Headache frequency and neck pain are associated with trapezius muscle T2 in tension-type headache among young adults.
Magnetic resonance imaging
Migraine
T2 mapping
Tension-type headache
Trapezius muscle
Trigemino-cervical complex
Journal
The journal of headache and pain
ISSN: 1129-2377
Titre abrégé: J Headache Pain
Pays: England
ID NLM: 100940562
Informations de publication
Date de publication:
12 Jul 2023
12 Jul 2023
Historique:
received:
19
06
2023
accepted:
05
07
2023
medline:
14
7
2023
pubmed:
13
7
2023
entrez:
12
7
2023
Statut:
epublish
Résumé
Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizes the emergence of headache in relation to neck pain. However, no objective biomarkers exist for the myofascial involvement in primary headaches. This study aimed to investigate the involvement of the trapezius muscles in primary headache disorders by quantitative magnetic resonance imaging (MRI), and to explore associations between muscle T2 values and headache frequency and neck pain. This cohort study prospectively enrolled fifty participants (41 females, age range 20-31 years): 16 subjects with TTH only (TTH-), 12 with mixed-type TTH plus migraine (TTH+), and 22 healthy controls (HC). The participants completed fat-suppressed T2-prepared three-dimensional turbo spin-echo MRI, a headache diary (over 30 days prior to MRI), manual palpation (two weeks before MRI), and evaluation of neck pain (on the day of MRI). The bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. Associations between muscle T2 and the presence of neck pain as well as the number of days with headache (considering the 30 days prior to imaging using the headache calendar) were analyzed using regression models (adjusting for age, sex, and body mass index). The TTH+ group demonstrated the highest muscle T2 values (right side: 31.4 ± 1.2 ms, left side: 31.4 ± 0.8 ms) as compared to the TTH- group or HC group (p < 0.001). Muscle T2 was significantly associated with the number of headache days (β-coefficient: 2.04, p = 0.04) and the presence of neck pain (odds ratio: 2.26, p = 0.04). With muscle T2 as the predictor, the area under the curve for differentiating between HC and the TTH+ group was 0.82. Increased T2 of trapezius muscles may represent an objective imaging biomarker for myofascial involvement in primary headache disorders, which could help to improve patient phenotyping and therapy evaluation. Pathophysiologically, the increased muscle T2 values could be interpreted as a surrogate of neurogenic inflammation and peripheral sensitization within myofascial tissues.
Sections du résumé
BACKGROUND
BACKGROUND
Tension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizes the emergence of headache in relation to neck pain. However, no objective biomarkers exist for the myofascial involvement in primary headaches. This study aimed to investigate the involvement of the trapezius muscles in primary headache disorders by quantitative magnetic resonance imaging (MRI), and to explore associations between muscle T2 values and headache frequency and neck pain.
METHODS
METHODS
This cohort study prospectively enrolled fifty participants (41 females, age range 20-31 years): 16 subjects with TTH only (TTH-), 12 with mixed-type TTH plus migraine (TTH+), and 22 healthy controls (HC). The participants completed fat-suppressed T2-prepared three-dimensional turbo spin-echo MRI, a headache diary (over 30 days prior to MRI), manual palpation (two weeks before MRI), and evaluation of neck pain (on the day of MRI). The bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. Associations between muscle T2 and the presence of neck pain as well as the number of days with headache (considering the 30 days prior to imaging using the headache calendar) were analyzed using regression models (adjusting for age, sex, and body mass index).
RESULTS
RESULTS
The TTH+ group demonstrated the highest muscle T2 values (right side: 31.4 ± 1.2 ms, left side: 31.4 ± 0.8 ms) as compared to the TTH- group or HC group (p < 0.001). Muscle T2 was significantly associated with the number of headache days (β-coefficient: 2.04, p = 0.04) and the presence of neck pain (odds ratio: 2.26, p = 0.04). With muscle T2 as the predictor, the area under the curve for differentiating between HC and the TTH+ group was 0.82.
CONCLUSIONS
CONCLUSIONS
Increased T2 of trapezius muscles may represent an objective imaging biomarker for myofascial involvement in primary headache disorders, which could help to improve patient phenotyping and therapy evaluation. Pathophysiologically, the increased muscle T2 values could be interpreted as a surrogate of neurogenic inflammation and peripheral sensitization within myofascial tissues.
Identifiants
pubmed: 37438700
doi: 10.1186/s10194-023-01626-w
pii: 10.1186/s10194-023-01626-w
pmc: PMC10337094
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
84Informations de copyright
© 2023. The Author(s).
Références
Nat Rev Dis Primers. 2022 Jan 13;8(1):2
pubmed: 35027572
Nature. 1986 Oct 30-Nov 5;323(6091):809-11
pubmed: 3490625
Expert Rev Neurother. 2012 Mar;12(3):315-22
pubmed: 22364330
Am Fam Physician. 2002 Feb 15;65(4):653-60
pubmed: 11871683
Cephalalgia. 2015 Mar;35(3):211-9
pubmed: 24853166
Curr Pain Headache Rep. 2007 Oct;11(5):365-72
pubmed: 17894927
J Bodyw Mov Ther. 2014 Oct;18(4):569-75
pubmed: 25440209
Eur J Pain. 2018 Feb;22(2):385-392
pubmed: 28952174
Cephalalgia. 2021 Jul;41(8):934-942
pubmed: 33615841
Clin J Pain. 2010 Oct;26(8):690-3
pubmed: 20664340
Headache. 2020 Jul;60(7):1259-1272
pubmed: 32602955
J Headache Pain. 2017 Sep 26;18(1):97
pubmed: 28952052
Cephalalgia. 2020 May;40(6):614-624
pubmed: 31852232
Eur J Paediatr Neurol. 2022 Jul;39:40-48
pubmed: 35660103
Neurol Clin. 2019 Nov;37(4):651-671
pubmed: 31563225
J Manipulative Physiol Ther. 2012 Oct;35(8):608-13
pubmed: 23158466
Lancet Neurol. 2018 Feb;17(2):174-182
pubmed: 29229375
J Headache Pain. 2022 Jul 1;23(1):74
pubmed: 35773650
Curr Pain Headache Rep. 2003 Oct;7(5):371-6
pubmed: 12946290
Eur J Paediatr Neurol. 2016 Nov;20(6):888-897
pubmed: 27528122
Cephalalgia. 2010 Oct;30(10):1250-67
pubmed: 20873360
Front Neurol. 2019 Jul 16;10:738
pubmed: 31379706
BMJ. 2020 Mar 26;368:m791
pubmed: 32217608
BMC Musculoskelet Disord. 2021 Sep 3;22(1):755
pubmed: 34479514
NMR Biomed. 2017 Nov;30(11):
pubmed: 28777496
Sci Rep. 2020 Apr 6;10(1):5954
pubmed: 32249788
Eur J Neurol. 2006 Mar;13(3):244-9
pubmed: 16618340
Eur J Paediatr Neurol. 2021 May;32:16-28
pubmed: 33743386
Arch Phys Med Rehabil. 2008 Jan;89(1):16-23
pubmed: 18164325
J Headache Pain. 2018 Sep 10;19(1):84
pubmed: 30203398
Cephalalgia. 2012 Feb;32(3):241-9
pubmed: 22250208
Physiol Rev. 2023 Apr 1;103(2):1565-1644
pubmed: 36454715
Toxins (Basel). 2020 Dec 17;12(12):
pubmed: 33348571
Pain Med. 2018 Jan 1;19(1):142-150
pubmed: 29025044
Nat Rev Dis Primers. 2021 Mar 25;7(1):24
pubmed: 33767185
Brain Sci. 2022 Jul 16;12(7):
pubmed: 35884738
J Headache Pain. 2019 Jan 18;20(1):8
pubmed: 30658563
Magn Reson Med. 1986 Jun;3(3):397-417
pubmed: 3724419
Cephalalgia. 2004 Jun;24(6):466-75
pubmed: 15154856
AJR Am J Roentgenol. 2009 Jun;192(6):1708-16
pubmed: 19457839
Headache. 1999 Jan;39(1):21-7
pubmed: 15613190
AJR Am J Roentgenol. 2010 Apr;194(4):W284-92
pubmed: 20308472
Headache. 2014 Jul-Aug;54(7):1203-10
pubmed: 24863346
Lancet Neurol. 2009 Jul;8(7):679-90
pubmed: 19539239
Magn Reson Med. 1986 Aug;3(4):562-74
pubmed: 3747818
Cephalalgia. 2013 Jul;33(9):629-808
pubmed: 23771276
Cephalalgia. 2016 Jul;36(8):807-11
pubmed: 26460336
Clin Neuroradiol. 2019 Jun;29(2):223-230
pubmed: 29322233
Phys Ther. 2022 May 5;102(5):
pubmed: 35230421
Curr Pain Headache Rep. 2003 Dec;7(6):419-25
pubmed: 14604500
Lancet. 2020 Oct 17;396(10258):1204-1222
pubmed: 33069326
Curr Pain Headache Rep. 2005 Dec;9(6):415-22
pubmed: 16282042