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Assessment of Pain Modulatory and Somatosensory Profiles in Chronic Tension-Type Headache Patients
Aarhus University, Aarhus, Denmark. (Scandinavian Center for Orofacial Neurosciences (SCON))
Aarhus University, Aarhus, Denmark. (Scandinavian Center for Orofacial Neurosciences (SCON))
Karolinska Institutet. (Scandinavian Center for Orofacial Neurosciences (SCON))
Aarhus University Hospital, Aarhus, Denmark.
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2021 (English)In: Pain medicine, ISSN 1526-2375, E-ISSN 1526-4637, Vol. 22, no 10, p. 2356-2365Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The aim of this study was to thoroughly phenotype a group of chronic tension-type headache (CTTH) patients.

METHODS: Fifteen CTTH patients diagnosed according to the International Classification of Headache Disorders-3 and 15 healthy controls were included in this study. Furthermore, 70 healthy controls were included to establish normative values. Quantitative sensory testing (QST), including temporal summation of pain (TSP), conditioned pain modulation (CPM), and psychological and sleep variables, was assessed in a single session. TSP and CPM were then combined to build pain modulation profiles (PMP) for each individual.

RESULTS: No difference was found between groups for PMP, TSP, and CPM. However, 10 CTTH patients showed a pronociceptive PMP, with 8 related to a deficient CPM and 2 to both a deficient CPM and increased TSP. Increased cold detection thresholds were the most common sensory disturbance found in CTTH patients. Significant differences were seen between groups for pain catastrophizing, depression, and sleep quality although not all patient's scores were above the clinically meaningful cutoffs.

CONCLUSIONS: In summary, CTTH patients presented with different PMP. These PMP may be related to increased TSP, deficient CPM, alterations in thermal detection that may be related to autonomic dysregulation, or a combination of all three. Overall, this suggests that due to their heterogeneous pathophysiology, CTTH patients should be managed according to their underlying pathophysiology and not with a one-size-fits-all approach.

Place, publisher, year, edition, pages
Oxford University Press, 2021. Vol. 22, no 10, p. 2356-2365
Keywords [en]
Conditioned Pain Modulation, Pain Modulation Profiles, Quantitative Sensory Testing
National Category
Nursing
Identifiers
URN: urn:nbn:se:mau:diva-46349DOI: 10.1093/pm/pnab084ISI: 000715367900024PubMedID: 33690821Scopus ID: 2-s2.0-85111085695OAI: oai:DiVA.org:mau-46349DiVA, id: diva2:1603407
Available from: 2021-10-15 Created: 2021-10-15 Last updated: 2024-02-05Bibliographically approved

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Svensson, Peter

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