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Open Access 01-10-2009 | Original

Effect of mental stress on cold pain in chronic tension-type headache sufferers

Authors: Stuart Cathcart, Anthony H. Winefield, Kurt Lushington, Paul Rolan

Published in: The Journal of Headache and Pain | Issue 5/2009

Abstract

Mental stress is a noted contributing factor in chronic tension-type headache (CTH), however the mechanisms underlying this are not clearly understood. One proposition is that stress aggravates already increased pain sensitivity in CTH sufferers. This hypothesis could be partially tested by examining effects of mental stress on threshold and supra-threshold experimental pain processing in CTH sufferers. Such studies have not been reported to date. The present study measured pain detection and tolerance thresholds and ratings of supra-threshold pain stimulation from cold pressor test in CTH sufferers (CTH-S) and healthy Control (CNT) subjects exposed to a 60-min stressful mental task, and in CTH sufferers exposed to a 60-min neutral condition (CTH-N). Headache sufferers had lower pain tolerance thresholds and increased pain intensity ratings compared to controls. Pain detection and tolerance thresholds decreased and pain intensity ratings increased during the stress task, with a greater reduction in pain detection threshold and increase in pain intensity ratings in the CTH-S compared to CNT group. The results support the hypothesis that mental stress contributes to CTH through aggravating already increased pain sensitivity in CTH sufferers.

Bendsten L (2000) Central sensitization in tension-type headache—possible pathophysiological mechanisms. Cephalalgia 20:486–508. doi:10.1046/j.1468-2982.2000.00070.xCrossRef

Nash JM, Thebarge RW (2006) Understanding psychological stress, its biological processes, and impact on primary headache. Headache 46:1377–1386CrossRefPubMed

Cathcart S, Petkov J, Pritchard D (2008) Effects of induced stress on experimental pain sensitivity in chronic tension-type headache sufferers. Eur J Neurol 15:552–558. doi:10.1111/j.1468-1331.2008.02124.xCrossRefPubMed

Janke EA, Holroyd KA, Romanek K (2004) Depression increases onset of tension-type headache following laboratory stress. Pain 111:230–238. doi:10.1016/j.pain.2004.06.007PubMedCentralCrossRefPubMed

Kim H, Neubert JK, Rowan JS, Brahim JS, Iadarola MJ, Dionne RA (2004) Comparison of experimental and acute clinical pain response in humans as pain phenotypes. J Pain 5(7):377–384. doi:10.1016/j.jpain.2004.06.003CrossRefPubMed

Edwards RR, Sarlani E, Wesselmann U, Fillingim RB (2005) Quantitative assessment of experimental pain perception: multiple domains of clinical relevance. Pain 114:315–319. doi:10.1016/j.pain.2005.01.007CrossRefPubMed

Ukestad LK, Wittrock DA (1996) Pain perception and coping in female headache sufferers and headache-free controls. Health Psychol 15(1):65–68. doi:10.1037/0278-6133.15.1.65CrossRefPubMed

Hassinger HJ, Semenchuk EM, O’Brien WH (1999) Appraisal and coping response to pain and stress in migraine headache sufferers. J Behav Med 22(4):327–340. doi:10.1023/A:1018722002393CrossRefPubMed

Bishop KL, Holm JE, Borowiak DM, Wilson BA (2001) Perception of pain in women with headache: a laboratory investigation of the influence of pain-related anxiety and fear. Headache 41:494–499. doi:10.1046/j.1526-4610.2001.01087.xCrossRefPubMed

10.

Zelman DC, Howland EW, Nichols SN, Cleeland CS (1991) The effects of induced mood on laboratory pain. Pain 46:105–111. doi:10.1016/0304-3959(91)90040-5CrossRefPubMed

11.

Caceres C, Burns JW (1997) Cardiovascular reactivity to psychological stress may enhance subsequent pain sensitivity. Pain 69:237–244. doi:10.1016/S0304-3959(96)03289-7CrossRefPubMed

12.

Absi M, Petersen KL (2003) Blood pressure but not cortisol mediates stress effects on subsequent pain perception in healthy men and women. Pain 106:285–295. doi:10.1016/S0304-3959(03)00300-2CrossRef

13.

Girdler SS, Maixner W, Naftel HA, Stewart PW, Moretz RL, Light KC (2005) Cigarette smoking, stress-induced analgesia and pain perception in men and women. Pain 114:372–385. doi:10.1016/j.pain.2004.12.035CrossRefPubMed

14.

Cathcart S, Petkov J, Winefield AH, Lushington K, Rolan P (2009) Central mechanisms of stress-induced headache. Cephalalgia (in press)

15.

International Headache Society (2004) The international classification of headache disorders, 2nd edn. Cephalalgia 24(Suppl 1):9–160. doi:10.1111/j.1468-2982.2003.00824.x

16.

Cathcart S, Winefield AH, Lushington K, Rolan P (2009) Reliability of temporal summation and diffuse noxious inhibitory controls. Headache (submitted)

17.

Cathcart S, Pritchard D (2008) Daily hassles and pain sensitivity in chronic tension-type headache sufferers. Stress Health 24:123–127. doi:10.1002/smi.1167CrossRef

18.

Spielberger CD, Gorsuch RL, Lushene RL (1970) Manual for the state trait anxiety inventory. Consulting Psychologists Press, Palo Alto

19.

Radloff LS (1977) The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1:385–481. doi:10.1177/014662167700100306CrossRef

20.

Martin PR, Todd J, Reece J (2005) Effects of noise and a stressor on head pain. Headache 45:1353–1364CrossRefPubMed

21.

Inc SPSS (2007) Statistical package for the social sciences, release 15.0. Vesta Services Inc., Chicago

22.

Ashina A, Babenko L, Jensen R, Ashina M, Mageri W, Bendsten L (2005) Increased muscular and cutaneous pain sensitivity in cephalic region in patients with chronic tension-type headache. Eur J Neurol 12(7):543–549. doi:10.1111/j.1468-1331.2005.01023.xCrossRefPubMed

23.

Ashina S, Bendtsen L, Ashina M, Magerl W, Jensen R (2006) Generalized hyperalgesia in patients with chronic tension-type headache. Cephalalgia 26:940–948. doi:10.1111/j.1468-2982.2006.01150.xCrossRefPubMed

24.

Marlowe N (1991) Pain sensitivity and headache: an examination of the central theory. J Psychosom Res 36:17–34. doi:10.1016/0022-3999(92)90110-NCrossRef

25.

Mitchell LA, MacDonald RA, Brodie EE (2004) Temperature and the cold pressor test. J Pain 5(4):233–238. doi:10.1016/j.jpain.2004.03.004CrossRefPubMed

26.

Langemark M, Olesen J (1987) Pericranial tenderness in tension headache. Cephalalgia 7:249–255. doi:10.1046/j.1468-2982.1987.0704249.xCrossRefPubMed

27.

Jensen R, Bendtsen L, Olesen J (1998) Muscular factors are of importance in tension-type headache. Headache 38:10–17. doi:10.1046/j.1526-4610.1998.3801010.xCrossRefPubMed

28.

Bendsten L, Jensen R, Olesen J (1996) Qualitatively altered nociception in chronic myofascial pain. Pain 65:259–264. doi:10.1016/0304-3959(95)00239-1CrossRef

29.

Olesen J (1991) Clinical and pathophysiological observations in migraine and tension-type headache explained by integration of vascular, supra-spinal and myofascial inputs. Pain 46:125–132. doi:10.1016/0304-3959(91)90066-7CrossRefPubMed

30.

Fumal A, Schoenen J (2008) Tension-type headache: current research and clinical management. Lancet Neurol 7:70–83. doi:10.1016/S1474-4422(07)70325-3CrossRefPubMed

31.

Gebhart GF (2004) Descending modulation of pain. Neurosci Biobehav Rev 27:729–737. doi:10.1016/j.neubiorev.2003.11.008CrossRefPubMed

32.

Gracely R (1999) Studies of pain in human subjects. In: Wall P, Melzack R (eds) Textbook of pain. Churchill Livingstone, New York, pp 385–407

33.

Jensen R, Rasmussen BK, Pederson B, Olesen J (1993) Muscle tenderness and pressure pain thresholds in headache: a population study. Pain 52:193–199. doi:10.1016/0304-3959(93)90131-8CrossRefPubMed

34.

Buchgreitz L, Lyngberg AC, Bendtsen L, Jensen R (2006) Frequency of headache is related to sensitization: a population study. Pain 123:19–27. doi:10.1016/j.pain.2006.01.040CrossRefPubMed

35.

Wittrock DA, Myers TC (1998) The comparison of individuals with recurrent tension-type headache and headache free controls in physiological response, appraisal, and coping with stressors: a review of the literature. Ann Behav Med 20(2):118–134. doi:10.1007/BF02884458CrossRefPubMed

36.

French DJ, France CR, France JL, Arnott LF (2005) The influence of acute anxiety on assessment of nociceptive flexion reflex threshold in healthy young adults. Pain 114:358–363. doi:10.1016/j.pain.2004.12.034CrossRefPubMed

37.

Koh CW, Drummond PD (2006) Dissociation between pain and the nociceptive blink reflex during psychological arousal. Clin Neurophysiol 117:851–854CrossRefPubMed

38.

Ge HY, Madeleine P, Arendt-Nielson L (2005) Gender differences in pain modulation evoked by repeated injections of glutamate into the human trapezius muscle. Pain 13:134–140. doi:10.1016/j.pain.2004.09.041CrossRef

39.

Serrao M, Rossi P, Sandrini G, Parisi L, Amabile GA, Nappi G, Pierelli F (2004) Effects of noxious inhibitory controls on temporal summation of the RIII reflex in humans. Pain 112:353–360. doi:10.1016/j.pain.2004.09.018CrossRefPubMed

40.

Nie H, Arendt-Nielsen L, Anderson H, Graven-Nielsen T (2005) Temporal summation of pain evoked by mechanical stimulation in deep and superficial tissue. J Pain 6(6):348–355. doi:10.1016/j.jpain.2005.01.352CrossRefPubMed

41.

Sandrini G, Rossi P, Milanov I, Serrao M, Cecchini AP, Nappi G (2006) Abnormal modulatory influence of diffuse noxious inhibitory controls in migraine and chronic tension-type headache patients. Cephalalgia 26:782–789. doi:10.1111/j.1468-2982.2006.01130.xCrossRefPubMed

Title: Effect of mental stress on cold pain in chronic tension-type headache sufferers
Authors: Stuart Cathcart
Anthony H. Winefield
Kurt Lushington
Paul Rolan
Publication date: 01-10-2009
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 5/2009
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1007/s10194-009-0131-5

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