title: Structural changes of the cervical muscles in elder women with cervicogenic headache.
abstract: Evidence suggests that cervicogenic headache is associated with increasing age. Cervical musculoskeletal impairments are common features in individuals with cervicogenic headache. There is some suggestion that the structure (size and fatty infiltration) of neck muscle may factor in or contribute to these impairments.
  
  
  
  To investigate relative cross sectional areas (rCSAs) and fatty infiltrate in the cervical muscles in elders with cervicogenic headache compared to controls.
  
  
  
  Fourteen elder women with cervicogenic headache and 14 controls participated in the study. The rCSAs and fat infiltration were measured for the rectus capitis posterior major, rectus capitis posterior minor, multifidus, semispinalis capitis, splenius capitis, longus capitis/colli, and sternocleidomastoid.
  
  
  
  Elder women with cervicogenic headache had significantly reduced rCSAs of the rectus capitis posterior major and multifidus muscles compared to controls (p < 0.05). Larger amounts of fat infiltrates were also observed in the rectus capitis posterior major and minor and splenius capitis muscles in the cervicogenic headache group (p < 0.05). There were no changes in the size and fat infiltrate in the cervical flexor muscles (p > 0.05).
  
  
  
  The study demonstrated muscle atrophy with increased fatty infiltration in regionally select muscles of the upper and segmental cervical spine in older women with cervicogenic headache. While such changes and their influence on clinical symptoms are unknown, they may have management implications. Future research investigations are required to determine whether such alterations could be modified with specific exercise and modifications to daily living to positively influence clinical symptoms.
authors.affiliation: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand; Research Center in Back, Neck and Other Joint Pain and Human Performance, Khon Kaen University, Khon Kaen, Thailand. Electronic address: sureeporn.uthaikhup@cmu.ac.th.
authors.forename: Sureeporn
authors.initials: S
authors.lastname: Uthaikhup
authors.affiliation: Department of Physical Therapy, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Jenjira
authors.initials: J
authors.lastname: Assapun
authors.affiliation: Department of Radiology, Faculty of Associated Medical Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Suchart
authors.initials: S
authors.lastname: Kothan
authors.affiliation: Department of Neurology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Kanokwan
authors.initials: K
authors.lastname: Watcharasaksilp
authors.affiliation: Department of Physical Therapy and Human Movement Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA.
authors.forename: James M
authors.initials: JM
authors.lastname: Elliott
mesh_terms: D000367:Age Factors; D000368:Aged; D000375:Aging / Q000502:physiology*; D002574:Cervical Vertebrae / Q000503:physiopathology*; D003430:Cross-Sectional Studies; D005260:Female; D006261:Headache / Q000503:physiopathology*; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000503:physiopathology*; D009133:Muscular Atrophy / Q000503:physiopathology*; D009334:Neck Muscles / Q000503:physiopathology*
keywords: Cervical muscles; Cervicogenic headache; Cross sectional area; Fat infiltration; Magnetic resonance imaging