Key result
Low-grade cognitive stress induced a maintained heart rate in patients with tension-type headache, whereas heart rate decreased in migraineurs and healthy controls (p=0.008), suggesting altered stress adaptation.
Why the study?
Does cognitive stress induce different cardiovascular and autonomic responses in patients with migraine or tension-type headache compared to healthy controls?
Case-Control (n=84)
No
Does cognitive stress induce different cardiovascular and autonomic responses in patients with migraine or tension-type headache compared to healthy controls?
Patients with tension-type headache exhibit delayed cardiovascular adaptation to cognitive stress compared to migraineurs and healthy controls.
Autonomic changes during office stress may precede headache pain; leaves open causal role in migraine and TTH.
BACKGROUND: The purpose of this study was to investigate the temporal relationship between autonomic changes and pain activation in migraine and tension-type headache induced by stress in a model relevant for everyday office-work. METHODS: We measured pain, blood pressure (BP), heart rate (HR) and skin blood flow (BF) during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free periods, 18 patients with tension-type headache (TTH) and 44 healthy controls. The stress lasted for one hour and was followed by 30 minutes of relaxation. RESULTS: Cardiovascular responses to cognitive stress in migraine did not differ from those in control subjects. In TTH patients HR was maintained during stress, whereas it decreased for migraineurs and controls. A trend towards a delayed systolic BP response during stress was also observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was associated with less vasoconstriction in TTH during recovery. CONCLUSION: It is hypothesized that TTH patients have different stress adaptive mechanisms than controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control system inhibition.
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Leistad et al. (2007) conducted a case-control in Migraine and tension-type headache (n=84). Low-grade cognitive stress (two-choice reaction-time test) vs. Healthy controls was evaluated on Heart rate adaptation during ongoing stress (time × group interaction) (p=0.008). Low-grade cognitive stress induced a maintained heart rate in patients with tension-type headache, whereas heart rate decreased in migraineurs and healthy controls (p=0.008), suggesting altered stress adaptation.
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