TY - JOUR

T1 - Increased neck muscle stiffness in migraine patients with ictal neck pain

T2 - A shear wave elastography study

AU - Hvedstrup, Jeppe

AU - Kolding, Lærke Tørring

AU - Ashina, Messoud

AU - Schytz, Henrik Winther

PY - 2020/5

Y1 - 2020/5

N2 - BACKGROUND: Ictal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography.OBJECTIVES: To determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls.METHODS: This was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls.RESULTS: Patients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain (p = 0.018) and controls (p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = -0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups.CONCLUSIONS: Migraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles. Trial registration: clinical-trials.gov, identifier: NCT03626805.

AB - BACKGROUND: Ictal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography.OBJECTIVES: To determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls.METHODS: This was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls.RESULTS: Patients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain (p = 0.018) and controls (p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = -0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups.CONCLUSIONS: Migraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles. Trial registration: clinical-trials.gov, identifier: NCT03626805.

U2 - 10.1177/0333102420919998

DO - 10.1177/0333102420919998

M3 - Journal article

C2 - 32295400

VL - 40

SP - 565

EP - 574

JO - Cephalalgia

JF - Cephalalgia

SN - 0800-1952

IS - 6

ER -