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).
Headache. 2011 Mar;51(3):384-391. doi: 10.1111/j.1526-4610.2010.01791.x. Epub 2010 Nov 4.
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).
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.
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.
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.
Our findings revealed bilateral widespread pressure pain hypersensitivity in patients with CH confirming the presence of central sensitization mechanisms in this headache condition.
探究丛集性头痛（CH）患者疼痛症状区域（三叉颈）和非疼痛症状区域（远处无痛）深部组织双侧广泛压痛性痛觉过敏。
中枢敏化被认为在 CH 中起重要作用。既往尚无研究在 CH 患者中探寻过疼痛症状区域和非疼痛症状区域深部组织的双侧广泛压痛性痛觉过敏。
本研究纳入了 16 名处于缓解期的男性 CH 患者（平均年龄：43±11 岁）和 16 名匹配的对照者。由一名对受试者状况不知情的评估员双侧测量眶上神经（V1）、眶下神经（V2）、颏神经（V3）、正中神经（C5）、桡神经（C6）、尺神经（C7）、C5-C6 关节突关节、乳突和胫骨前肌的压痛阈（PPT）。
结果显示，与健康对照者相比，CH 患者双侧 PPT 水平显著降低（所有部位，P<0.001）。在乳突部位发现了更大程度的敏化（P<0.001），而在胫骨前肌部位发现了较低程度的敏化（P<0.01）。
本研究结果显示 CH 患者存在双侧广泛压痛性痛觉过敏，证实了中枢敏化机制在这种头痛状况中的存在。
