title: Topographical Pressure Pain Sensitivity Maps of the Temporalis Muscle in People with Frequent Episodic and Chronic Tension-Type Headache.
abstract: Previous pilot studies suggest the presence of heterogeneous sensitivity to pressure in primary headaches without considering the frequency of headache episodes.
  
  
  
  To investigate the differences in topographical pressure pain sensitivity maps in the temporalis muscle between individuals with frequent episodic (FETTH) and chronic (CTTH) tension-type headache by controlling the presence of anxiety and depression.
  
  
  
  oPressure pain thresholds (PPTs) were assessed bilaterally from 9 points distributed over the temporalis muscle (3 points in the anterior portion, 3 in the middle portion, and the remaining 3 in the posterior portion of the muscle belly) in 113 patients with FETTH and 91 with CTTH in a blinded design. Topographical pressure pain sensitivity maps based on interpolation of the PPTs were constructed. Clinical features of headache were collected in a 4-week headache diary. Anxiety and depression (Hospital Anxiety and Depression Scale) were also assessed.
  
  
  
  The multilevel analysis of covariance found significant difference in PPT levels between points (F = 47.649; P < 0.001), but not between groups (F = 0.801; P = 0.602) or sides (F = 0.331; P = 0.565). No significant effect of gender (F = 0.785; P = 0.667), depression (F = 0.515; P = 0.846), or anxiety (F = 0.639; P = 0.745) was observed. Post hoc comparisons revealed: (1) no differences between FETTH and CTTH; (2) no side-to-side differences; and (3) anterior-to-posterior gradient with the most sensitive points located in the anterior column, followed by those located in the central column and the posterior column of the muscle (all, P < 0.001).
  
  
  
  This study confirmed an anterior-to-posterior gradient of sensitivity to pressure in both groups, with the highest sensitivity at the anterior part of the muscle. Further, we found similar pressure pain sensitivity in the trigeminal area in people with FETTH or CTTH with no association with depressive or anxiety levels.
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.|Sensory and Motor Interaction (SMI) Center, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: María
authors.initials: M
authors.lastname: Palacios Ceña
authors.affiliation: Sensory and Motor Interaction (SMI) Center, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.|Department of Physical Therapy, University of Siena, Siena, Italy.|Poliambulatorio Fisiocenter, Collecchio, Parma, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Castaldo
authors.affiliation: Sensory and Motor Interaction (SMI) Center, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Kelun
authors.initials: K
authors.lastname: Wang
authors.affiliation: Physical Activity and Human Performance Group, Sensory and Motor Interaction (SMI) Center, Department of Health Science and Technology, Aalborg University, Aalborg, Denmark.
authors.forename: Pascal
authors.initials: P
authors.lastname: Madeleine
authors.affiliation: Headache Unit, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.
authors.forename: Ángel L
authors.initials: ÁL
authors.lastname: Guerrero
authors.affiliation: Sensory and Motor Interaction (SMI) Center, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: Lars
authors.initials: L
authors.lastname: Arendt-Nielsen
authors.affiliation: Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.|Sensory and Motor Interaction (SMI) Center, Department of Health Science and Technology, Faculty of Medicine, Aalborg University, Aalborg, Denmark.
authors.forename: César
authors.initials: C
authors.lastname: Fernández-de-Las-Peñas
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation; D011312:Pressure; D013703:Temporal Muscle; D018781:Tension-Type Headache / Q000503:physiopathology*
keywords: pressure pain; temporalis; tension-type headache