Document Detail


In vivo evidence of altered skeletal muscle blood flow in chronic tension-type headache.
MedLine Citation:
PMID:  11844732     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Painful impulses from tender pericranial muscles may play a major role in the pathophysiology of chronic tension-type headache. Firm evidence for peripheral muscle pathology as a cause of muscle pain and chronic headache is still lacking. Using a microdialysis technique, we aimed to estimate in vivo blood flow and interstitial lactate concentrations in the trapezius muscle at rest and during static exercise in patients with chronic tension-type headache and in healthy subjects. We recruited 16 patients with chronic tension-type headache and 17 healthy control subjects. Two microdialysis catheters were inserted into the trapezius muscle (on the non-dominant side) of subjects, and dialysates were collected at rest, 15 and 30 min after the start of static exercise (10% of maximal force) and 15 and 30 min after the exercise was completed. All samples were coded and analysed blind. The primary endpoints were to detect a difference between patients and controls in changes of muscle blood flow and the interstitial lactate concentration from baseline to exercise and post-exercise periods. The increase in muscle blood flow from baseline to exercise and post-exercise periods was significantly lower in patients than controls (P = 0.03). There was no difference in resting blood flow between patients and controls (P = 0.43). Resting interstitial concentration of lactate did not differ between patients (2.51 +/- 0.18 mM; mean +/- standard error of the mean) and controls (2.35 +/- 0.23 mM, P = 0.57). There was no difference in change in interstitial lactate from baseline to exercise and post-exercise periods between patients and controls (P = 0.38). The present study provides in vivo evidence of decreased blood flow in response to static exercise in a tender muscle in patients with chronic tension-type headache. We suggest that, because of increased excitability of neurones in the CNS, the central interpretation and response to normal sensory input are altered in patients with chronic tension-type headache. This may lead to enhanced sympathetically mediated vasoconstriction and thereby a decreased blood flow in response to static exercise.
Authors:
M Ashina; B Stallknecht; L Bendtsen; J F Pedersen; H Galbo; P Dalgaard; J Olesen
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Brain : a journal of neurology     Volume:  125     ISSN:  0006-8950     ISO Abbreviation:  Brain     Publication Date:  2002 Feb 
Date Detail:
Created Date:  2002-02-14     Completed Date:  2002-03-07     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372537     Medline TA:  Brain     Country:  England    
Other Details:
Languages:  eng     Pagination:  320-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurology, Glostrup Hospital, University of Copenhagen, Denmark. ashina@dadlnet.dk
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Exercise
Female
Humans
Lactic Acid / metabolism
Male
Microdialysis / methods
Middle Aged
Muscle, Skeletal / blood supply*,  metabolism,  ultrasonography
Regional Blood Flow
Tension-Type Headache / etiology,  physiopathology*
Chemical
Reg. No./Substance:
50-21-5/Lactic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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