Abstract
Tension-type headache (TTH) is the most prevalent type of primary headache. Many studies have shown that the pathogenesis of primary headache is associated with fine structural or functional changes. However, these studies were mainly based on migraine. The present study aimed to investigate whether TTH patients show functional disturbances compared with healthy subjects. We used restingstate functional magnetic resonance imaging (fMRI) and regional homogeneity (ReHo) analysis to identify changes in the local synchronization of spontaneous activity in patients with TTH. Ten patients with TTH and 10 age-, gender-, and education-matched healthy controls participated in the study. After demographic and clinical characteristics were acquired, a 3.0-T MRI system was used to obtain resting-state fMRIs. Compared with healthy controls, the TTH group exhibited significantly lower ReHo values in the bilateral caudate nucleus, the precuneus, the putamen, the left middle frontal gyrus, and the superior frontal gyrus. There was no correlation between mean ReHo values in TTH patients and duration of TTH, number of attacks, duration of daily attacks, Visual Analogue Scale score, or Headache Impact Test-6 score. These results suggest that TTH patients exhibit reduced synchronization of neuronal activity in multiple regions involved in the integration and processing of pain signals.
Keywords: tension-type headache, resting-state fMRI, ReHo, basal ganglia
Footnotes
These authors contributed equally to this work.
References
- [1].Bendtsen L, Evers S, Linde M, Mitsikostas DD, Sandrini G, Schoenen J, et al. EFNS guideline on the treatment of tension-type headache — report of an EFNS task force. Eur J Neurol. 2010;17:1318–1325. doi: 10.1111/j.1468-1331.2010.03070.x. [DOI] [PubMed] [Google Scholar]
- [2].Stovner L, Hagen K, Jensen R, Katsarava Z, Lipton R, Scher A, et al. The global burden of headache: a documentation of headache prevalence and disability worldwide. Cephalalgia. 2007;27:193–210. doi: 10.1111/j.1468-2982.2007.01288.x. [DOI] [PubMed] [Google Scholar]
- [3].Rasmussen BK, Jensen R, Schroll M, Olesen J. Epidemiology of headache in a general population—a prevalence study. J Clin Epidemiol. 1991;44:1147–1157. doi: 10.1016/0895-4356(91)90147-2. [DOI] [PubMed] [Google Scholar]
- [4].Rasmussen BK. Epidemiology of headache. Cephalalgia. 2001;21:774–777. doi: 10.1046/j.1468-2982.2001.00248.x. [DOI] [PubMed] [Google Scholar]
- [5].Bendtsen L, Fumal A, Schoenen J. Tension-type headache: mechanisms. Handb Clin Neurol. 2010;97:359–366. doi: 10.1016/S0072-9752(10)97029-2. [DOI] [PubMed] [Google Scholar]
- [6].Headache Classification Subcommittee of the International Headache Society. The International Classification of Headache Disorders. Cephalalgia. 2004;24(Suppl1):9–160. doi: 10.1111/j.1468-2982.2003.00824.x. [DOI] [PubMed] [Google Scholar]
- [7].Schmidt-Wilcke T, Leinisch E, Straube A, Kampfe N, Draganski B, Diener HC, et al. Gray matter decrease in patients with chronic tension type headache. Neurology. 2005;65:1483–1486. doi: 10.1212/01.wnl.0000183067.94400.80. [DOI] [PubMed] [Google Scholar]
- [8].Baumgartner R, Somorjai R, Summers R, Richter W. Assessment of cluster homogeneity in fMRI data using Kendall’s coefficient of concordance. Magn Reson Imaging. 1999;17:1525–1532.. doi: 10.1016/S0730-725X(99)00101-0. [DOI] [PubMed] [Google Scholar]
- [9].Yu D, Yuan K, Zhao L, Zhao L, Dong M, Liu P, et al. Regional homogeneity abnormalities in patients with interictal migraine without aura: A resting state study. NMR Biomed. 2012;25:806–812. doi: 10.1002/nbm.1796. [DOI] [PubMed] [Google Scholar]
- [10].Lai C-H, Wu Y-T. Frontal regional homogeneity increased and temporal regional homogeneity decreased after remission of first-episode drug-naïve major depressive disorder with panic disorder patients under duloxetine therapy for 6weeks. J Affect Disord. 2012;136:453–458. doi: 10.1016/j.jad.2011.11.004. [DOI] [PubMed] [Google Scholar]
- [11].Zhu Y, Gao B, Hua J, Liu W, Deng Y, Zhang L, et al. Effects of methylphenidate on resting-state brain activity in normal adults: an fMRI study. Neurosci Bull. 2013;29:16–27. doi: 10.1007/s12264-013-1306-2. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [12].Zuo XN, Xu T, Jiang L, Yang Z, Cao XY, He Y, et al. Toward reliable characterization of functional homogeneity in the human brain: preprocessing, scan duration, imaging resolution and computational space. Neuroimage. 2013;65:374–386. doi: 10.1016/j.neuroimage.2012.10.017. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [13].Liu Y, Liang M, Zhou Y, He Y, Hao Y, Song M, et al. Disrupted small-world networks in schizophrenia. Brain. 2008;131:945–961. doi: 10.1093/brain/awn018. [DOI] [PubMed] [Google Scholar]
- [14].Song XW, Dong ZY, Long XY, Li SF, Zuo XN, Zhu CZ, et al. REST: a toolkit for resting-state functional magnetic resonance imaging data processing. PLoS One. 2011;6:e25031. doi: 10.1371/journal.pone.0025031. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [15].Zang Y, Jiang T, Lu Y, He Y, Tian L. Regional homogeneity approach to fMRI data analysis. Neuroimage. 2004;22:394–400. doi: 10.1016/j.neuroimage.2003.12.030. [DOI] [PubMed] [Google Scholar]
- [16].Guo W-b, Sun X-l, Liu L, Xu Q, Wu R-r, Liu Z-n, et al. Disrupted regional homogeneity in treatment-resistant depression: a resting-state fMRI study. Prog Neuro-Psychopharmacol Biol Psychiatry. 2011;35:1297–1302. doi: 10.1016/j.pnpbp.2011.02.006. [DOI] [PubMed] [Google Scholar]
- [17].Power JD, Barnes KA, Snyder AZ, Schlaggar BL, Petersen SE. Spurious but systematic correlations in functional connectivity MRI networks arise from subject motion. Neuroimage. 2012;59:2142–2154. doi: 10.1016/j.neuroimage.2011.10.018. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [18].Graybiel AM. Network-level neuroplasticity in cortico-basal ganglia pathways. Parkinsonism Relat Disord. 2004;10:293–296. doi: 10.1016/j.parkreldis.2004.03.007. [DOI] [PubMed] [Google Scholar]
- [19].Chudler EH, Dong WK. The role of the basal ganglia in nociception and pain. Pain. 1995;60:3–38. doi: 10.1016/0304-3959(94)00172-B. [DOI] [PubMed] [Google Scholar]
- [20].Apkarian AV, Bushnell MC, Treede RD, Zubieta JK. Human brain mechanisms of pain perception and regulation in health and disease. Eur J Pain. 2005;9:463–463. doi: 10.1016/j.ejpain.2004.11.001. [DOI] [PubMed] [Google Scholar]
- [21].Borsook D, Upadhyay J, Chudler EH, Becerra L. A key role of the basal ganglia in pain and analgesia-insights gained through human functional imaging. Mol Pain. 2010;6:27. doi: 10.1186/1744-8069-6-27. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [22].Maleki N, Becerra L, Nutile L, Pendse G, Brawn J, Bigal M, et al. Migraine attacks the basal ganglia. Mol Pain. 2011;7:71. doi: 10.1186/1744-8069-7-71. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [23].Yang FC, Chou K H, Fuh JL, Huang CC, Lirng JF, Lin YY, et al. Altered gray matter volume in the frontal pain modulation network in patients with cluster headache. Pain. 2013;154(6):801–807. doi: 10.1016/j.pain.2013.02.005. [DOI] [PubMed] [Google Scholar]
- [24].Absinta M, Rocca MA, Colombo B, Falini A, Comi G, Filippi M. Selective decreased grey matter volume of the pain-matrix network in cluster headache. Cephalalgia. 2012;32:109–115. doi: 10.1177/0333102411431334. [DOI] [PubMed] [Google Scholar]
- [25].Lutz J, Jäger L, de Quervain D, Krauseneck T, Padberg F, Wichnalek M, et al. White and gray matter abnormalities in the brain of patients with fibromyalgia: a diffusion tensor and volumetric imaging study. Arthritis Rheum. 2008;58:3960–3969. doi: 10.1002/art.24070. [DOI] [PubMed] [Google Scholar]
- [26].Margulies DS, Vincent JL, Kelly C, Lohmann G, Uddin LQ, Biswal BB, et al. Precuneus shares intrinsic functional architecture in humans and monkeys. Proc Natl Acad Sci U S A. 2009;106:20069–20074. doi: 10.1073/pnas.0905314106. [DOI] [PMC free article] [PubMed] [Google Scholar]
- [27].Goffaux P, Girard-Tremblay L, Marchand S, Daigle K, Whittingstall K. Individual differences in pain sensitivity vary as a function of precuneus reactivity. Brain Topogr. 2014;27:366–374. doi: 10.1007/s10548-013-0291-0. [DOI] [PubMed] [Google Scholar]