Sensory function in headache: a comparative study among patients with cluster headache, migraine, tension-type headache,
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ORIGINAL ARTICLE
Sensory function in headache: a comparative study among patients with cluster headache, migraine, tension-type headache, and asymptomatic subjects Miguel Malo-Urriés 1,2 & Elena Estébanez-de-Miguel 1,2 & Elena Bueno-Gracia 1,2 & José Miguel Tricás-Moreno 1,2 & Sonia Santos-Lasaosa 3 & César Hidalgo-García 1,2 Received: 24 December 2019 / Accepted: 28 March 2020 # Fondazione Società Italiana di Neurologia 2020
Abstract Aims Studies evaluating sensory function of the entire trigeminocervical region in patients with cluster headache (CH), migraine (MH), and tension-type headache (TH) are required. The purpose of the present study was to evaluate and compare sensory function in the trigeminocervical region in patients with CH, MH, and TH and healthy controls (HC). Methods Quantitative sensory testing (QST), including pressure pain threshold (PPT), tactile detection threshold (TDT), prick detection threshold (PDT), and two-point detection threshold (2PDT), was evaluated in 139 patients with headache (CH = 16, MH = 52, TH = 71) and 30 HC. Test sites included bilaterally the first, second, and third divisions of trigeminal nerve (V1, V2, and V3), cervical spine, and thenar eminence. Results TH presented significantly lower PPT values compared with CH (p < 0.015), MH (p < 0.048), and HC (p < 0.009), while MH demonstrated significantly lower values than HC (p = 0.001–0.023). When analyzing TDT, CH in the symptomatic side presented significantly higher values in V1 compared with MH (p = 0.001), TH (p < 0.001), and HC (p < 0.001) and in V2 compared with TH (p = 0.035). No statistically significant differences were found for PDT (p > 0.005). With regard to 2PDT, CHs presented significantly higher values in V1 with respect to HC (p = 0.016) but lower values in V2 compared with MH (p < 0.001) and TH (p = 0.003). Conclusion The results of the present study indicate specific and different altered mechanical sensory thresholds in CH, MH, and TH patients compared with HC subjects. Keywords Quantitative sensory testing . Headache . Trigeminal autonomic cephalalgia . Pain
Introduction International Headache Classification divides headaches into primary headaches, due to the headache condition itself, and secondary headaches, due to an underlying
* Miguel Malo-Urriés [email protected]; [email protected] 1
Physiotherapy Research Unit, Department of Psychiatry and Nursing, University of Zaragoza, Zaragoza, Spain
2
Facultad de Ciencias de la Salud, Universidad de Zaragoza, c/ Domingo Miral s/n, 50009 Zaragoza, Spain
3
Neurology Service, University Clinical Hospital Lozano Blesa, Zaragoza, Spain
cause. Among the primary headaches, three groups are differentiated: migraine (MH), tension-type headache (TH), and trigeminal autonomic cephalalgias (TACs), with cluster headache (CH) as the most representative TAC. Primary headaches contribute to considerable reductions in specific domains of health-related quality of life, depending of the type of headache [1]. However, once headache becomes chronic, the overall
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