scholarly journals Identifying Chinese Medicine patterns of Tension-type Headache (TTH) and its implication on understanding TTH subgroups

2019 ◽  
Author(s):  
Xinyu Hao ◽  
Fanrong Liang ◽  
Linpeng Wang ◽  
Kenneth Mark Greenwood ◽  
Charlie Changli Xue ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
International Headache Society ◽  
Principal Component ◽  
Signs And Symptoms ◽  
Tension Type Headache ◽  
Mental Strain ◽  
Neck Stiffness ◽  
Targeted Interventions ◽  
Symptom Patterns ◽  
Type Headache

Abstract Background Acupuncture is commonly used to relieve tension-type of headache (TTH), however, there is a lack of consistent approach of devising acupuncture interventions for TTH due to limited evidence for symptom patterns according to Chinese medicine. This study aimed to identity common Chinese medicine symptom patterns of TTH.Methods We applied a validated Chinese Medicine Headache Questionnaire to a group of headache sufferers. The questionnaire consisted of information about headache, aggravating and relieving factors and accompanying symptoms. The Migraine Disability Assessment Test (MIDAS) was used to assess disability and the Perceived Stress Scale (PSS) for the level of stress. Information about comorbidities was collected. The modified International Headache Society TTH diagnostic criteria (ICHD-II) were used to screen the participants. Principal component analysis was used for factor extraction and Two-Step cluster analyses for clustering. One-way analysis of variance (ANOVA) was used to compare cluster groups in disability and stress.Results In total 170 participants, including 114 females and 56 males, met the selection criteria. The commonest headache features were continuous pain (64%) and fixed location (74%). Headache was aggravated by overwork (74%), stress (74%), and mental strain (70%) and relieved by sleeping (78%). The commonest accompanied symptoms were fatigue (71%) and neck stiffness (70%). Four clusters were identified with 46, 34, 46 and 44 participants in Clusters 1-4, respectively. Assessed by experts, the four clusters could be assigned to three different patterns, including Ascendant hyperactivity of Liver-Yang (Cluster 1), Dual Qi and Blood deficiency (Cluster 2), Liver depression forming Fire (Cluster 3), and an Un-labelled group (Cluster 4). The four clusters differed in their key signs and symptoms. Additionally, over 75% participants in clusters 1 and 2 were episodic TTH, over one third in Cluster 3 having chronic TTH, and the majority in Cluster 4 were in-frequent TTH. The three patterns identified also differed in levels of disability and some elements of coping as measured with PSS.Conclusion The three symptom patterns identified are common clinical presentations of TTH. The new information will contribute to further understanding of the subtypes of TTH and guide the development of targeted interventions, including acupuncture, for clinical practice and research.

scholarly journals Identifying Chinese Medicine Patterns of Tension-Type Headache and Understanding Its Subgroups

2021 ◽  
Vol 2021 ◽  
pp. 1-23
Author(s):  
Xinyu Hao ◽  
Fanrong Liang ◽  
Linpeng Wang ◽  
Kenneth Mark Greenwood ◽  
Charlie Changli Xue ◽  
...  
Keyword(s):  
Chinese Medicine ◽  
Management Strategies ◽  
Principal Component ◽  
Signs And Symptoms ◽  
Tension Type Headache ◽  
Mental Strain ◽  
Neck Stiffness ◽  
Accompanying Symptoms ◽  
Type Headache ◽  
Individualized Management

Tension-type headache (TTH) is common among adults. Individualized management strategies are limited due to lack of understanding of subtypes of TTH. Chinese medicine (CM) uses the pattern differentiation approach to subtype all health conditions. There is, however, a lack of evidence-based information on CM patterns of TTH. This study aimed to identity common CM patterns of TTH. TTH sufferers were invited for a survey, consisting of a validated Chinese Medicine Headache Questionnaire (CMHQ), Migraine Disability Assessment Test, and Perceived Stress Scale. The CMHQ consisted of information about headache, aggravating and relieving factors, and accompanying symptoms. Principal component analysis was used for factor extraction and TwoStep cluster analyses for identifying clusters. ANOVA was used to compare cluster groups with disability and stress. In total, 170 eligible participants took part in the survey. The commonest headache features were continuous pain (64%); fixed location (74%); aggravated by overwork (74%), stress (74%), or mental strain (70%); and relieved by sleeping (78%). The commonest nonpain symptoms were fatigue (71%) and neck stiffness (70%). Four clusters, differing in their key signs and symptoms, could be assigned to three different CM patterns including ascendant hyperactivity of liver yang (cluster 1), dual qi and blood deficiency (cluster 2), liver depression forming fire (cluster 3), and an unlabelled group (cluster 4). Additionally, over 75% participants in clusters 1 and 2 have episodic TTH, over one-third participants in cluster 3 have chronic TTH, and a majority of participants in cluster 4 have infrequent TTH. The three patterns identified also differed in levels of disability and some elements of coping as measured with PSS. The three CM patterns identified are common clinical presentations of TTH. The new information will contribute to further understanding of the subtypes of TTH and guide the development of targeted intervention combinations for clinical practice and research.

scholarly journals Prevalence and impact of headache in undergraduate students in Southern Brazil

2010 ◽  
Vol 68 (6) ◽  
pp. 873-877 ◽  
Author(s):  
Asdrubal Falavigna ◽  
Alisson Roberto Teles ◽  
Maíra Cristina Velho ◽  
Viviane Maria Vedana ◽  
Roberta Castilhos da Silva ◽  
...  
Keyword(s):  
Undergraduate Students ◽  
International Headache Society ◽  
Primary Headache ◽  
Tension Type Headache ◽  
Significant Difference ◽  
Headache Episode ◽  
Headache Type ◽  
Probable Migraine ◽  
Type Headache ◽  
The University

OBJECTIVE: To determine the prevalence, characteristics and impact of headache among university students. METHOD: The criteria established by the International Headache Society were used to define the primary headache subtypes and the Migraine Disability Assessment Questionnaire (MIDAS), to assess the disability. The students were then grouped into six categories: [1] migraine; [2] probable migraine; [3] tension-type headache; [4] probable tension-type headache; [5] non-classifiable headache; [6] no headache. RESULTS: Of all undergraduate students interviewed, 74.5% had at least one headache episode in the last three months. Regarding disability, there was a significant difference between the headache types (p<0.0001). In the post-hoc analysis, migraine was the headache type with most reported disability. CONCLUSION: Headache is a highly prevalent condition among the students at the University of Caxias do Sul. This disease may have a major impact on the students' lives and in some cases, ultimately lead to educational failure.

Migraine and Glaucoma: an Epidemiologic Survey of French Ophthalmologists

Cephalalgia ◽  
1998 ◽  
Vol 18 (2) ◽  
pp. 74-76 ◽  
Author(s):  
A Pradalier ◽  
P Hamard ◽  
E Sellem ◽  
L Bringer
Keyword(s):  
Potential Role ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Epidemiologic Survey ◽  
Migraine Prevalence ◽  
Low Tension Glaucoma ◽  
Ihs Criteria ◽  
Type Headache ◽  
Low Tension

Glaucoma is a common ocular disorder; a high intraocular pressure is observed in the majority of glaucoma (HIOPG) cases, but some patients have low-tension glaucoma (LTG). In the literature, some works link LTG and migraine, which is speculative of a potential role of a vasospastic factor or diathesis common to migraine and LTG. Using a standardized questionnaire based on International Headache Society (IHS) criteria, we investigated 954 glaucoma patients; 320 (33.5%) described a headache (migraine or tension-type headache) and 240 (25.1%) presented the IHS criteria for migraine. Migraine prevalence was not significantly different between HIOPG and LTG patients (22.8% and 32%, respectively) in this study.

A Population-Based Analysis of the Diagnostic Criteria of the International Headache Society

Cephalalgia ◽  
1991 ◽  
Vol 11 (3) ◽  
pp. 129-134 ◽  
Author(s):  
Birthe Krogh Rasmussen ◽  
Rigmor Jensen ◽  
Jes Olesen
Keyword(s):  
Physical Activity ◽  
Diagnostic Criteria ◽  
International Headache Society ◽  
Normal Subjects ◽  
Population Based ◽  
Tension Type Headache ◽  
Headache Disorders ◽  
Specific Proposal ◽  
Accompanying Symptoms ◽  
Type Headache

In 740 representative normal subjects a diagnostic headache interview and a neurological examination provided the necessary information to classify headache disorders according to the operational diagnostic criteria of the International Headache Society (IHS). Sixteen per cent (n = 119) had migraine, 78% (n = 578) tension-type headache. In migraineurs, pain was of a pulsating quality in 78%, severe in 85%, unilateral in 62%, and aggravated by routine physical activity in 96%. Tension-type headache was of a pressing quality in 78%, mild or moderate in 99%, bilateral in 90%, and 72% had no aggravation by physical activity. The accompanying symptoms of nausea, photo- and phonophobia occurred frequently and were usually moderate or severe in migraine subjects, and if present in subjects with tension-type headache, they were usually mild. Only two subjects had unclassifiable headache. The IHS Classification is thus exhaustive. The criteria may be improved by mandatory demands to the criterion of pain intensity leaving other features of pain as supportive for the diagnosis and by including graded severity of accompanying symptoms. A specific proposal is given.

Long-Term Outcome of Patients with Headache and Drug Abuse after Inpatient Withdrawal

Cephalalgia ◽  
1996 ◽  
Vol 16 (7) ◽  
pp. 481-485 ◽  
Author(s):  
P Schnider ◽  
S Aull ◽  
C Baumgartner ◽  
A Marterer ◽  
C Wöber ◽  
...  
Keyword(s):  
Drug Abuse ◽  
Drug Withdrawal ◽  
International Headache Society ◽  
Close Correlation ◽  
Tension Type Headache ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Daily Headache ◽  
Type Headache

Thirty-eight patients with “chronic daily” headache and ergotamine and/or analgesics abuse according to the criteria proposed by the international Headache Society were re-investigated 5 years after inpatient drug withdrawal. At the end of the observation period, 19 patients (50.0%) had their headaches on only 8 days per month or less, 18 patients (47.4%) were free of symptoms or had only mild headaches. A close correlation was found between the frequency of headache and the duration of drug abuse, as well as between the intensity of headache and the number of tablets taken per month. Frequency and intensity of headache had changed within the first 2 years after withdrawal, but remained stable afterwards. Fifteen patients (39.5%) reported on recurrent drug abuse. Patients with migraine showed a tendency towards a better prognosis compared to patients with tension-type headache or with combined migraine and tension-type headache. The results of this study highlight the long-term efficacy of inpatient drug withdrawal in patients with headache and ergotamine and/or analgesics abuse.

The Prevalence of Headache Among Elderly in a Low-Income Area of São Paulo, Brazil

Cephalalgia ◽  
2008 ◽  
Vol 28 (4) ◽  
pp. 329-333 ◽  
Author(s):  
IM Benseñor ◽  
PA Lotufo ◽  
AC Goulart ◽  
PR Menezes ◽  
M Scazufca
Keyword(s):  
Low Income ◽  
International Headache Society ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Sao Paulo ◽  
Tension Type Headache ◽  
São Paulo ◽  
Cross Sectional ◽  
Migraine Headaches ◽  
Type Headache

There are scarce data about headache prevalence and its characteristics among elderly people. The aim was to carry out a cross-sectional study to determine the 1-year prevalence of tension-type and migraine headaches in people >65 years old in the city of São Paulo, Brazil. All 1615 people living in the study catchment area who agreed to participate in the study answered a questionnaire based in the International Headache Society criteria. Prevalence (mean and 95% confidence interval) of any type of headache in the last year was 45.6% (43.2, 48.0). Prevalence of tension-type headache in the last year was 33.1% (30.8, 35.4): 28.1% (24.6, 31.6) for men and 36.4% (33.4, 39.4) for women; for migraine headaches, prevalence in the last year was 10.6% (9.1, 12.1): 5.1% (3.4, 6.8) for men and 14.1% (11.9, 16.3) for women. One-year prevalence rates of headaches, and especially of migraine headaches, are very high among the elderly in Brazil.

Headache Prevalence Among Adolescents — The German DMKG Headache Study

Cephalalgia ◽  
2007 ◽  
Vol 27 (4) ◽  
pp. 347-354 ◽  
Author(s):  
K Fendrich ◽  
M Vennemann ◽  
V Pfaffenrath ◽  
S Evers ◽  
A May ◽  
...  
Keyword(s):  
International Headache Society ◽  
Primary Headache ◽  
Population Based ◽  
Cross Sectional Study ◽  
Tension Type Headache ◽  
Cross Sectional ◽  
Primary Headache Disorders ◽  
Ihs Criteria ◽  
Probable Migraine ◽  
Type Headache

This population-based cross-sectional study examined the 3-month prevalence of headache, migraine and tension-type headache (TTH) among adolescents aged 12-15 years in Germany Students ( n = 3324) from 20 schools completed a questionnaire on general and headache-specific pain which included a sociodemographic module. The headache-specific questionnaire complied with the respective revised criteria of the International Headache Society (IHS). 'Modified criteria' changed the item 'duration' in migraine (>30 min instead of >4 h). The overall 3-month prevalence of headache was 69.4% (boys 59.5%, girls 78.9%), with 4.4% of the adolescents suffering from frequent (≥ 14 days/3 months) and severe (grade 8-10 on a 10-point visual analogue scale) headache and 1.4% (boys 0.9%, girls 1.9%) from headache ≥15 days/month. The 3-month prevalence of migraine was 2.6% (boys 1.6%, girls 3.5%) applying strict IHS criteria and 6.9% (boys 4.4%, girls 9.3%) with modified criteria; 12.6% (boys 8.3%, girls 16.7%) suffered from probable migraine, 0.07% fulfilled the criteria for chronic migraine, 4.5% (boys 4.6%, girls 4.3%) suffered from TTH, 0.2% from chronic TTH and 15.7% (boys 14.5%, girls 16.9%) from probable TTH. Headache and migraine were more common in girls than in boys and in teenagers, especially in girls, aiming at higher education. Recurrent headache and primary headache disorders are common complaints among German adolescents, especially among girls.

Evaluation of Chronic Daily Headache—Comparison to Criteria for Chronic Tension-Type Headache

Cephalalgia ◽  
1992 ◽  
Vol 12 (6) ◽  
pp. 365-368 ◽  
Author(s):  
Seymour Solomon ◽  
Richard B Lipton ◽  
Lawrence C Newman
Keyword(s):  
Chronic Daily Headache ◽  
Medication Overuse ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Chronic Tension Type Headache ◽  
Ihs Classification ◽  
Analgesic Medication ◽  
Daily Headache ◽  
Ihs Criteria ◽  
Type Headache

The purpose of this study was to evaluate the adequacy of the International Headache Society (IHS) criteria for chronic tension-type headache and, if appropriate, suggest modifications of the IHS classification. We evaluated 100 consecutive patients with chronic daily headache. Approximately two-thirds of our patients fulfilled the criteria for chronic tension-type headache. Most of the patients who failed to meet the criteria did so because they had more than one migrainous feature. Approximately 50% of patients took excessive amounts of analgesic medication. We conclude that the IHS criteria should be modified to include chronic daily headache evolving from migraine; subtypes with and without medication overuse should be distinguished.

Diagnosis of Headache in Childhood and Adolescence: A Study in 437 Patients

Cephalalgia ◽  
1995 ◽  
Vol 15 (1) ◽  
pp. 13-21 ◽  
Author(s):  
C Wöber-Bingöl ◽  
C Wöber ◽  
A Karwautz ◽  
C Vesely ◽  
C Wagner-Ennsgraber ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Outpatient Clinic ◽  
International Headache Society ◽  
Tension Type Headache ◽  
Childhood And Adolescence ◽  
Highly Sensitive ◽  
Ihs Criteria ◽  
Type Headache ◽  
Structured Questionnaire

We investigated whether the criteria for idiopathic headache published by the International Headache Society (IHS) are useful in childhood and adolescence and compared the diagnoses according to this classification with those of Vahlquist. We used a semi-structured questionnaire to examine a total of 437 children and adolescents referred consecutively to a headache outpatient clinic. Twenty-eight of 437 patients were excluded because of symptomatic or unclassifiable headache. Of 409 patients with idiopathic headache, 70.4% had definite migraine or tension-type headache (IHS 1.1, 1.2, 2.1, 2.2), 20.5% had a migrainous disorder (IHS 1.7) and 9.1% had headache of the tension-type not fulfilling the criteria (IHS 2.3). In the differential diagnosis of migraine and tension-type headache the intensity of pain, aggravation of headache by physical activity, nausea and vomiting were the most important features. The quality of pain, photo- and phonophobia were less helpful and location least important. The duration of migraine attacks was less than 2 h in 19.0% of the migraine patients. In general, the diagnostic criteria of migraine were highly specific but less sensitive, and those of tension-type headache highly sensitive but less specific. The agreement between IHS criteria and those of Vahlquist was marked (kappa = 0.57). We conclude that the IHS criteria are useful for classifying headache in children and adolescents referred to a headache outpatient clinic. A forthcoming modification of the IHS criteria should consider a reduction of the minimum duration of migraine attacks from 2 h to I h and should try to increase the sensitivity of the criteria for migraine and the specificity of the criteria for tension-type headache.

The International Headache Society (IHS) Headache Classification as Applied to a Headache Clinic Population

Cephalalgia ◽  
1994 ◽  
Vol 14 (6) ◽  
pp. 443-446 ◽  
Author(s):  
LC Sanin ◽  
NT Mathew ◽  
LR Bellmeyer ◽  
S Ali
Keyword(s):  
International Headache Society ◽  
Chronic Cluster Headache ◽  
Tension Type Headache ◽  
Drug Induced ◽  
Advantages And Disadvantages ◽  
Common Diagnosis ◽  
History Of ◽  
Headache Clinic ◽  
Type Headache ◽  
Drug Induced Headache

Four hundred patients attending a headache clinic were classified using the IHS criteria. The majority required more than two, often three or four, diagnoses. Even though migraine was the most common diagnosis, only 1/4 of those with a migraine diagnosis had it as the only diagnosis. Seventy-five percent of migraine patients had coexistent chronic tension-type headache (CTTH), drug-induced headache or both. Ninety-six percent of patients diagnosed as having migraine with aura also suffered from migraine without aura. More than 1/3 of patients (37.7%) attending the clinic suffered from chronic daily headache (CDH) (chronic cluster headache excluded), which is not included as a separate entity in the IHS classification. Pure CTTH formed only a small minority of CDH, whereas 86.6% of CDH had migraine as one of the diagnoses. Drug-induced headache was a prominent second or third diagnosis. The advantages and disadvantages of multiple verses single diagnosis in CDH and the need to recognize the natural history of headache disorders in the classification are discussed.

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