Decreased pain detection and tolerance thresholds in chronic tension-type headache
L. Bendtsen, R. Jensen and J. Olesen
Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.
OBJECTIVE: To study nociceptive processing in patients with chronic
tension-type headache. METHODS: Forty patients with chronic tension-type
headache and 40 healthy controls were examined. Pericranial tenderness was
recorded by manual palpation, pressure pain detection and tolerance
thresholds were recorded with an electronic pressure algometer, and the
relative (pain detection minus sensory detection) electrical pain threshold
was recorded with a constant current stimulator. RESULTS: Patients were
considerably more tender than controls at all the locations examined by
manual palpation (P<.001). Pressure pain detection and tolerance
thresholds recorded in the finger were significantly lower in patients than
in controls (P<.001). A nonsignificant similar trend was observed in the
temple (P < or =.12). Detection and tolerance thresholds were decreased
to a similar degree in patients compared with controls, and pain thresholds
recorded in the finger and in the temple were highly correlated (r=.84,
P<.001). The relative electrical pain threshold recorded at the labial
commissure was significantly decreased in patients compared with controls
(P=.03). All of the examined pain thresholds were significantly correlated
to the pericranial tenderness recorded by palpation (r=-.35 to -.53, P <
or = .03). CONCLUSION: The present finding of a general hypersensitivity to
pain stimuli in chronic tension-type headache indicates that central
factors play an important role in the pathogenesis of this disorder.
