Changes of Heart Autonomic Regulation as Predictors of Tension Type Headache

The aim of the study was to investigate the dynamics of heart rate variability (HRV) and its relation to the daily physical activity and emotional stress level in tension type headache (TTH) patients in order to identify the objective correlates of headache. Materials and Methods. 166 medical students have been examined: 60 students with frequent episodic TTH (FETTH), 28 students with chronic TTH (CTTH), 18 students with migraine combined with FETTH, and 60 headache-free persons. The examination included clinical neurological and somatic examination, assessment of daily physical activity and emotional stress level, as well as investigation of the autonomic nervous system using HRV at rest and in the process of students’ daily activity. Results and Discussion. In young people with FETTH and CTTH the parameters of HRV differ from headache-free persons. These changes indicate the increase of the sympathetic and decrease of the parasympathetic activity. The young people with CTTH have flat daytime profiles of HRV parameters. The decrease of HRV and the flattening of daytime profiles of HRV parameters are associated with high level of emotional stress and hypodynamia. Headache may have some independent influence on HRV parameters, but this impact is less than impact of emotional stress and hypodynamia. Conclusion. The characteristics of HRV dynamics during the day (daytime profiles) may be used as objective neurophysiological indicators of high emotional stress and hypodynamia which are the factors of TTH development and chronicity.