Chen Wei-Ta, Hsiao Fu-Jung, Wang Shuu-Jiun
Brain Research Center, National Yang-Ming University, Taipei, Taiwan.
School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Curr Pain Headache Rep. 2021 Jan 7;24(12):82. doi: 10.1007/s11916-020-00916-1.
Tension-type headache is often regarded as the "normal" headache due to its high prevalence and mild disability in contrast with migraine. Clinically, both headaches are common comorbidities to each other. To date there has been many studies linked migraine to a brain excitability disorder. This review summarized earlier studies on brain excitability of TTH and discuss if TTH is a separate clinical entity from migraine as suggested by the diagnostic criteria.
A recent magnetoencephalographic study from our group enrolled patients with "strict-criteria" TTH (i.e., absence of any migraine characteristics and associated symptoms) to compare the somatosensory excitability with patients with migraine and controls. This study provided evidence that TTH and migraine differ in excitability profiles and the measurement of preactivation excitability was able to discriminate TTH from migraine. Earlier studies on brain excitability of TTH yielded negative findings or a common change shared with migraine. Future studies using strict diagnostic criteria to avoid the unwanted interference from migraine comorbidity may help decipher the "true" pathophysiology of TTH, which may pave the way to a TTH-specific brain signature and treatment.
紧张型头痛因其高患病率和与偏头痛相比轻度的失能状况，常被视为“普通”头痛。临床上，这两种头痛互为常见的共病。迄今为止，已有许多研究将偏头痛与脑兴奋性障碍联系起来。本综述总结了早期关于紧张型头痛脑兴奋性的研究，并讨论紧张型头痛是否如诊断标准所提示的那样是一种与偏头痛不同的临床实体。
我们团队最近的一项脑磁图研究纳入了“严格标准”的紧张型头痛患者（即没有任何偏头痛特征和相关症状），以比较其与偏头痛患者及对照组的体感兴奋性。这项研究提供了证据，表明紧张型头痛和偏头痛在兴奋性特征上存在差异，并且预激活兴奋性的测量能够将紧张型头痛与偏头痛区分开来。早期关于紧张型头痛脑兴奋性的研究结果为阴性，或显示出与偏头痛共有的变化。未来使用严格诊断标准以避免偏头痛共病产生不必要干扰的研究，可能有助于解读紧张型头痛的“真正”病理生理学，这可能为紧张型头痛特有的脑特征及治疗方法铺平道路。
