Characterization and predictive mechanisms of experimentally induced tension-type headache

TY - JOUR

T1 - Characterization and predictive mechanisms of experimentally induced tension-type headache

AU - Exposto, Fernando Gustavo

AU - Bendixen, Karina H

AU - Ernberg, Malin

AU - Bach, Flemming Winther

AU - Svensson, Peter

PY - 2019

Y1 - 2019

N2 - OBJECTIVE: Studies have shown it is possible to elicit a tension-type headache episode in 15 to 30% of healthy individuals following a tooth-clenching or stress-inducing task. Despite this, no studies have attempted to understand why some healthy individuals develop a headache episode while others do not.METHODS: The present randomized, single-blind, controlled study recruited 60 healthy participants who participated in a 30-minute tooth-clenching task and 10 participants who participated in a control task. Before the tasks, participants had their pericranial tenderness and pain modulation profiles (wind-up ratio and conditioned pain modulation) assessed. Two hours later, pericranial tenderness and pressure pain thresholds were assessed as well as any developing temporomandibular disorders. Pain diaries were kept for 24 hours to register any developing pain or headache.RESULTS: Participants with a decrease in pericranial tenderness after the tooth-clenching task were less likely to develop headache when compared to participants without. Pain modulation profiles could not predict who developed headache and who did not. Finally, no difference was found between groups for developing temporomandibular disorders. No difference in frequency of participants who developed headache was found between the tooth-clenching and the control task.CONCLUSIONS: In conclusion, it was shown that increased pericranial tenderness was not required to trigger an episode of tension-type headache in healthy participants. Furthermore, pain modulation profiles could not predict who developed headache and who did not. Finally, activation of descending inhibitory pathways, as assessed by decreases in pericranial tenderness, was protective against the development of headache. These findings provide new insights into the pathophysiology of experimentally-induced tension-type headache.

AB - OBJECTIVE: Studies have shown it is possible to elicit a tension-type headache episode in 15 to 30% of healthy individuals following a tooth-clenching or stress-inducing task. Despite this, no studies have attempted to understand why some healthy individuals develop a headache episode while others do not.METHODS: The present randomized, single-blind, controlled study recruited 60 healthy participants who participated in a 30-minute tooth-clenching task and 10 participants who participated in a control task. Before the tasks, participants had their pericranial tenderness and pain modulation profiles (wind-up ratio and conditioned pain modulation) assessed. Two hours later, pericranial tenderness and pressure pain thresholds were assessed as well as any developing temporomandibular disorders. Pain diaries were kept for 24 hours to register any developing pain or headache.RESULTS: Participants with a decrease in pericranial tenderness after the tooth-clenching task were less likely to develop headache when compared to participants without. Pain modulation profiles could not predict who developed headache and who did not. Finally, no difference was found between groups for developing temporomandibular disorders. No difference in frequency of participants who developed headache was found between the tooth-clenching and the control task.CONCLUSIONS: In conclusion, it was shown that increased pericranial tenderness was not required to trigger an episode of tension-type headache in healthy participants. Furthermore, pain modulation profiles could not predict who developed headache and who did not. Finally, activation of descending inhibitory pathways, as assessed by decreases in pericranial tenderness, was protective against the development of headache. These findings provide new insights into the pathophysiology of experimentally-induced tension-type headache.

KW - CONDITIONED PAIN MODULATION

KW - DIAGNOSTIC-CRITERIA

KW - DOUBLE-BLIND

KW - MUSCLES

KW - NETWORK

KW - PERIPHERAL NEUROPATHIC PAIN

KW - PHENOTYPE

KW - RELIABILITY

KW - STIMULATION

KW - TENDERNESS

KW - Tension-type headache

KW - pain modulation

KW - pericranial tenderness

KW - total tenderness score

UR - http://www.scopus.com/inward/record.url?scp=85071708146&partnerID=8YFLogxK

U2 - 10.1177/0333102419840779

DO - 10.1177/0333102419840779

M3 - Journal article

C2 - 30922083

SN - 0333-1024

VL - 39

SP - 1207

EP - 1218

JO - Cephalalgia

JF - Cephalalgia

IS - 10

ER -