Jensen Rigmor
Department of Neurology, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
Pain. 1996 Feb;64(2):251-256. doi: 10.1016/0304-3959(95)00114-X.
Pericranial muscle tenderness, EMG levels and thermal and mechanical pain thresholds were studied in 28 patients with tension-type headache and in 30 healthy controls. Each patient was studied during as well as outside a spontaneous episode of tension-type headache. Outside of headache, muscle tenderness and EMG levels were significantly increased compared to values in controls subjects, while mechanical and thermal pain thresholds were largely normal. During headache, muscle tenderness evaluated by blinded manual palpation increased significantly, while pressure pain thresholds remained normal and pressure pain tolerances decreased. Thermal pain detection and tolerance threshold decreased significantly in the temporal region, but remained normal in the hand. EMG levels were unchanged during headache. It is concluded that one of the primary sources of pain in tension-type headache may be a local and reversible sensitization of nociceptors in the pericranial muscles. In addition, a segmental central sensitization may contribute to the pain in frequent sufferers of tension-type headache.
对28例紧张型头痛患者和30名健康对照者进行了颅周肌肉压痛、肌电图水平以及热痛和机械痛阈值的研究。每位患者在紧张型头痛自发发作期间及发作之外均接受了研究。在无头痛期间，与对照受试者的值相比，肌肉压痛和肌电图水平显著升高，而机械痛和热痛阈值基本正常。在头痛期间，通过盲法手动触诊评估的肌肉压痛显著增加，而压痛阈值保持正常，压痛耐受性降低。颞区的热痛检测和耐受阈值显著降低，但手部仍正常。头痛期间肌电图水平未发生变化。结论是，紧张型头痛疼痛的主要来源之一可能是颅周肌肉中伤害感受器的局部和可逆性致敏。此外，节段性中枢致敏可能导致紧张型头痛频发患者的疼痛。
