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Review
. 2023 Jul 21;24(1):92.
doi: 10.1186/s10194-023-01614-0.

Debate: differences and similarities between tension-type headache and migraine

Dilara Onan  1 , Samaira Younis  2 , William David Wellsgatnik  3 , Fatemeh Farham  4 , Saulius Andruškevičius  5 , Ana Abashidze  6 , Asel Jusupova  7 , Yuriy Romanenko  8 , Oxana Grosu  9 , Meerimgul Zamirbekovna Moldokulova  10 , Ulkar Mursalova  11 , Saida Saidkhodjaeva  12 , Paolo Martelletti #  3 , Sait Ashina #  13   14
Affiliations
Review

Debate: differences and similarities between tension-type headache and migraine

Dilara Onan et al. J Headache Pain. .

Abstract

Tension-type headache (TTH) and migraine are two common primary headaches distinguished by clinical characteristics according to the 3rd edition of the International Classification of Headache Disorders. Migraine is identified by specific features such as being more prevalent in females, being aggravated by physical activity, certain genetic factors, having photophobia, phonophobia, nausea, vomiting, or aura, and responding to specific drugs. Nonetheless, TTH and migraine share some common characteristics, such as onset occurring in the 20 s, and being triggered by psychological factors like stress, moderate pain severity, and mild nausea in chronic TTH. Both conditions involve the trigeminovascular system in their pathophysiology. However, distinguishing between TTH and migraine in clinical practice, research, and epidemiological studies can be challenging, as there is a lack of specific diagnostic tests and biomarkers. Moreover, both conditions may coexist, further complicating the diagnostic process. This review aims to explore the similarities and differences in the pathophysiology, epidemiology, burden and disability, comorbidities, and responses to pharmacological and non-pharmacological treatments of TTH and migraine. The review also discusses future research directions to address the diagnostic challenges and improve the understanding and management of these conditions.

Keywords: CGRP; Central sensitization; Headache; International Classification of Headache Disorders; Migraine; Pericranial tenderness; Tension-type headache; Triptan.

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Conflict of interest statement

Dilara Onan, Samaira Younis, William David Wellsgatnik, Fatemeh Farham, Saulius Andruškevičius, Ana Abashidze, Asel Jusupova, Yuriy Romanenko, Oxana Grosu, Meerimgul Zamirbekovna Moldokulova, Ulkar Mursalova and Saida Saidkhodjaeva declare no conflict of interest.

Sait Ashina received honoraria for consulting from Allergan/AbbVie, Amgen, Biohaven Pharmaceuticals, Eli Lilly and Company, Impel NeuroPharma, Linpharma, Lundbeck, Novartis, Satsuma, Supernus, Teva, Theranica, Percept. Sait Ashina is an associate editor for Neurology Reviews, Frontiers in Neurology, and BMC Neurology, serves on the advisory board for the Journal of Headache and Pain, and is a member of the Education Committee of the International Headache Society. Paolo Martelletti is the Editor in Chief of The Journal of Headache and Pain and Editor-in-Chief of SN Comprehensive Clinical Medicine.

Figures

Fig. 1
Fig. 1
Pathophysiology of migraine and tension-type headache: nociceptive pathways
See this image and copyright information in PMC

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