title: Morphology of muscular function in chronic tension-type headache: a pilot study.
abstract: Chronic pain has been thought to induce muscular changes in chronic tension-type headache (CTTH) patients. As the knowledge of muscular responses in CTTH is inconsistent, we decided to introduce new electromyogram signal shape descriptors. We also wanted to compare the discriminatory power of proposed indices with classical measures to establish their potential to act as markers for CTTH. Thirty-eight headache patients with twenty healthy volunteers were recruited. Twenty patients had CTTH, while 18 had migraine without aura. Surface electromyogram data were recorded from right sternocleidomastoid and left temporalis muscles during rest and in a headache-free situation. Besides conventional root mean square (RMS) and median frequency (MDF), two morphological-based indices, skewness and kurtosis, were proposed to quantify the shape variations of signal distribution. Results demonstrated that the skewness outperformed RMS and MDF in terms of discriminatory power (p < 0.00). Kurtosis values for both muscles differed considerably among study groups (p < 0.04). RMS for both muscles was noticeably higher in CTTH group (p < 0.00). Regarding MDF, migraineurs revealed highest (p < 0.05), while CTTH patients represented the lowest values. Skewness was the most relevant predictor for headache diagnosis, especially in temporalis muscle (migraine, odds ratio = 21.1, p = 0.01; Ctension-type headache, odds ratio = 78.8, p = 0.00). There are detectable distinct muscular responses in chronic headache sufferers. This finding could be due to adaptation to muscle underuse or sustained contraction, leading to impaired recruitment and muscle fiber-type conversion with dominant type I fibers in CTTH.
authors.affiliation: Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Opposite Holy Shrine of Imam Khomeini, Khalij Fars Expressway, P.O.Box: 18155/159, Tehran, 3319118651, Iran. f.biyouki@gmail.com.
authors.forename: Fariba
authors.identifier: http://orcid.org/0000-0001-9746-6963
authors.initials: F
authors.lastname: Biyouki
authors.affiliation: Department of Physical and Rehabilitation Medicine, Turku University Hospital, Turku, Finland.
authors.forename: Katri
authors.initials: K
authors.lastname: Laimi
authors.affiliation: Department of Electrical Engineering, Mashhad Branch, Islamic Azad University, Mashhad, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Rahati
authors.affiliation: Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Boostani
authors.affiliation: Department of Neurology, Mashhad University of Medical Sciences, Mashhad, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Shoeibi
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004576:Electromyography / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000503:physiopathology / Q000628:therapy*; D009135:Muscular Diseases / Q000503:physiopathology / Q000628:therapy*; D009334:Neck Muscles / Q000503:physiopathology*; D010147:Pain Measurement; D010865:Pilot Projects; D018781:Tension-Type Headache / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D055815:Young Adult
keywords: Chronic tension-type headache (CTTH); Differential diagnosis; Electromyogram (EMG); Migraine without aura (MwoA); Shape analysis