P42-S Neurophysiological Study of the Pathogenesis of the Chronic Tension-type Headache

Abstract

Background Tension-type headache is the most common variant of cephalgia. Objective Our objective was to study the pathogenesis of CCTH. Methods 84 CTTH patients (age 39.2 ± 6.1) and 25 healthy controls were enrolled. Clinico-neurological examination, nociceptive flexor reflex (RIII reflex), blink reflex, transcranial magnetic stimulation were performed. All patients were examined before the therapy with drugs with proven efficacy taken at therapeutic doses for three months. After all were divided into 2 groups: 1 with good response to therapy and 2 with minimal effect/its absence. Results Comparative neurophysiological analysis of data obtained in patients before the course of preventive treatment showed significant differences with greater reduction in pain threshold (6.3 ± 4.1) and pain threshold/threshold reflex (0.78 ± 0.12) - RIII; significantly greater decrease in threshold of R3 (7.9 ± 2.3) and disruption of component’s sensitivity in 2 group, decrease MEPs thresholds (42.3 ± 3.3 right and 41.7 ± 2.3 left, respectively) compared with 1 group (47.6 ± 2.5 right and 47.2 ± 2.1 left) and controls (49.2 ± 3.1 right and 48.6 ± 2.5 left). Conclusion Our study showed significant violations of integral mechanisms of pain control in patients with low efficacy of standard preventive therapy. This calls to neurophysiological examination prior to treatment and possible use of anticonvulsants on hyperexcitability of neurons of motor cortex in CTTN.