Hypovitaminosis D effect on pericranial muscle dysfunction in women with chronic tension headache

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Background. Nowadays there are a large number of studies revealing the significance of hypovitaminosis D in chronic pain conditions and diseases, in which musculoskeletal factors are dominant in the formation of pain. In chronic tension type headache (CTTH) pathogenesis the role of muscular factor is well-established. However there is insufficient data regarding the interrelations between hypovitaminosis D, headache and pericraial muscle dysfunction (PMD) in CTTH.Objective. To investigate the effect of vitamin D level on PMD and cephalgia parameters in CTTH.Methods. One hundred twenty women with CTTH aged 25 to 55 years were enrolled. Evaluated parameters were the following: pericranial muscle tenderness (PMT), headache frequency (HF), headache duration (HD), headache intensity (HI). Vitamin D level measured by 25-hydroxyvitamin D [25(OH)D] of serum blood samples.Results. Number of CTTH with DPM cases in the group of vitamin D deficiency (serum level of 25(OH)D less than 20 ng/mL) was equal to one in normal vitamin group (higher than 30 ng/mL), p > 0.05. Greater degree of DPM was identified in vitamin D deficiency than in normal level: total PMT score 5.0 vs 3.0 score (р < 0.001). At the same time significant difference was observed in cephalgia parameters between groups of deficiency and normal vitamin D level: HF 28.0 and 23.0 days per month (р < 0.001), HD 14.5 and 10.0 hours per day respectively. Also daily headache was associated with vitamin D deficiency with a risk ratio 4.4 (95 % CI: 1.4–14,0) as compared to the normal level. Middle-power negative correlation was noted between serum vitamin D levels and total PMT score (Spearman’s r = –0.55; р < 0,001), HF (r = –0.65; р < 0,001) and HD (r = 0.67; р < 0,001).Conclusion. Vitamin D deficiency leads to increased degree of pericraial muscle dysfunction in CTTH women. That may result in rising central sensitization and finally be a reason of more severe headache.