Magnetic resonance imaging study of the morphometry of cervical extensor muscles in chronic tension-type headache
Magnetic resonance imaging study of the morphometry of cervical extensor muscles in chronic tension-type headache
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DOI：
10.1111/j.1468-2982.2007.01293.x
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发表时间：
2007-04-01
期刊：
影响因子：
4.9
通讯作者：
Pareja, J. A.
中科院分区：
文献类型：
--
作者：
Fernandez-de-las-Penas, C.;Bueno, A.;Pareja, J. A.
本研究分析了慢性紧张型头痛（CTTH）患者和健康对照者之间通过磁共振成像（MRI）评估的几种颈部伸肌相对横截面积（rCSA）的差异。对15名女性CTTH患者和15名匹配的对照者进行了颈椎MRI检查。使用与C2/3椎间盘平行的轴位MR切片，从轴位T1加权图像上测量了头后小直肌（RCPmin）、头后大直肌（RCPmaj）、头半棘肌和头夹肌的rCSA值。记录4周的头痛日记以证实诊断并记录疼痛病史。与对照组相比，CTTH患者的RCPmin和RCPmaj肌肉的rCSA均降低（P < 0.01），但头半棘肌和头夹肌的rCSA无变化。头痛强度、持续时间或频率与RCPmin和RCPmaj肌肉的rCSA呈负相关（P < 0.05）：头痛强度、持续时间或频率越大，RCPmin和RCPmaj肌肉的rCSA越小。CTTH患者表现出头后直肌萎缩。这种选择性肌肉萎缩是原发性还是继发性现象尚不清楚。无论如何，肌肉萎缩可能导致这些肌肉的本体感觉输出减少，从而促使疼痛持续存在。
This study analyses the differences in the relative cross-sectional area (rCSA) of several cervical extensor muscles, assessed by magnetic resonance imaging (MRI), between patients with chronic tension-type headache (CTTH) and healthy controls. MRI of the cervical spine was performed on 15 CTTH females and 15 matched controls. The rCSA values for the rectus capitis posterior minor (RCPmin), rectus capitis posterior major (RCPmaj), semispinalis capitis and splenius capitis muscles were measured from axial T1-weighted images using axial MR slices aligned parallel to the C2/3 intervertebral disc. A headache diary was kept for 4 weeks in order to substantiate the diagnosis and record the pain history. CTTH patients showed reduced rCSA for both RCPmin and RCPmaj muscles (P < 0.01), but not for semispinalis and splenius capitis muscles, compared with controls. Headache intensity, duration or frequency and rCSA in both RCPmin and RCPmaj muscles were negatively correlated (P < 0.05): the greater the headache intensity, duration or frequency, the smaller the rCSA in the RCPmin and RCPmaj muscles. CTTH patients demonstrate muscle atrophy of the rectus capitis posterior muscles. Whether this selective muscle atrophy is a primary or secondary phenomenon remains unclear. In any case, muscle atrophy could possibly account for a reduction of proprioceptive output from these muscles, and thus contribute to the perpetuation of pain.