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Association of dynamic and widespread mechanical sensitivity in cluster headache

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Abstract

We investigated if dynamic pressure pain sensitivity in the symptomatic area is associated with pressure sensitivity in local and distant pain-free areas in cluster headache (CH). A pressure algometry set consisting of 8 rollers with fixed pressure levels ranging from 500 to 5300 g was used to assess dynamic pressure pain sensitivity in men with episodic CH. Each roller was moved from an anterior-to-posterior direction over the temporalis muscle. The load level of the first painful roller was considered the dynamic pain threshold (DPT). Further, pain elicited during DPT (roller evoked pain) was also assessed. We used a pressure algometer to determine pressure pain thresholds (PPTs) over the temporalis muscle, C5/C6 joint, second metacarpal, and tibialis anterior. Patients were assessed in an asymptomatic (remission) phase, at least 6 months after their last cluster period and without taking pharmacological treatment. Forty men with episodic CH (mean age 42 years) were included. Both outcomes, DPTs (r = 0.781, P < 0.001) and roller-evoked pain (r = 0.586; P < 0.001) were bilaterally correlated. Further, DPT, but not roller-evoked pain, was moderately associated with PPTs measured at the symptomatic (temporalis: r = 0.665, P < 0.001) and distant pain-free (C5–C6 joint: r = 0.389, P = 0.013; second metacarpal: r = 0.551, P < 0.001; and, tibialis anterior: r = 0.308, P = 0.035) points. Dynamic pressure sensitivity in the trigeminal area was correlated to pressure pain sensitivity at both symptomatic and distant pain-free areas in men with CH supporting the use of roller pressure algometry. Dynamic pressure algometry may be a new tool for assessing the status of sensitization in primary headaches.

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Acknowledgements

The Shionogi Science Program.

Funding

No funds were obtained for this study.

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Authors and Affiliations

  1. Neurology Department, Hospital Clínico Universitario Valladolid, Valladolid, Spain

    Ángel Guerrero-Peral & David García-Azorín

  2. Neurology Department, Hospital Clínico San Carlos, Madrid, Spain

    Víctor Gómez-Mayordomo, Nuria González-García & María L. Cuadrado

  3. Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Facultad de Ciencias de la Salud, Universidad Rey Juan Carlos, Avenida de Atenas s/n, 28922, Alcorcón, Madrid, Spain

    César Fernández-de-las-Peñas

  4. Department of Health Science and Technology, Faculty of Medicine, CNAP, Sensory-Motor Interaction (SMI) Center, Aalborg University, Aalborg, Denmark

    César Fernández-de-las-Peñas & Lars Arendt-Nielsen

Authors
  1. Ángel Guerrero-Peral
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  2. Víctor Gómez-Mayordomo
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  3. David García-Azorín
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  4. Nuria González-García
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  5. César Fernández-de-las-Peñas
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  6. Lars Arendt-Nielsen
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  7. María L. Cuadrado
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Contributions

All authors contributed to the study concept and design. MLC and CFdlP did the statistical analysis and interpretation of data. AGP, VGM and DGA contributed to draft the paper. All authors provided administrative, technical, and material support. LAN and MLC supervised the study. All authors have read, revised and approved the final version of the manuscript.

Corresponding author

Correspondence to César Fernández-de-las-Peñas.

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Conflict of interest

Ángel Guerrero-Peral, Víctor Gómez-Mayordomo, David García-Azorín, Nuria González-García, César Fernández-de-las-Peñas, Lars Arendt-Nielsen, María L. Cuadrado declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Guerrero-Peral, Á., Gómez-Mayordomo, V., García-Azorín, D. et al. Association of dynamic and widespread mechanical sensitivity in cluster headache. Acta Neurol Belg 120, 1265–1270 (2020). https://doi.org/10.1007/s13760-020-01450-y

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  • DOI: https://doi.org/10.1007/s13760-020-01450-y

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