有颈痛和无颈痛偏头痛患者：临床特征、敏化、肌肉骨骼损伤和心理负担的差异。

Migraine patients with and without neck pain: Differences in clinical characteristics, sensitization, musculoskeletal impairments, and psychological burden.

机构信息

Department of Health Science and Technology, Center for Pain and Neuroplasticity (CNAP), SMI, School of Medicine, Aalborg University, 9220, Aalborg, Denmark; Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics and Maternal Child Health, University of Genoa, 16132, Genoa, Italy.

Department of Health Science and Technology, Center for Pain and Neuroplasticity (CNAP), SMI, School of Medicine, Aalborg University, 9220, Aalborg, Denmark; Department of Medical Gastroenterology, Mech-Sense, Aalborg University Hospital, 9220, Aalborg, Denmark; Steno Diabetes Center North Denmark, Clinical Institute, Aalborg University Hospital, 9220, Aalborg, Denmark.

出版信息

Musculoskelet Sci Pract. 2023 Aug;66:102800. doi: 10.1016/j.msksp.2023.102800. Epub 2023 Jun 14.

DOI:10.1016/j.msksp.2023.102800

PMID:37344290

Abstract

AIMS

This study aims to assess differences in clinical characteristics across healthy controls and migraine patients with (MNP) and without (MwoNP) neck pain.

METHOD

This study assessed: headache frequency; headache disability index (HDI); central sensitization inventory (CSI); Hospital Anxiety (HADS-A) and Depression (HADS-D) scale; active range of motion (AROM); flexion rotation test (FRT); activation pressure score (APS); number of active/latent myofascial trigger points (MTrPs) in head/neck muscles; number of positive cervical vertebral segments (C1/C2) who reproduce migraine pain; wind-up ratio (WUR); mechanical pain threshold (MPT) and static pressure pain threshold (sPPT) over the trigeminal area; sPPT and dynamic PPT (dPPT) over the cervical area; sPPTs and MPT over the hand.

RESULTS

Compared to controls, MNP had: worse CSI, HADS-A, and HADS-D (all, p < 0.002); reduced AROM (flexion, extension, left lateral-flexion, and right-rotation), FRT, APS, and a higher number of MTrPs and positive cervical vertebral segments (all, p < 0.020); reduced trigeminal MPT and sPPT, cervical sPPT and dPPT, hand MPT and sPPT (all, p < 0.006). Compared to controls, MwoNP had: worse CSI, and HADS-A (all, p < 0.002); reduced AROM (flexion, and left lateral-flexion), FRT, APS, and a higher number of MTrPs and positive cervical vertebral segments (all, p < 0.017); reduced trigeminal MPT and cervical dPPT (all, p < 0.007). Compared to MwoNP, MNP had higher headache frequency, worse HDI and CSI (all, p < 0.006); reduced AROM (flexion, and right rotation) (all, p < 0.037); reduced cervical dPPT (all, p < 0.002).

CONCLUSION

MNP had worse headache characteristics, more pronounced cervical musculoskeletal impairments, enhanced signs and symptoms related to sensitization, and worse psychological burden compared to MwoNP.

摘要

目的

本研究旨在评估伴有（MNP）和不伴有（MwoNP）颈部疼痛的偏头痛患者与健康对照组之间的临床特征差异。

方法

本研究评估了以下内容：头痛频率；头痛残疾指数（HDI）；中枢敏化量表（CSI）；医院焦虑量表（HADS-A）和抑郁量表（HADS-D）；主动活动范围（AROM）；屈伸旋转试验（FRT）；激活压力评分（APS）；头颈部肌肉中活跃/潜伏肌筋膜触发点（MTrP）的数量；再现偏头痛疼痛的颈椎节段（C1/C2）阳性数量；峰比（WUR）；三叉神经区域的机械痛阈（MPT）和静态压痛阈（sPPT）；颈椎区域的 sPPT 和动态压痛阈（dPPT）；手部的 sPPT 和 MPT。

结果

与对照组相比，MNP 具有：更差的 CSI、HADS-A 和 HADS-D（均 p<0.002）；受限的 AROM（屈伸、左侧屈和右侧旋转）、FRT、APS 和更多的 MTrP 和阳性颈椎节段（均 p<0.020）；三叉神经 MPT 和 sPPT、颈椎 sPPT 和 dPPT、手部 MPT 和 sPPT 降低（均 p<0.006）。与对照组相比，MwoNP 具有：更差的 CSI 和 HADS-A（均 p<0.002）；受限的 AROM（屈伸和左侧屈）、FRT、APS 和更多的 MTrP 和阳性颈椎节段（均 p<0.017）；三叉神经 MPT 和颈椎 dPPT 降低（均 p<0.007）。与 MwoNP 相比，MNP 具有更高的头痛频率、更差的 HDI 和 CSI（均 p<0.006）；受限的 AROM（屈伸和右侧旋转）（均 p<0.037）；颈椎 dPPT 降低（均 p<0.002）。