Langguth Berthold, Hund Verena, Landgrebe Michael, Schecklmann Martin
Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany.
Department of Psychiatry, Psychosomatics and Psychotherapy, kbo-Lech-Mangfall-Klinik Agatharied, Hausham, Germany.
Front Neurol. 2017 Aug 28;8:440. doi: 10.3389/fneur.2017.00440. eCollection 2017.
Both clinical experience and clinical studies suggest a relationship between tinnitus and headache. Here, we aimed to investigate the influence of comorbid headache type and headache laterality on tinnitus characteristics.
The Tinnitus Research Initiative database was screened for patients of the Tinnitus Center of the University Regensburg who reported comorbid headaches. These patients were contacted to complete additional validated questionnaires. Based on these data, patients were categorized according to headache type and headache laterality, and their clinical characteristics were compared with tinnitus patients, who did not report comorbid headaches.
Data from 193 patients with tinnitus and comorbid headaches were compared with those from 765 tinnitus patients without comorbid headaches. Tinnitus patients with comorbid headache have higher scores in tinnitus questionnaires, a lower quality of life and more frequently comorbidities such as painful sensation to loud sounds, vertigo, pain (neck, temporomandibular, and general), and depressive symptoms when compared with tinnitus patients without headaches. Both headache laterality and headache type interact with the degree of comorbidity with higher impairment in patients with left-sided and bilateral headaches as well as in patients with migraine or cluster headache.
The observed increased impairment in tinnitus patients with comorbid headache can be explained as an additive effect of both disorders on health-related quality of life. The more frequent occurrence of further comorbidities suggests a generally increased amplification of sensory signals in a subset of tinnitus patients with comorbid headaches.
临床经验和临床研究均表明耳鸣与头痛之间存在关联。在此,我们旨在研究共病头痛类型和头痛偏侧性对耳鸣特征的影响。
对雷根斯堡大学耳鸣中心报告共病头痛的患者的耳鸣研究倡议数据库进行筛选。联系这些患者以完成额外的经过验证的问卷。基于这些数据,根据头痛类型和头痛偏侧性对患者进行分类,并将他们的临床特征与未报告共病头痛的耳鸣患者进行比较。
将193例伴有共病头痛的耳鸣患者的数据与765例无共病头痛的耳鸣患者的数据进行比较。与无头痛的耳鸣患者相比,伴有共病头痛的耳鸣患者在耳鸣问卷中的得分更高,生活质量更低,并且更频繁地出现共病,如对大声响的疼痛感、眩晕、疼痛(颈部、颞下颌关节和全身)以及抑郁症状。头痛偏侧性和头痛类型均与共病程度相互作用,左侧和双侧头痛患者以及偏头痛或丛集性头痛患者的损害程度更高。
观察到的伴有共病头痛的耳鸣患者损害增加可解释为两种疾病对健康相关生活质量的叠加效应。更多共病的频繁发生表明在一部分伴有共病头痛的耳鸣患者中,感觉信号普遍增强。