Department of Systems Neuroscience, University Medical Center Eppendorf, Martinistraße 52, 20246, Hamburg, Germany.
Department of Academic Physiotherapy, University of Luebeck, Luebeck, Germany.
J Headache Pain. 2018 Mar 20;19(1):26. doi: 10.1186/s10194-018-0851-5.
Migraineurs have a high prevalence of neck pain prior to or during headache attacks. Whether neck pain is a symptom of migraine or an indicator for a constant neck muscle dysfunction potentially triggering migraine attacks is a topic of scientific debate. The presence of myofascial trigger points in neck muscles including the trapezius muscle, points towards muscle alterations associated with migraine. We measured electromyography (EMG) of the neck muscles in a large cohort to identify whether neck pain and neckmuscle tension reported by migraine patients can be attributed to increased neck muscle activation during rest, mental stress or physical activity.
Surface EMG responses of the trapezius muscle were recorded during a paradigm including rest periods, mental stress and physical activity of 102 participants (31 chronic migraine, 43 episodic migraine, 28 healthy participants).
All groups showed increased trapezius activity during mental stress and physical activity compared to rest. There was no statistically significant difference between migraine patients and healthy controls for any of the 3 conditions except for the initial mental stress situation (F (2,56.022) = 8.302, p = 0.001), where controls increased tension by only 4.75%, episodic migraineurs by 17.39% and chronic migraineurs by 28.61%. Both migraine groups returned to resting EMG levels within the same timeframe as healthy controls.
Neck pain associated with migraine can therefore not be attributed to increased trapezius activity during rest, mental stress and physical activity or prolonged muscle activity and should not be seen as a constantly underlying trigger but rather as an accompanying symptom of migraine.
偏头痛患者在头痛发作前或发作期间常有颈部疼痛。颈部疼痛是偏头痛的症状还是潜在触发偏头痛发作的颈部肌肉持续功能障碍的指标，这是一个科学争论的话题。斜方肌等颈部肌肉中存在肌筋膜触发点，表明与偏头痛相关的肌肉变化。我们对大量患者的颈部肌肉进行了肌电图（EMG）测量，以确定偏头痛患者报告的颈部疼痛和颈部肌肉紧张是否归因于休息、精神压力或体力活动期间颈部肌肉的过度激活。
在包括休息期、精神压力和体力活动的范式中记录 102 名参与者（31 名慢性偏头痛、43 名发作性偏头痛、28 名健康参与者）斜方肌的表面 EMG 反应。
与休息相比，所有组在精神压力和体力活动期间斜方肌活动均增加。除了初始精神压力情况（F（2，56.022）=8.302，p=0.001）外，偏头痛患者与健康对照组之间在任何 3 种情况下均无统计学差异，在初始精神压力情况下，对照组仅增加了 4.75%，发作性偏头痛患者增加了 17.39%，慢性偏头痛患者增加了 28.61%。两个偏头痛组在与健康对照组相同的时间内恢复到休息时的 EMG 水平。
因此，偏头痛相关的颈部疼痛不能归因于休息、精神压力和体力活动期间斜方肌活动增加或肌肉活动延长，不应被视为持续存在的触发因素，而应视为偏头痛的伴随症状。
