation) plus exercise was the most effective intervention to reduce headache frequency compared to control (MD: -13.03, low confidence) and usual care (MD: -13.95, moderate confidence).
CONCLUSION
Results suggest a combination of passive physiotherapy techniques with exercise and/or transcutaneous electrical stimulation as the most effective physiotherapy intervention to reduce pain intensity and frequency in the short term. More research is needed to investigate mid-term and long-term effects.: This review was prospectively registered in www.aspredicted.org under the registration number #46098 and an updated protocol was registered in the Open Science Framework (OSF) with the registration DOI: https://doi.org/10.17605/OSF.IO/RVUEY.
Topics: Headache; Humans; Network Meta-Analysis; Physical Therapy Modalities; Quality of Life; Tension-Type Headache
PubMed: 35236143
DOI: 10.1177/03331024221082073 -
Cephalalgia : An International Journal... Jun 2022Neck pain is a frequent complaint among patients with migraine and seems to be correlated with the headache frequency. Neck pain is more common in patients with chronic... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Neck pain is a frequent complaint among patients with migraine and seems to be correlated with the headache frequency. Neck pain is more common in patients with chronic migraine compared to episodic migraine. However, prevalence of neck pain in patients with migraine varies among studies.
OBJECTIVE
To estimate the prevalence of neck pain in patients with migraine and non-headache controls in observational studies.
METHODS
A systematic literature search on PubMed and Embase was conducted to identify studies reporting prevalence of neck pain in migraine patients. This review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data was extracted by two independent investigators and results were pooled using random-effects meta-analysis. The protocol was registered with PROSPERO (CRD42021264898).
RESULTS
The search identified 2490 citations of which 30 contained relevant original population based and clinic-based data. Among these, 24 studies provided data eligible for the analysis. The meta-analysis for clinic-based studies demonstrated that the pooled relative frequency of neck pain was 77.0% (95% CI: 69.0-86.4) in the migraine group and 23.2% (95% CI:18.6-28.5) in the non-headache control group. Neck pain was more frequent in patients with chronic migraine (87.0%, 95% CI: 77.0-93.0) compared to episodic migraine (77.0%, 95% CI: 69.0-84.0). Neck pain was 12 times more prevalent in migraine patients compared to non-headache controls and two times more prevalent in patients with chronic migraine compared to episodic migraine. The calculated heterogeneity (I values) ranged from 61.3% to 72.0%.
CONCLUSION
Neck pain is a frequent complaint among patients with migraine. The heterogeneity among the studies emphasize important aspects to consider in future research of neck pain in migraine to improve our understanding of the driving mechanisms of neck pain in a major group of migraine patients.
Topics: Headache; Humans; Migraine Disorders; Neck Pain; Prevalence; Tension-Type Headache
PubMed: 35166137
DOI: 10.1177/03331024211068073