scholarly journals Are Migraine and Tension-Type Headache Genetically Related? An Investigation of Twin Family Data

2018 ◽  
Vol 21 (2) ◽  
pp. 112-118 ◽  
Author(s):  
Lannie Ligthart ◽  
Annemarie Huijgen ◽  
Gonneke Willemsen ◽  
Eco J. C. de Geus ◽  
Dorret I. Boomsma
Keyword(s):  
Genetic Factors ◽  
Population Level ◽  
Tension Type Headache ◽  
Twin Design ◽  
Lifestyle Risk Factors ◽  
Younger Age ◽  
The Difference ◽  
Lifestyle Risk ◽  
Type Headache

Migraine and tension-type headache (TTH) are often viewed as distinct entities and defined as such in the International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, although there is also empirical evidence to suggest they may be etiologically similar. This study aims to investigate whether migraine and TTH are etiologically related conditions. First, we explored whether migraine and TTH were associated with the same environmental and lifestyle risk factors at the population level. Second, we examined comorbidity of migraine and TTH in a twin design. By comparing the associations in monozygotic (MZ) and dizygotic (DZ) twin pairs, we investigated whether the comorbidity can be explained by genetic factors that influence both conditions. Results indicated that migraine and TTH were largely associated with the same environmental and lifestyle factors, including younger age, female sex, higher body mass index, more depression, stress at home, and less participation in regular exercise, with consistently stronger effects for migraine than for TTH. Migraine in one twin was significantly associated with TTH in the other twin. A stronger cross-trait, cross-twin association in MZ than DZ twins suggested that this comorbidity may also be partly due to shared genetic factors, although the difference in associations was not significant. In conclusion, our findings are consistent with the hypothesis that migraine and TTH have partly shared etiologies. For both treatment and research, it may be advisable not to make a rigid distinction, but to treat migraine and TTH as related conditions.

Assessment of Pain Modulatory and Somatosensory Profiles in Chronic Tension-Type Headache Patients

Pain Medicine ◽  
2021 ◽  
Author(s):  
Fernando G Exposto ◽  
Karina H Bendixen ◽  
Malin Ernberg ◽  
Flemming W Bach ◽  
Peter Svensson
Keyword(s):  
Pain Catastrophizing ◽  
Tension Type Headache ◽  
Pain Modulation ◽  
Normative Values ◽  
Healthy Controls ◽  
Single Session ◽  
Chronic Tension Type Headache ◽  
Type Headache ◽  
Underlying Pathophysiology

Abstract 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.

Characteristics of Brain Tumour-Associated Headache

Cephalalgia ◽  
2007 ◽  
Vol 27 (8) ◽  
pp. 904-911 ◽  
Author(s):  
CJ Schankin ◽  
U Ferrari ◽  
VM Reinisch ◽  
T Birnbaum ◽  
R Goldbrunner ◽  
...  
Keyword(s):  
Brain Tumour ◽  
Univariate Analysis ◽  
Positive Family History ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Moderate Intensity ◽  
Secondary Headache ◽  
History Of ◽  
Type Headache

Eighty-five brain tumour patients were examined for further characteristics of brain tumour-associated headache. The overall prevalence of headache in this population was 60%, but headache was the sole symptom in only 2%. Pain was generally dull, of moderate intensity, and not specifically localized. Nearly 40% met the criteria of tension-type headache. An alteration of the pain with the occurrence of the tumour was experienced by 82.5%, implying that the preexisting and the brain tumour headaches were different. The classic characteristics mentioned in the International Classification of Headache Disorders (worsening in the morning or during coughing) were not found; this might be explained by the patients not having elevated intracranial pressure. Univariate analysis revealed that a positive family history of headache and the presence of meningiomas are risk factors for tumour-associated headache, and the use of β-blockers is prophylactic. Pre-existing headache was the only risk factor according to logistic regression, suggesting that patients with pre-existing (primary) headache have a greater predisposition to develop secondary headache. Dull headache occurs significantly more often in patients with glioblastoma multiforme, and pulsating headache in patients with meningioma. In our study, only infratentorial tumours were associated with headache location, and predominantly with occipital but rarely frontal pain.

A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks

Cephalalgia ◽  
2019 ◽  
Vol 40 (4) ◽  
pp. 337-346 ◽  
Author(s):  
Alberto Terrin ◽  
Federico Mainardi ◽  
Carlo Lisotto ◽  
Edoardo Mampreso ◽  
Matteo Fuccaro ◽  
...  
Keyword(s):  
Prospective Study ◽  
Diagnostic Criteria ◽  
Migraine Without Aura ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Headache Attack ◽  
Accompanying Symptoms ◽  
Type Headache ◽  
A Prospective Study

Background In literature, osmophobia is reported as a specific migrainous symptom with a prevalence of up to 95%. Despite the International Classification of Headache Disorders 2nd edition proposal of including osmophobia among accompanying symptoms, it was no longer mentioned in the ICHD 3rd edition. Methods We conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache or a combination of these. After a retrospective interview, each patient was asked to describe in detail osmophobia, when present, in the following four headache attacks. Results In all, 45.7% of migraine without aura attacks were associated with osmophobia, 67.2% of migraineurs reported osmophobia in at least a quarter of the attacks. No episodic tension-type headache attack was associated with osmophobia. It was associated with photophobia or phonophobia in 4.3% of migraine without aura attacks, and it was the only accompanying symptom in 4.7% of migraine without aura attacks. The inclusion of osmophobia in the ICHD-3 diagnostic criteria would enable a 9.0% increased diagnostic sensitivity. Conclusion Osmophobia is a specific clinical marker of migraine, easy to ascertain and able to disentangle the sometimes challenging differential diagnosis between migraine without aura and episodic tension-type headache. We recommend its inclusion among the diagnostic criteria for migraine as it increases sensitivity, showing absolute specificity.

Definitions and participant characteristics of frequent recurrent headache types in clinical trials: A systematic review

Cephalalgia ◽  
2017 ◽  
Vol 38 (4) ◽  
pp. 786-793 ◽  
Author(s):  
Maria-Eliza R Aguila ◽  
Trudy Rebbeck ◽  
Kristofferson G Mendoza ◽  
Mary-Grace L De La Peña ◽  
Andrew M Leaver
Keyword(s):  
Systematic Review ◽  
Clinical Trials ◽  
Cluster Headache ◽  
Cervicogenic Headache ◽  
Tension Type Headache ◽  
Inclusion Criteria ◽  
Recurrent Headache ◽  
Episode Frequency ◽  
Type Headache

Background Clear definitions of study populations in clinical trials may facilitate application of evidence to clinical populations. This review aimed to explore definitions of study populations in clinical trials on migraine, tension-type headache, cluster headache, and cervicogenic headache. Methods We performed a systematic review of clinical trials investigating treatment efficacy for migraine, tension-type headache, cluster headache, and cervicogenic headache. We extracted data on diagnosis, inclusion criteria and baseline headache characteristics. Results Of the 229 studies reviewed, 205 studies (89.5%) defined their populations in adherence to the International Classification of Headache Disorders (ICHD) criteria. Some studies ( n = 127, 55.5%) specified diagnosing through interview, clinical examination and diary entry. The most commonly reported inclusion criteria were pain intensity for migraine and tension-type headache studies ( n = 123, 66.1% and n = 21, 67.7%, respectively), episode frequency ( n = 5, 71.4%) for cluster headache studies, and neck-related pain for cervicogenic headache studies ( n = 3, 60%). Few studies reported details on the extent to which diagnostic criteria were present at baseline. Conclusions ICHD is routinely used in defining populations in headache studies. Details of baseline headache characteristics were not as consistently reported.

scholarly journals Associations between stress and migraine and tension-type headache: Results from a school-based study in adolescents from grammar schools in Germany

Cephalalgia ◽  
2011 ◽  
Vol 31 (7) ◽  
pp. 774-785 ◽  
Author(s):  
Astrid Milde-Busch ◽  
Astrid Blaschek ◽  
Florian Heinen ◽  
Ingo Borggräfe ◽  
Inga Koerte ◽  
...  
Keyword(s):  
Tension Type Headache ◽  
Major Contributor ◽  
Headache Disorders ◽  
Behavioural Interventions ◽  
School Based ◽  
Different Types ◽  
Stressful Experiences ◽  
Type Headache ◽  
Linear Regressions

Introduction: Stress is considered the major contributor to migraine and tension-type headache in adolescents. Previous studies have focused on general stressors, whereas the aim of the present study was to investigate associations between individuals’ stressful experiences and different types of headache. Methods: Adolescents from 10th and 11th grades of grammar schools filled in questionnaires. Stressful experiences were measured with the Trier Inventory of Chronic Stress. Type of headache was classified according to the International Classification of Headache Disorders. Linear regressions, adjusted for sex and grade, were calculated to estimate differences in stress scores that can be attributed to migraine, tension-type headache or miscellaneous headache. Results: A total of 1260 questionnaires were analysed. Tension-type headache, migraine and co-existing migraine plus tension-type headache were found in 48.7%, 10.2% and 19.8% of the participants. In subjects with migraine or co-existing migraine plus tension-type headache, high increases in stress scores were found in all investigated dimensions, whereas much weaker and inconsistent associations were found in subjects with tension-type headache only. Conclusions: The characteristic of migraine is more associated with stressful experiences than this is the case for tension-type headache. This suggests that adolescent migraine patients might especially benefit from behavioural interventions regarding stress.

scholarly journals Diagnosis of primary headache in children younger than 6 years: A clinical challenge

Cephalalgia ◽  
2016 ◽  
Vol 37 (10) ◽  
pp. 947-954 ◽  
Author(s):  
Roberto Torriero ◽  
Alessandro Capuano ◽  
Rosanna Mariani ◽  
Roberto Frusciante ◽  
Samuela Tarantino ◽  
...  
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Preschool Age ◽  
Clinical Feature ◽  
Primary Headaches ◽  
Clinical Challenge ◽  
Adults And Children ◽  
Type Headache

Background Criteria defined by the International headache Society are commonly used for the diagnosis of the different headache types in both adults and children. However, some authors have stressed some limits of these criteria when applied to preschool age. Objective Our study aimed to describe the characteristics of primary headaches in children younger than 6 years and investigate how often the International Classification of Headache Disorders (ICHD) criteria allow a definitive diagnosis. Methods This retrospective study analysed the clinical feature of 368 children younger than 6 years with primary headache. Results We found that in our patients the percentage of undefined diagnosis was high when either the ICHD-II or the ICHD-III criteria were used. More than 70% of our children showed a duration of their attacks shorter than 1 hour. The absence of photophobia/phonophobia and nausea/vomiting significantly correlate with tension-type headache (TTH) and probable TTH. The number of first-degree relatives with migraine was positively correlated to the diagnosis of migraine in the patients ( p < 0.001). Conclusions Our study showed that the ICHD-III criteria are difficult to use in children younger than 6 years. The problem is not solved by the reduction of the lowest duration limit for the diagnosis of migraine to 1 hour, as was done in the ICHD-II.

Interrelation of Chronic Tension-Type Headache With and Without Medication Overuse and Migraine in the General Population: The Akershus Study of Chronic Headache

Cephalalgia ◽  
2009 ◽  
Vol 29 (3) ◽  
pp. 331-337 ◽  
Author(s):  
K Aaseth ◽  
RB Grande ◽  
C Lundqvist ◽  
MB Russell
Keyword(s):  
General Population ◽  
Chronic Headache ◽  
Medication Overuse ◽  
Age At Onset ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Increased Risk ◽  
Type Headache ◽  
Complex Matter

We studied the interrelation of chronic tension-type headache with and without medication overuse (CTTH) and migraine in a random sample of 30 000 persons aged 30–44 years. They received a mailed questionnaire. Those with a possible chronic headache were interviewed by neurological residents. The International Classification of Headache Disorders was used. A total of 386 persons had CTTH. Compared with the general population, men had a 2.8-fold and women a 2.4-fold significantly increased risk of migraine without aura (MO). The risk of migraine with aura (MA) was not increased. The mean age at onset of CTTH was significantly higher in those with than in those without co-occurrence of MO. Bilateral MO attacks were significantly more frequent in those with age at onset of CTTH prior to age at onset of MO compared with those with age at onset in reverse order. CTTH and MO are interrelated, possibly in a complex matter. In contrast, CTTH and MA are not interrelated.

Classification of Chronic Daily Headache by International Headache Society Criteria: Limits and New Proposals

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 37-43 ◽  
Author(s):  
GC Manzoni ◽  
F Granella ◽  
G Sandrini ◽  
A Cavallini ◽  
C Zanferrari ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Chronic Daily Headache ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Clear Cut ◽  
Ihs Classification ◽  
Daily Headache ◽  
Type Headache ◽  
Headache Centres

We conducted a retrospective study of 150 patients with chronic daily headache (CDH) to determine how to categorize their headache according to the classification of the International Headache Society (IHS). All patients were first evaluated at Parma and Pavia Headache Centres (from January 1992 to March 1993) and had had headache for at least 15 days a month during the previous 6 months. Four patients were thereafter excluded due to poor reliability. The 146 patients who met our CDH criteria (92 with and 54 without clear-cut migraine attacks) could be classified into four groups: (i) chronic tension-type headache (CTTH)-27 patients; (ii) coexisting migraine plus CTTH-65 patients; (iii) unclassifiable daily headache-27 patients; and (iv) migraine and an unclassifiable interval headache-27 patients. Seventy-two percent of patients with CDH had migraine as the initial form of their headache. We therefore propose to revise the IHS classification for migraine, taking into account its evolution, and add two subcategories, migraine with interparoxysmal headache and chronic migraine.

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