In a small prospective cohort study conducted by Nico Sollmann, MD, of University Hospital Ulm in Germany, the link between inflammation and edema of the trapezius muscles and tension and migraine headaches was explored. The study found that patients with mixed-type tension and migraine headaches had the highest muscle T2 MRI values compared to those with tension headaches only and healthy controls. The results of the study suggest that neck muscles play a significant role in the pathophysiology of primary headaches, opening up potential treatment options that target these muscles.
The research team enrolled 50 participants ranging in age from 20 to 31 years. The participants were divided into three groups: those with tension-type headaches, those with mixed-type tension and migraine headaches, and healthy controls without regular headache issues. The study found that higher T2 signals in the trapezius muscles were associated with more headache days and a higher likelihood of neck pain. Muscle T2 mapping could be a useful tool for stratifying patients with primary headaches and monitoring the effectiveness of potential treatments. The researchers also noted that trapezius muscle T2 had a good discriminatory ability for differentiating between mixed-type tension and migraine headaches and no history of regular headaches.
The findings of the study support the idea that neck muscles may contribute to the development of primary headaches. Treatments targeting the neck muscles may provide simultaneous relief for both neck pain and headache symptoms. Sollmann suggests that neck muscle T2 mapping could be used as an objective biomarker to differentiate between tension-type headaches and migraines in healthy individuals. By applying magnetic stimulation to the neck muscles, it may be possible to relieve pain at both the neck and brain levels. This non-invasive approach could offer an alternative treatment option for some individuals.
The study findings have potential implications for the diagnostic workup of patients with headaches. Currently, trapezius muscles are not routinely examined during the evaluation of headache patients. However, this study suggests that assessing these muscles through a quick T2 examination could provide valuable information about the presence of neck abnormalities. This, in turn, could help identify individuals who would be good candidates for magnetic stimulation therapy.
The researchers are currently conducting a controlled clinical trial to further investigate the effects of treating inflammation and edematous changes in the trapezius muscles. The results of this trial will help determine whether such treatment leads to observable differences in individuals with tension and migraine headaches. If successful, this approach could provide a non-medication-based treatment option for individuals suffering from these types of headaches.
The study conducted by Sollmann and his team highlights the importance of neck muscles in the pathophysiology of primary headaches. The findings suggest that inflammation and edema of the trapezius muscles are associated with tension and migraine headaches. By using muscle T2 mapping, it may be possible to differentiate between different types of headaches and monitor treatment effects. This research opens up new possibilities for targeted treatments that focus on neck muscles, providing potential relief for both headache and neck pain symptoms. Further studies and clinical trials are needed to validate these findings and explore the full potential of this approach.
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