Decreased Pain Detection and Tolerance Thresholds in Chronic Tension-Type Headache

doi:10.1001/archneur.1996.00550040113021

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Vol. 53 No. 4, April 1996

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Decreased Pain Detection and Tolerance Thresholds in Chronic Tension-Type Headache

Lars Bendtsen, MD; Rigmor Jensen, MD; Jes Olesen, MD

Arch Neurol. 1996;53(4):373-376.

Abstract

Objective
To study nociceptive processing in patients with chronic tension-typeheadache.

Methods
Forty patients with chronic tension-type headache and 40 healthycontrols were examined. Pericranial tenderness was recordedby manual palpation, pressure pain detection and tolerance thresholdswere recorded with an electronic pressure algometer, and therelative (pain detection minus sensory detection) electricalpain threshold was recorded with a constant current stimulator.

Results
Patients were considerably more tender than controls at allthe locations examined by manual palpation (P<.001). Pressurepain detection and tolerance thresholds recorded in the fingerwere significantly lower in patients than in controls (P<.001).A nonsignificant similar trend was observed in the temple (P $≤$ .12).Detection and tolerance thresholds were decreased to a similardegree in patients compared with controls, and pain thresholdsrecorded in the finger and in the temple were highly correlated(r=.84, P<.001). The relative electrical pain threshold recordedat the labial commissure was significantly decreased in patientscompared with controls (P=.03). All of the examined pain thresholdswere significantly correlated to the pericranial tendernessrecorded by palpation (r=–.35 to –.53, P $≤$ .03).

Conclusion
The present finding of a general hypersensitivity to pain stimuliin chronic tension-type headache indicates that central factorsplay an important role in the pathogenesis of this disorder.

Author Affiliations

From the Department of Neurology, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark.

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