Central and peripheral sensitization in tension-type headache
- 109 Downloads
Recent studies on tension-type headache indicate that the nociceptive input to the central nervous system may be increased as a result of activation or sensitization of peripheral sensory afferents. Moreover, pain perception studies and pharmacologic studies strongly suggest that the central nervous system is sensitized in patients with chronic tensiontype headache. The barrage of nociceptive impulses from the periphery may be responsible for the sensitization of second- and third-order neurons in the central nervous system. In this way, sensitization may play a role in the initiation and maintenance of tension-type headache. Studies have demonstrated that treatment with drugs that counteract sensitization has an analgesic effect on tension-type headache. Targeting this mode of action seems to be a promising way of improving the treatment for this prevalent disorder.
Unable to display preview. Download preview PDF.
References and Recommended Reading
- 13.Newham DJ, Edwards RHT, Mills KR: Skeletal muscle pain. In Textbook of Pain. Edited by Wall PD, Melzack R. Edinburgh: Churchill Livingstone; 1994:423–440.Google Scholar
- 15.Schoenen J, Bendtsen L: Neurophysiology of tension-type headache. In The Headaches. Edited by Olesen J, Tfelt-Hansen P, Welch KM. Philadelphia: Lippincott Williams and Wilkins; 2000:579–587.Google Scholar
- 19.Mork H, Ashina M, Bendtsen L, et al.: Possible mechanisms of pain perception in patients with episodic tension-type headache: a new model of myofascial pain. Cephalalgia 2003, in press. Interesting study investigating the role of inflammatory mediators for the muscular hypersensitivity in tension-type headache.Google Scholar
- 28.Jensen K: Quantification of tenderness by palpation and use of pressure algometers. In Advances in Pain Research and Therapy. Edited by Fricton JR, Awad E. New York: Raven Press; 1990:165–181.Google Scholar
- 37.Ashina M, Lassen LH, Bendtsen L, et al.: Effect of inhibition of nitric oxide synthase on chronic tension-type headache: a randomised crossover trial. Lancet 1999, 353:287–289. Important study demonstrating an analgesic effect of a drug that counteracts central sensitization in chronic tension-type headache.PubMedCrossRefGoogle Scholar