Department of Systems Neuroscience, University of Hamburg-Eppendorf, Hamburg, Germany.
Department of Health Sciences, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, Brazil.
Cephalalgia. 2021 Mar;41(3):383-391. doi: 10.1177/0333102420970184. Epub 2020 Nov 17.
Most migraine patients report neck pain as part of their migraine symptomatology, but it is unknown whether triggering neck pain would induce migraine attacks. Our aim was to assess the occurrence of headache and/or neck pain after an endurance test of the neck muscles among migraineurs and controls.
Sixty-five patients with migraine and 32 headache-free participants underwent a manual examination of the cervical spine by an assessor blinded towards the diagnosis and were sub-classified according to the appearance or absence of neck pain. Subsequently, the endurance of the neck flexors and extensors was tested three times, in a random order. The maximum sustained duration was recorded and the test was terminated when the subject was unable to maintain the position or reported pain. On the day after the assessment, participants were asked to report the potential occurrence of headache or neck symptoms.
None of the controls reported headache after assessment, while migraine-like headache was reported by 42% of the patients with migraine ( < 0.001) after 15.8 h (SD: 10.0). Neck pain was more prevalent in migraineurs compared to controls (45% vs. 16%, = 0.006). When considering the neck pain subtype, there were no differences among the three profiles regarding neck pain but participants with referred pain to the head reported a migraine attack more often (45%, = 0.03).
Patients with migraine are more likely to report neck pain and migraine attacks following a neck muscle endurance test. Participants with neck pain referred to the head during manual examination had a greater prevalence of migraine attacks than those without or with only local pain.
大多数偏头痛患者报告颈部疼痛是其偏头痛症状的一部分，但尚不清楚触发颈部疼痛是否会引发偏头痛发作。我们的目的是评估偏头痛患者和对照组在颈部肌肉耐力测试后头痛和/或颈部疼痛的发生情况。
65 名偏头痛患者和 32 名无头痛的参与者由一位评估员进行颈椎的体格检查，该评估员对诊断情况不知情，并根据是否存在颈部疼痛进行分类。随后，颈部屈肌和伸肌的耐力以随机顺序测试三次。记录最大持续时间，当受试者无法保持姿势或报告疼痛时，测试结束。在评估后的第二天，要求参与者报告潜在的头痛或颈部症状的发生情况。
对照组中无人报告评估后出现头痛，而偏头痛患者中有 42%（ < 0.001）在 15.8 小时（SD：10.0）后报告偏头痛样头痛。与对照组相比，偏头痛患者的颈部疼痛更为常见（45% vs. 16%， = 0.006）。当考虑颈部疼痛亚型时，三种类型之间在颈部疼痛方面没有差异，但有头部牵涉痛的参与者更常报告偏头痛发作（45%， = 0.03）。
在进行颈部肌肉耐力测试后，偏头痛患者更有可能报告颈部疼痛和偏头痛发作。在体格检查中报告颈部疼痛牵涉到头的参与者比无牵涉痛或仅有局部疼痛的参与者更易发生偏头痛发作。
