Debate: differences and similarities between tension-type headache and migraine

Onan, Dilara; Younis, Samaira; Wellsgatnik, William David; Farham, Fatemeh; Andruškevičius, Saulius; Abashidze, Ana; Jusupova, Asel; Romanenko, Yuriy; Grosu, Oxana; Moldokulova, Meerimgul Zamirbekovna; Mursalova, Ulkar; Saidkhodjaeva, Saida; Martelletti, Paolo; Ashina, Sait

doi:10.1186/s10194-023-01614-0

Cited by 27 publications

(14 citation statements)

References 151 publications

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“…As both pathological conditions involve the trigeminovascular system, serving as a cornerstone to explain shared features ( 34 ), it is reasonable that CCFT may not reveal any significant difference. Additionally, the coexistence of both clinical entities makes accurate diagnosis challenging.…”

Section: Discussionmentioning

confidence: 99%

Cervical impairments in subjects with migraine or tension type headache: an observational study

del Blanco Muñiz,

Sánchez Sierra,

Ladriñán Maestro

et al. 2024

Front. Neurol.

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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.

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Section: Discussionmentioning

confidence: 99%

Cervical impairments in subjects with migraine or tension type headache: an observational study

del Blanco Muñiz,

Sánchez Sierra,

Ladriñán Maestro

et al. 2024

Front. Neurol.

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“…Furthermore, the limited number of samples does not allow us to evaluate our results as a function of age, sex, frequency of attacks, and duration, which, in light of the above-mentioned considerations on the maturation process in children and variations in phenotype during developmental ages [2,3], are aspects that should not be overlooked. The absence in the control population of subjects suffering from tension-type headaches is an aspect that will need to be examined because at a developmental age, the boundaries between the two disorders are less clear than in adulthood, and there is frequently a transition from one form of headache to the other (more frequently from a tension-type headache to migraine) [46,47]. Finally, it would also be appropriate to compare our results with other non-invasive methods such as evoked potentials, quantitative EEG, etc., in the same subjects [48].…”

Section: Discussionmentioning

confidence: 99%

Pediatric Migraine and Visual Cortical Excitability: A Prospective Observational Study with Sound-Induced Flash Illusions

Di Marco,

Pilati,

Torrente

et al. 2024

Children

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The pathophysiological mechanisms underlying migraine are more difficult to investigate in children than in the adult population. Abnormal cortical excitability turns out to be one of the most peculiar aspects of migraine, accounting for the manifestations of migraine attacks. Recently, visual cortical excitability has been explored effectively in adult migraineurs with a technique based on cross-modal audio-visual illusions (with sound-induced flash illusions (SIFIs) being reduced in migraineurs compared to non-migraineur subjects). On such a basis, in this study, we investigated visual cortical excitability in children with migraine using SIFIs using combinations of visual and sound stimuli presented randomly. We evaluated 26 children with migraine without aura and 16 healthy children. Migraineurs did not differ from the age-matched healthy subjects regarding fission or fusion illusions but perceived more flashes in trials of multiple flashes with or without beeps. The higher number of SIFIs in migraineur children compared to adults may be due to a greater propensity of visual stimulation to be driven by auditory stimuli (i.e., acoustic dominance). The increased ability to perceive flashes reveals a hyperfunctional visual cortex, demonstrating that the use of SIFIs is a valid tool for assessing visual cortical responsiveness even in pediatric migraine.

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“…In other stressful context, the type of coping strategies can be different for each individual and influenced by other factors such as the duration of the stressful context, past experiences and resources (e.g., social support) ( 62 , 63 ). Regarding the similar use of coping strategies between teleworkers with migraine and those with TTH, a recent review reported that both primary headaches are negatively affected by psychological factors such as stress ( 64 ). As the pandemic was a common stressful situation for all participants, it is then not surprising that teleworkers with either migraine or TTH tried to cope using similar coping strategies.…”

Section: Discussionmentioning

confidence: 99%

Headache-related clinical features in teleworkers and their association with coping strategies during the COVID-19 pandemic

Houle,

Ducas,

Lardon

et al. 2023

Front. Public Health

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ObjectivesThe objectives were (1) to describe and compare headache-related clinical features between teleworkers with migraine and those with tension-type headache (TTH) and (2) to determine the association between coping strategies and headache frequency, and intensity in the context of the COVID-19 pandemic.MethodsThis cross-sectional online survey was conducted with 284 teleworkers (127 with migraine and 157 with TTH). Sociodemographic data, information related to work factors, headache clinical features, coping strategies used during the COVID-19 pandemic, and headache-related clinical features were compared between headache profiles. Bivariate logistic regression analyses were used to determine the association between coping strategies and headache frequency, and intensity.ResultsResults showed that teleworkers with migraine had longer and more painful headache episodes than teleworkers with TTH (ps < 0.001). Higher migraine frequency was associated with the use of the denial coping strategy (p = 0.006) while lower migraine intensity was associated with planning (p = 0.046) and the use of positive reframing (p = 0.025). Higher TTH frequency was associated with the use of venting, self-blame, and behavioral disengagement (ps < 0.007) while higher TTH intensity was associated with substance use and behavioral disengagement (ps < 0.030). All associations remained significant after adjusting for BMI as a covariate.Discussion/conclusionTeleworkers with migraine had more intense and longer headache episodes than teleworkers with TTH. This could be explained by the fact that a greater proportion of individuals suffering from migraine experienced headaches prior to the beginning of the pandemic compared with teleworkers suffering from TTH. Regarding coping strategies, both primary headache profiles were associated with different types of coping strategies. Most of the coping strategies associated with headache frequency or intensity were maladaptive except for planning and positive reframing that were found to be inversely associated with migraine intensity.

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Debate: differences and similarities between tension-type headache and migraine

Cited by 27 publications

References 151 publications

Cervical impairments in subjects with migraine or tension type headache: an observational study

Cervical impairments in subjects with migraine or tension type headache: an observational study

Pediatric Migraine and Visual Cortical Excitability: A Prospective Observational Study with Sound-Induced Flash Illusions

Headache-related clinical features in teleworkers and their association with coping strategies during the COVID-19 pandemic

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