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Review
. 2021 Jan 7;24(12):82.
doi: 10.1007/s11916-020-00916-1.

Brain Excitability in Tension-Type Headache: a Separate Entity from Migraine?

Wei-Ta Chen  1   2   3 , Fu-Jung Hsiao  4 , Shuu-Jiun Wang  4   5   6
Affiliations
Review

Brain Excitability in Tension-Type Headache: a Separate Entity from Migraine?

Wei-Ta Chen et al. Curr Pain Headache Rep. .

Abstract

Purpose of review: Tension-type headache is often regarded as the "normal" headache due to its high prevalence and mild disability in contrast with migraine. Clinically, both headaches are common comorbidities to each other. To date there has been many studies linked migraine to a brain excitability disorder. This review summarized earlier studies on brain excitability of TTH and discuss if TTH is a separate clinical entity from migraine as suggested by the diagnostic criteria.

Recent findings: A recent magnetoencephalographic study from our group enrolled patients with "strict-criteria" TTH (i.e., absence of any migraine characteristics and associated symptoms) to compare the somatosensory excitability with patients with migraine and controls. This study provided evidence that TTH and migraine differ in excitability profiles and the measurement of preactivation excitability was able to discriminate TTH from migraine. Earlier studies on brain excitability of TTH yielded negative findings or a common change shared with migraine. Future studies using strict diagnostic criteria to avoid the unwanted interference from migraine comorbidity may help decipher the "true" pathophysiology of TTH, which may pave the way to a TTH-specific brain signature and treatment.

Keywords: Brain excitability; Magnetoencephalography (MEG); Migraine; Neurophysiology; Somatosensory gating; Tension-type headache (TTH).

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References

Papers of particular interest, published recently, have been highlighted as: •• Of major importance
    1. Global, regional, and national burden of migraine and tension-type headache, 1990–2016: A systematic analysis for the global burden of disease study 2016. Lancet Neurol. 2018;17(11):954–76.
    1. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 2018;38(1):1–211.
    1. Jensen RH. Tension-Type Headache - The Normal and Most Prevalent Headache. Headache. 2018;58(2):339–45.
    1. •• Yu S, Han X. Update of chronic tension-type headache. Curr Pain Headache Rep. 2015;19(1):469 This intensive review summaries the update knowledge on CTTH regarding pathogenesis and therapeutic strategies.
    1. Kaniecki RG. Tension-type headache. Continuum (Minneap Minn). 2012;18(4):823–34.

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