Palacios-Ceña María, Castaldo Matteo, Wang Kelun, Catena Antonella, Torelli Paola, Arendt-Nielsen Lars, Fernández-de-Las-Peñas César
Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain Department of Health Science and Technology, Center for Sensory-Motor Interaction (SMI), School of Medicine, Aalborg University, Aalborg, Denmark Department of Physical Therapy, University of Siena, Siena Poliambulatorio Fisiocenter, Collecchio Department of Experimental Clinical Medicine, Headache Center, University of Parma, Parma, Province of Parma, Italy.
Medicine (Baltimore). 2017 Mar;96(13):e6548. doi: 10.1097/MD.0000000000006548.
To investigate the differences in the presence of trigger points (TrPs) and their association with headache-related disability and mood disorders in people with frequent episodic tension-type headache (TTH) (FETTH) and chronic TTH (CTTH). One hundred twenty-two individuals with TTH participated. Clinical features of headache (i.e., intensity, duration, and frequency) were recorded on a headache diary. Headache-related disability was assessed with the Headache Disability Inventory, trait and state anxiety levels with State-Trait Anxiety Inventory, and depression with the Hospital Anxiety and Depression Scale. TrPs were bilaterally explored in the temporalis, masseter, suboccipital, upper trapezius, splenius capitis, and sternocleidomastoid muscles. Sixty-two (51%) patients were classified as FETTH, whereas 60 (49%) were classified as CTTH. Individuals with CTTH showed higher burden of headache and depression than FETTH (P < 0.001). Subjects with FETTH showed similar number of TrPs (total number: 5.9 ± 3.1, active TrPs: 4.7 ± 2.5, and latent TrPs: 1.2 ± 1.9) than those with CTTH (total number: 5.7 ± 3.2, active TrPs: 4.2 ± 3.0, and latent TrPs: 1.5 ± 1.8). The number of active TrPs was significantly associated with the burden of headache (r = 0.189; P = 0.037) and trait anxiety (r = 0.273; P = 0.005): the higher the number of active TrPs, the greater the physical burden of headache or the more the trait anxiety level. No association with the depression was observed. The presence of active TrPs in head and neck/shoulder muscles was similar between individuals with FETTH and CTTH and associated with the physical burden of headache and trait anxiety levels independently of the subgroup of TTH.
为研究频繁发作性紧张型头痛（FETTH）和慢性紧张型头痛（CTTH）患者中触发点（TrP）的存在差异及其与头痛相关残疾和情绪障碍的关联。122例紧张型头痛患者参与研究。在头痛日记中记录头痛的临床特征（即强度、持续时间和频率）。使用头痛残疾量表评估头痛相关残疾，使用状态-特质焦虑量表评估特质和状态焦虑水平，使用医院焦虑抑郁量表评估抑郁情况。双侧探查颞肌、咬肌、枕下肌、上斜方肌、头夹肌和胸锁乳突肌中的TrP。62例（51%）患者被归类为FETTH，60例（49%）被归类为CTTH。CTTH患者的头痛和抑郁负担高于FETTH患者（P<0.001）。FETTH患者的TrP数量（总数：5.9±3.1，活跃TrP：4.7±2.5，潜伏TrP：1.2±1.9）与CTTH患者（总数：5.7±3.2，活跃TrP：4.2±3.0，潜伏TrP：1.5±1.8）相似。活跃TrP的数量与头痛负担（r=0.189；P=0.037）和特质焦虑（r=0.273；P=0.005）显著相关：活跃TrP数量越多，头痛的身体负担越大或特质焦虑水平越高。未观察到与抑郁的关联。FETTH和CTTH患者头颈部/肩部肌肉中活跃TrP的存在情况相似，且与头痛的身体负担和特质焦虑水平相关，与紧张型头痛的亚组无关。
