Publication:
Sensory Thresholds and Peripheral Nerve Responses in Chronic Tension-Type Headache and Neuropsychological Correlation.

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Date

2022-03-27

Authors

Romero-Godoy, Rosalinda
Romero-Godoy, Sara Raquel
Romero-Acebal, Manuel
Gutierrez-Bedmar, Mario

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MDPI
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Abstract

Chronic tension-type headache (CTTH) is a common disease with no fully defined pathophysiological processes. We designed a study to value electrophysiological responses in these patients and their correlation with possible psychopathological manifestations in order to deepen understanding of central and peripheral mechanisms of CTTH. In 40 patients with CTTH and 40 healthy controls, we used electrical stimulation to determine sensory threshold (SPT) and pain perception threshold (PPT) and the characteristics of the electrophysiological sensory nerve action potential (SNAP): initial sensory response (ISR) and supramaximal response (SMR). We then calculated the intensity differences between thresholds (IDT), namely SPT-PPT, ISR-SMR and SMR-PPT, and correlated these IDTs with psychological characteristics: trait and state anxiety, depression, and emotional regulation.The SPT, together with the ISR and SMR thresholds, were higher (p < 0.01) in CTTH patients. The SMR-PPT IDT was smaller and correlated with significantly higher indicators of depression, state and trait anxiety, and poorer cognitive reappraisal. CTTH patients have less capacity to recognize non-nociceptive sensory stimuli, greater tendency toward pain facilitation, and a poor central pain control requiring higher stimulation intensity thresholds to reach the start and the peak amplitude of the SNAP. This is consistent with relative hypoexcitability of the Aβ nerve fibers in distant regions from the site of pain, and therefore, it could be considered a generalized dysfunction with a focal expression. Pain facilitation is directly associated with psychological comorbidity.

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MeSH Terms

Tension-type headache
Depression
Emotional regulation
Action potentials
Sensory thresholds
Anxiety
Pain perception
Electric stimulation
Nerve fibers
Mental disorders

DeCS Terms

Ansiedad
Depresión
Estimulación eléctrica
Fibras Nerviosas
Percepción del dolor
Potenciales de acción
Regulación emocional
Trastornos mentales
Umbral sensorial

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Keywords

Aβ fiber excitability, central sensitization, chronic tension-type headache, electrical nerve stimulation, pain threshold, peripheral sensitization, sensory threshold

Citation

Romero-Godoy R, Romero-Godoy SR, Romero-Acebal M, Gutiérrez-Bedmar M. Sensory Thresholds and Peripheral Nerve Responses in Chronic Tension-Type Headache and Neuropsychological Correlation. J Clin Med. 2022 Mar 29;11(7):1905