César Fernández-de-Las-Peñas1,2,3, María Palacios-Ceña4,5, Juan A Valera-Calero6,7, Maria L Cuadrado8,9, Angel Guerrero-Peral10, Juan A Pareja11, Lars Arendt-Nielsen5,12, Umut Varol7. 1. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. cesar.fernandez@urjc.es. 2. Department of Health Science and Technology, Center for Neuroplasticity and Pain (CNAP), Faculty of Medicine, SMI, Aalborg University, Aalborg, Denmark. cesar.fernandez@urjc.es. 3. Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922, Alcorcón, Madrid, Spain. cesar.fernandez@urjc.es. 4. Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos, Alcorcón, Madrid, Spain. 5. Department of Health Science and Technology, Center for Neuroplasticity and Pain (CNAP), Faculty of Medicine, SMI, Aalborg University, Aalborg, Denmark. 6. Department of Physiotherapy, Faculty of Health, Camilo José Cela University, Villanueva de la Cañada, Madrid, Spain. 7. VALTRADOFI Research Group, Department of Physiotherapy, Faculty of Health, Camilo Jose Cela University, Madrid, Spain. 8. Department of Neurology, Hospital Clínico San Carlos, Madrid, Spain. 9. Department of Medicine, School of Medicine, Universidad Complutense de Madrid, Madrid, Spain. 10. Headache Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain. 11. Department of Neurology, Hospital Quirón Pozuelo, Madrid, Spain. 12. Department of Medical Gastroenterology, Mech-Sense, Aalborg University Hospital, Aalborg, Denmark.
Abstract
OBJECTIVE: Evidence supports that tension-type headache (TTH) involves complex underlying mechanisms. The current study aimed to quantify potential multivariate relationships between headache-related, psychophysical, psychological and health-related variables in patients with TTH using network analysis. METHODS: Demographic (age, height, weight), headache-related (intensity, frequency, duration, and headache-related disability), psychological and emotional (Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index), psycho-physical (pressure pain thresholds [PPTs] and myofascial trigger points) and health-related variables (SF-36 questionnaire) were collected in 169 TTH patients. Network connectivity analysis was unsupervised conducted to quantify the adjusted correlations between the modelled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the modelled network). RESULTS: The connectivity network showed local associations between psychophysical and headache-related variables. Multiple significant local positive correlations between PPTs were observed, being the strongest weight between PPTs over the cervical spine and temporalis area ([Formula: see text]: 0.41). The node with the highest strength, closeness and betweenness centrality was depressive levels. Other nodes with high centrality were vitality and headache intensity. DISCUSSION: This is the first study applying a network analysis to understand the connections between headache-related, psychophysical, psychological and health-related variables in TTH. Current findings support a model on how the variables are connected, albeit in separate clusters. The role of emotional aspects, such as depression, is supported by the network. Clinical implications of the findings, such as developing TTH treatments strategies targeting these most important variables, are discussed.
OBJECTIVE: Evidence supports that tension-type headache (TTH) involves complex underlying mechanisms. The current study aimed to quantify potential multivariate relationships between headache-related, psychophysical, psychological and health-related variables in patients with TTH using network analysis. METHODS: Demographic (age, height, weight), headache-related (intensity, frequency, duration, and headache-related disability), psychological and emotional (Hospital Anxiety and Depression Scale, Pittsburgh Sleep Quality Index), psycho-physical (pressure pain thresholds [PPTs] and myofascial trigger points) and health-related variables (SF-36 questionnaire) were collected in 169 TTH patients. Network connectivity analysis was unsupervised conducted to quantify the adjusted correlations between the modelled variables and to assess their centrality indices (i.e., the connectivity with other symptoms in the network and the importance in the modelled network). RESULTS: The connectivity network showed local associations between psychophysical and headache-related variables. Multiple significant local positive correlations between PPTs were observed, being the strongest weight between PPTs over the cervical spine and temporalis area ([Formula: see text]: 0.41). The node with the highest strength, closeness and betweenness centrality was depressive levels. Other nodes with high centrality were vitality and headache intensity. DISCUSSION: This is the first study applying a network analysis to understand the connections between headache-related, psychophysical, psychological and health-related variables in TTH. Current findings support a model on how the variables are connected, albeit in separate clusters. The role of emotional aspects, such as depression, is supported by the network. Clinical implications of the findings, such as developing TTH treatments strategies targeting these most important variables, are discussed.
Authors: T Ferrante; G C Manzoni; M Russo; C Camarda; A Taga; L Veronesi; C Pasquarella; G Sansebastiano; P Torelli Journal: Neurol Sci Date: 2013-05 Impact factor: 3.307
Authors: César Fernández-de-Las-Peñas; Manuel Herrero-Montes; Ignacio Cancela-Cilleruelo; Jorge Rodríguez-Jiménez; Paula Parás-Bravo; Umut Varol; Pablo Del-Valle-Loarte; Gema Flox-Benítez; Lars Arendt-Nielsen; Juan A Valera-Calero Journal: Diagnostics (Basel) Date: 2022-06-24
Authors: Marta Ríos-León; Juan Antonio Valera-Calero; Ricardo Ortega-Santiago; Umut Varol; César Fernández-de-Las-Peñas; Gustavo Plaza-Manzano Journal: Int J Environ Res Public Health Date: 2022-08-18 Impact factor: 4.614