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Fu GJ, Wang LD, Chi XS, Liang X, Wei JJ, Huang ZH, Shen W, Zhang YL. Research Progress on the Experimental Model and Underlying Mechanistic Studies of Tension-Type Headaches. Curr Pain Headache Rep 2024:10.1007/s11916-024-01238-2. [PMID: 38502437 DOI: 10.1007/s11916-024-01238-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/07/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE OF REVIEW Tension-type headaches (TTH) significantly diminish patients' quality of life and increase absenteeism, thereby imposing a substantial economic burden. Animal models are essential tools for studying disease mechanisms and drug development. However, until now, little focus has been placed on summarizing the animal models of TTH and associated mechanistic studies. This narrative review discusses the current animal models of TTH and related mechanistic studies to provide insights into the pathophysiological mechanisms of and treatments for TTH. RECENT FINDINGS The primary method for constructing an animal model of TTH involves injecting a solution of pain relievers, such as adenosine triphosphate, nerve growth factor, or a high concentration of salt solution, into the neck to initiate harmful cervical muscle responses. This model enables the examination of the interaction between peripheral muscles and central sensitization, which is crucial for understanding the pathophysiology of TTH. Mechanistic studies based on this model have investigated the effect of the P2X receptor antagonist, P2X7 receptor blockade, the P2Y1 receptor agonist 2-MESADP, P2Y1 receptor antagonist MRS2179, nitric oxide synthase inhibitors, and acetylsalicylic acid. Despite notable advancements, the current model of TTH has limitations, including surgical complexity and the inability to replicate chronic tension-type headache (CTTH). To gain a more comprehensive understanding and develop more effective treatment methods, future studies should focus on simplifying surgical procedures, examining other predisposing factors, and establishing a model for chronic TTH. This will offer a deeper insight into the pathophysiological mechanism of TTH and pave the way for improved treatment approaches.
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Affiliation(s)
- Guo-Jing Fu
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China
| | - Liu-Ding Wang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China
| | - Xian-Su Chi
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China
| | - Xiao Liang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China
| | - Jing-Jing Wei
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China
| | - Zhi-Hong Huang
- Yidu Central Hospital of Weifang, Weifang, 262,550, China
| | - Wei Shen
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China.
| | - Yun-Ling Zhang
- Xiyuan Hospital of China Academy of Chinese Medical Sciences, Beijing, 100,091, China.
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Rodríguez-Almagro D, Achalandabaso-Ochoa A, Molina-Ortega FJ, Obrero-Gaitán E, Ibáñez-Vera AJ, Lomas-Vega R. Neck Pain- and Unsteadiness-Inducing Activities and their Relationship to the Presence, Intensity, Frequency, and Disability of Headaches. Brain Sci 2020; 10:brainsci10070425. [PMID: 32635312 PMCID: PMC7407814 DOI: 10.3390/brainsci10070425] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 06/26/2020] [Accepted: 07/01/2020] [Indexed: 01/01/2023] Open
Abstract
(1) Background: Headache is a significant public health problem. Despite the association between headache and neck pain, little is known about the relationships among specific activities that generate neck pain and headache. The aim of this study was to identify the specific activities that result in neck pain and unsteadiness, and determine how they are linked to headache in university students. (2) Methods: One hundred and six patients with physician-diagnosed headache and 92 healthy university students completed surveys assessing demographics; the presence, frequency, intensity, and disability of headaches; and activities generating neck pain and unsteadiness. (3) Results: The presence of headache was related to female gender (p = 0.001), neck pain when reading or watching television (p = 0.024), and unsteadiness when moving the head (p = 0.005). Headache-related disability was associated with intensity of neck pain (p < 0.001), neck pain when reading or watching television (p = 0.033), and stumbling (p < 0.001). Headache frequency was related to smoking (p = 0.004), the duration of neck pain-associated symptoms (p = 0.047), and neck pain when driving (p = 0.039). Intensity of headache was associated with female gender (p = 0.002), smoking (p = 0.013), and neck pain-related sleep alterations (p = 0.024). (4) Conclusions: Female gender, smoking, neck pain, and unsteadiness when moving the head are factors related to headache in university students.
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Fuensalida-Novo S, Jiménez-Antona C, Benito-González E, Cigarán-Méndez M, Parás-Bravo P, Fernández-De-Las-Peñas C. Current perspectives on sex differences in tension-type headache. Expert Rev Neurother 2020; 20:659-666. [PMID: 32510251 DOI: 10.1080/14737175.2020.1780121] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Clinical and experimental evidence supports the presence of several gender differences in the pain experience. AREAS COVERED The current paper discusses biological, psychological, emotional, and social differences according to gender and their relevance to TTH. Gender differences have also been observed in men and women with tension-type headache and they should be considered by clinicians managing this condition. It appears that multimodal treatment approaches lead to better outcomes in people with tension-type headache; however, management of tension-type headache should consider these potential gender differences. Different studies have observed the presence of complex interactions between tension-type headache, emotional stress, sleep, and burden and that these interactions are different between men and women. EXPERT OPINION Based on current results, the authors hypothesize that treatment of men with tension-type headache should focus on the improvement of sleep quality and the level of depression whereas treatment of women with TTH should focus on nociceptive mechanisms and emotional/stressful factors. Future trials should investigate the proposed hypotheses.
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Affiliation(s)
- Stella Fuensalida-Novo
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
| | - Carmen Jiménez-Antona
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
| | - Elena Benito-González
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
| | | | - Paula Parás-Bravo
- Department of Nursing, Universidad de Cantabria , Spain.,Nursing Area, Nursing Research Group IDIVAL , Santander, Cantabria, Spain
| | - César Fernández-De-Las-Peñas
- Department of Physical Therapy, Occupational Therapy, Rehabilitation and Physical Medicine, Universidad Rey Juan Carlos , Alcorcón, Spain
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Nijs J, Mairesse O, Neu D, Leysen L, Danneels L, Cagnie B, Meeus M, Moens M, Ickmans K, Goubert D. Sleep Disturbances in Chronic Pain: Neurobiology, Assessment, and Treatment in Physical Therapist Practice. Phys Ther 2018; 98:325-335. [PMID: 29425327 DOI: 10.1093/ptj/pzy020] [Citation(s) in RCA: 88] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Accepted: 02/05/2018] [Indexed: 02/09/2023]
Abstract
Among people with chronic pain, insomnia is highly prevalent, closely related to the mechanism of central sensitization, characterized by low-grade neuroinflammation, and commonly associated with stress or anxiety; in addition, it often does not respond effectively to drug treatments. This review article applies the current understanding of insomnia to clinical practice, including assessment and conservative treatment of insomnia in people with chronic pain. Cognitive-behavioral therapy for insomnia can be efficacious for improvements in sleep initiation, sleep maintenance, perceived sleep quality, and pain interference with daily functioning in people with chronic pain. A recent systematic review concluded that with additional training, physical therapist-led cognitive-behavioral interventions are efficacious for low back pain, allowing their implementation within the field. Cognitive-behavioral therapy for insomnia, as provided to people with chronic pain, typically includes education, sleep restriction measures, stimulus control instructions, sleep hygiene, and cognitive therapy.
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Affiliation(s)
- Jo Nijs
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, the Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Belgium, and Vrije Universiteit Brussel, Building F-Kima, Laarbeeklaan 103, BE-1090 Brussels, Belgium
| | - Olivier Mairesse
- Brugmann University Hospital, Sleep Laboratory and Unit for Chronobiology U78, Université Libre de Bruxelles - Vrije Universiteit Brussel, Brussels, Belgium, and the Department of Experimental and Applied Psychology (EXTO), Vrije Universiteit Brussel
| | - Daniel Neu
- Brugmann University Hospital, Sleep Laboratory and Unit for Chronobiology U78, Université Libre de Bruxelles - Vrije Universiteit Brussel, and UNI Neuroscience Institute, ULB312 Faculty of Medicine, and ULB388 Faculty of Motor Sciences, Université Libre de Bruxelles
| | - Laurence Leysen
- Pain in Motion International Research Group, and the Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel
| | - Lieven Danneels
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University, Ghent, Belgium
| | - Barbara Cagnie
- Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University
| | - Mira Meeus
- Pain in Motion International Research Group, Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University
| | - Maarten Moens
- Department of Neurosurgery and Radiology, University Hospital, and the Department of Manual Therapy, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel
| | - Kelly Ickmans
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, and the Department of Physical Medicine and Physiotherapy, University Hospital Brussels
| | - Dorien Goubert
- Pain in Motion International Research Group, Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, and Department of Rehabilitation Sciences and Physiotherapy, Faculty of Medicine, Ghent University
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