Lipchik G L, Holroyd K A, Talbot F, Greer M
Department of Psychology, Ohio University, Athens 45701, USA.
Headache. 1997 Jun;37(6):368-76. doi: 10.1046/j.1526-4610.1997.3706368.x.
The aim of the present study was to examine the ability of pericranial muscle tenderness and the second exteroceptive suppression period to distinguish chronic tension-type headache sufferers, migraine sufferers, and controls in a young adult population utilizing a blind design. The second exteroceptive suppression periods were assessed using the methodology recommended by the European Headache Federation and were scored with an automated computer software program designed in our laboratory to provide reliable, standardized, and precise quantification of exteroceptive suppression periods and eliminate any influence of experimenter bias that may occur with manual scoring. Our sample consisted of 45 subjects diagnosed according to IHS criteria: 25 with chronic tension-type headache and 20 with migraine without aura. Twenty-three headache-free controls were recruited. Consistent with our previous findings, abnormalities in pericranial muscle tenderness, but not in the second exteroceptive suppression period distinguished chronic tension-type headache sufferers from controls. The chronic tension headache sufferers exhibited the highest pericranial muscle tenderness and the control group exhibited the lowest tenderness (P < .001). Pericranial muscle tenderness was quite successful in distinguishing recurrent headache sufferers from controls, but failed to distinguish chronic tension-type headache sufferers from migraineurs. Our findings raise the possibility that pericranial muscle tenderness is present early in the development of chronic tension-type headache and migraine without aura, and thus might contribute to the etiology of headache disorders. Our findings also indicate that a shortened second exteroceptive suppression period is not a reliable marker for chronic tension-type headache in young adults.
本研究的目的是利用盲法设计，检验在年轻成人中，颅周肌肉压痛和第二外感受性抑制期区分慢性紧张型头痛患者、偏头痛患者和对照组的能力。使用欧洲头痛联盟推荐的方法评估第二外感受性抑制期，并使用我们实验室设计的自动化计算机软件程序进行评分，以提供可靠、标准化和精确的外感受性抑制期量化，并消除手动评分可能出现的实验者偏差的任何影响。我们的样本包括根据国际头痛协会标准诊断的45名受试者：25名慢性紧张型头痛患者和20名无先兆偏头痛患者。招募了23名无头痛的对照者。与我们之前的研究结果一致，颅周肌肉压痛异常，而非第二外感受性抑制期异常，可将慢性紧张型头痛患者与对照组区分开来。慢性紧张型头痛患者表现出最高的颅周肌肉压痛，而对照组表现出最低的压痛（P < .001）。颅周肌肉压痛在区分复发性头痛患者与对照组方面相当成功，但未能区分慢性紧张型头痛患者与偏头痛患者。我们的研究结果提出了一种可能性，即颅周肌肉压痛在慢性紧张型头痛和无先兆偏头痛的早期发展中就已存在，因此可能有助于头痛疾病的病因学研究。我们的研究结果还表明，缩短的第二外感受性抑制期不是年轻成人慢性紧张型头痛的可靠标志物。
