Tumurbaatar Enkhnaran, Bat-Erdene Enkhjin, Amartuvshin Tsolmontuya, Dashtseren Myagmartseren, Tumur-Ochir Gantsetseg, Boldbaatar Damdindorj, Jadamba Tsolmon, Hiramoto Tetsuya, Oka Takakazu, Lkhagvasuren Battuvshin
Brain and Mind Research Institute, Mongolian Academy of Sciences, Ulaanbaatar 16066, Mongolia.
Brain Science Institute, Graduate School, Mongolian National University of Medical Sciences, Ulaanbaatar 14210, Mongolia.
IBRO Neurosci Rep. 2023 Sep 11;15:194-202. doi: 10.1016/j.ibneur.2023.09.004. eCollection 2023 Dec.
The relationship between tension-type headache (TTH) and autonomic functions is poorly understood, although TTH is one of the most prevalent disorders in the general population. The aim of this study was to investigate the direct and indirect effects of TTH on the autonomic functions measured by heart rate variability (HRV).
This population-based cross-sectional study was carried out in the general population of Ulaanbaatar between July and September in 2020. After physical examination, trained researchers applied structured interviews to examine the remote history of TTH and mental distress, followed by a recording of HRV to detect autonomic activity. Psychological factors and the quality of life were measured using Hospital Anxiety Depression Scale (HADS), Pittsburgh Sleep Quality Index (PSQI), and the World Health Organization Quality of Life-Brief (WHOQOL-BREF). Binary logistic regression and GLM mediation model analysis were used to examine the effects of risk factors on the associations between TTH and autonomic functions.
Among participants (n = 217, mean age=41.8 ± 11.5 years), a total of 117 (53.9%) participants had a remote history of TTH. The age and sex-adjusted prevalence was 43%. Groups did not differ statistically in the HRV indices. LF/HF (ratio of low-frequency to high frequency), the index of sympathovagal balance, was correlated with the HADS anxiety. TTH was associated with mental distress. Binary logistic regression analysis confirms the relationship suggesting that TTH was associated with increased likelihood of mental distress, and decreasing RMSSD (root mean square of the sum of the squares of differences between adjacent NN intervals) and pNN50 (NN50 divided by the total number of NN intervals) were the independent predictors of TTH. GLM mediation model indicated that the relationship between TTH and RMSSD was mediated by mental distress.
The present study suggests that mental distress is a critical factor in the association between TTH and autonomic dysfunction. Additionally, our findings demonstrate the influence of age and gender on TTH. These results highlight the need to understand the mechanisms underlying pathophysiology to facilitate targeted and efficacious prevention and management approaches for TTH.
紧张型头痛（TTH）是普通人群中最常见的疾病之一，但其与自主神经功能之间的关系尚不清楚。本研究旨在探讨TTH对通过心率变异性（HRV）测量的自主神经功能的直接和间接影响。
本基于人群的横断面研究于2020年7月至9月在乌兰巴托的普通人群中进行。经过体格检查后，训练有素的研究人员采用结构化访谈来调查TTH的既往史和精神困扰，随后记录HRV以检测自主神经活动。使用医院焦虑抑郁量表（HADS）、匹兹堡睡眠质量指数（PSQI）和世界卫生组织生活质量简表（WHOQOL-BREF）来测量心理因素和生活质量。采用二元逻辑回归和广义线性模型（GLM）中介模型分析来检验危险因素对TTH与自主神经功能之间关联的影响。
在参与者（n = 217，平均年龄 = 41.8 ± 11.5岁）中，共有117名（53.9%）参与者有TTH既往史。年龄和性别调整后的患病率为43%。两组在HRV指标上无统计学差异。交感迷走神经平衡指标低频/高频（LF/HF）与HADS焦虑量表得分相关。TTH与精神困扰有关。二元逻辑回归分析证实了这种关系，表明TTH与精神困扰可能性增加相关，RMSSD（相邻NN间期差值平方和的平方根）和pNN50（NN50除以NN间期总数）降低是TTH的独立预测因素。GLM中介模型表明，TTH与RMSSD之间的关系由精神困扰介导。
本研究表明，精神困扰是TTH与自主神经功能障碍之间关联的关键因素。此外，我们的研究结果显示了年龄和性别对TTH的影响。这些结果凸显了了解病理生理学潜在机制以促进针对TTH的有针对性且有效的预防和管理方法的必要性。
