Abstract
BackgroundNeck pain in migraine patients is very prevalent between and during migraine attacks, but the underlying mechanism behind neck pain in migraine is unknown. The neck muscle rectus capitis posterior minor muscle (RCPmi) may be important since it is connected to the occipital dura mater. In this study, we examined the RCPmi volume in migraine patients and compared with controls.MethodsWe conducted a cross-sectional MRI study examining muscle volume in 40 episodic migraine patients and 40 controls in preexisting images from prior studies. Three-dimensional T1 weighted sequences were collected with a 3.0 T MRI Scanner. The volume of RCPmi was examined by manually tracing the muscle circumference with Horos medical image viewer. The observer was blinded to participant information. No information regarding neck pain status during or between migraine attacks were available.ResultsThe mean RCPmi volume was 1.22cm3 in migraine patients and 1.17cm3 in controls (p = 0.549). We found no differences in RCPmi volume on the pain side vs. the non-pain side (p = 0.237) in patients with unilateral migraine. There were no association between the muscle volume and years with migraine, headache or migraine frequency, age or BMI.ConclusionsWe found no difference in RCPmi volume between migraine patients and controls, suggesting no structural RCPmi pathology in migraine.
Highlights
Neck pain in migraine patients is very prevalent between and during migraine attacks, but the underlying mechanism behind neck pain in migraine is unknown
The rectus capitis posterior minor muscle (RCPmi) is of particular interest in migraine as it is innervated by the first cervical nerve and connected to the dura via a myodural bridge [8,9,10] (Fig. 1)
To identify possible confounders when testing muscle volume, we explored the following in both patients and controls: whether age, weight or Body mass index (BMI) was associated with volume, and if there was a difference between sexes
Summary
Neck pain in migraine patients is very prevalent between and during migraine attacks, but the underlying mechanism behind neck pain in migraine is unknown. Neck pain is a common feature of migraine, with a high prevalence between attacks [1] as well as during attacks [2] This often leads migraine patients to assume cervical pathology [3], but the mechanism behind neck pain in migraine is unknown. It could be caused by convergence of nociceptive input from pericranial neck muscles and dura. It is a possibility that increased activity of the RCPmi may cause hypertrophy and thereby dural tension via this myodural bridge This may result in increased nociceptive input from upper cervical and dural afferents, which could contribute to migraine headache
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