César Fernández-de-Las-Peñas1, Ricardo Ortega-Santiago1, María L Cuadrado1, Carlos López-de-Silanes1, Juan A Pareja1. 1. From the Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain; Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Spain (C. Fernández-de-las-Peñas and R. Ortega-Santiago); Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Spain; Department of Neurology of Hospital Clínico San Carlos, Madrid, Spain; Universidad Complutense, Madrid, Spain (M.L. Cuadrado); Department of Neurology and Neurophysiology of Fundación Hospital, Alcorcón, Spain (C. López-de-Silanes); Esthesiology Laboratory of Universidad Rey Juan Carlos, Alcorcón, Spain; Department of Neurology and Neurophysiology of Fundación Hospital, Alcorcón, Spain (J.A. Pareja).
Abstract
OBJECTIVE: To investigate bilateral widespread pressure pain hyperalgesia in deep tissues over symptomatic (trigemino-cervical) and nonsymptomatic (distant pain-free) regions in patients with cluster headache (CH). BACKGROUND: Central sensitization is claimed to play a relevant role in CH. No study has previously searched for widespread pressure hyperalgesia in deep tissues over both symptomatic (trigemino-cervical) and nonsymptomatic (distant pain-free) regions in patients with CH. METHODS: Sixteen men (mean age: 43 ± 11 years) with CH in a remission phase and 16 matched controls were recruited. Pressure pain thresholds (PPTs) were bilaterally measured over the supra-orbital (V1), infra-orbital (V2), mental (V3), median (C5), radial (C6), and ulnar (C7) nerves, C5-C6 zygapophyseal joint, mastoid process, and tibialis anterior muscle by an assessor blinded to the subjects' condition. RESULTS: The results showed that PPT levels were significantly decreased bilaterally in patients with CH as compared with healthy controls (all sites, P < .001). A greater degree of sensitization over the mastoid process (P < .001) and a lower degree of sensitization over the tibialis anterior muscle (P < .01) was found. CONCLUSIONS: Our findings revealed bilateral widespread pressure pain hypersensitivity in patients with CH confirming the presence of central sensitization mechanisms in this headache condition.
OBJECTIVE: To investigate bilateral widespread pressure pain hyperalgesia in deep tissues over symptomatic (trigemino-cervical) and nonsymptomatic (distant pain-free) regions in patients with cluster headache (CH). BACKGROUND: Central sensitization is claimed to play a relevant role in CH. No study has previously searched for widespread pressure hyperalgesia in deep tissues over both symptomatic (trigemino-cervical) and nonsymptomatic (distant pain-free) regions in patients with CH. METHODS: Sixteen men (mean age: 43 ± 11 years) with CH in a remission phase and 16 matched controls were recruited. Pressure pain thresholds (PPTs) were bilaterally measured over the supra-orbital (V1), infra-orbital (V2), mental (V3), median (C5), radial (C6), and ulnar (C7) nerves, C5-C6 zygapophyseal joint, mastoid process, and tibialis anterior muscle by an assessor blinded to the subjects' condition. RESULTS: The results showed that PPT levels were significantly decreased bilaterally in patients with CH as compared with healthy controls (all sites, P < .001). A greater degree of sensitization over the mastoid process (P < .001) and a lower degree of sensitization over the tibialis anterior muscle (P < .01) was found. CONCLUSIONS: Our findings revealed bilateral widespread pressure painhypersensitivity inpatients with CH confirming the presence of central sensitization mechanisms in this headache condition.
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