Department of General Practice and Elderly Care Medicine, Amsterdam Public Health research institute, VU University Medical Center, van der Boechorststraat 7, Amsterdam, 1081 BT, the Netherlands.
Healthcare center Haarlemmermeer, Waddenweg, Hoofddorp, 2134 XL, the Netherlands.
J Headache Pain. 2018 Jan 26;19(1):9. doi: 10.1186/s10194-018-0833-7.
Sensitivity of tissues can be measured by algometry. Decreased pressure pain thresholds over the cranio-cervical area are supposed to reflect signs of sensitization of the trigemino-cervical nucleus caudalis. A systematic review was conducted to assess the current scientific literature describing pressure pain threshold (PPT) values over the cranio-cervical region in patients with migraine, tension-type headache (TTH), and cervicogenic headache (CeH). A literature search was executed in three databases. The search strategy included the following keywords: migraine, TTH, CeH, PPT and algometry. A total of 624 papers was identified of which relevant papers were subsequently assessed for methodological quality. Twenty-two selected papers were assessed by two independent reviewers and the majority of studies scored low risk of bias on the selected items. Mean PPT values of several sites measured in the cranio-cervical region in patients with migraine, chronic TTH and CeH scored lower values compared to controls. The trapezius muscle (midpoint between vertebrae C7 and acromion) was the most frequently targeted site and showed significantly lower PPT values in adults with migraine (pooled standardized mean difference kPa: 1.26 [95%CI -1.71, -0.81]) and chronic TTH (pooled standardized mean difference kPa: -2.00 [95%CI -2.93, -1.08]). Most studies found no association between PPT values and headache characteristics such as frequency, duration or intensity. Further standardization of PPT measurement in the cranio-cervical region is recommended.
通过压痛测定法可以测量组织的敏感性。颅颈区域的压力疼痛阈值降低被认为反映了三叉神经颈核尾端敏化的迹象。进行了一项系统评价，以评估描述偏头痛、紧张型头痛（TTH）和颈源性头痛（CeH）患者颅颈区域压力疼痛阈值（PPT）值的当前科学文献。在三个数据库中进行了文献检索。搜索策略包括以下关键词：偏头痛、TTH、CeH、PPT 和压痛测定法。共确定了 624 篇论文，随后对相关论文进行了方法学质量评估。22 篇选定的论文由两名独立的评审员进行评估，大多数研究在所选项目上的偏倚风险评分较低。与对照组相比，偏头痛、慢性 TTH 和 CeH 患者颅颈区域几个部位的平均 PPT 值较低。斜方肌（颈椎 7 椎体和肩峰之间的中点）是最常被靶向的部位，偏头痛（ pooled standardized mean difference kPa: 1.26 [95%CI -1.71, -0.81]）和慢性 TTH（ pooled standardized mean difference kPa: -2.00 [95%CI -2.93, -1.08]）成年患者的 PPT 值显著降低。大多数研究发现 PPT 值与头痛特征（如频率、持续时间或强度）之间没有关联。建议进一步规范颅颈区域 PPT 的测量。
