ArticleThe journal of headache and pain2023
Headache frequency and neck pain are associated with trapezius muscle T2 in tension-type headache among young adults.
Article in The journal of headache and pain, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 12 papers, 2 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 13 citations in OpenAlex.
- Biomarkers in headaches as a potential solution to simplify differential diagnosis of primary headache disorders: a systematic review.The journal of headache and pain · 2025Pooled it
- The efficacy of physiotherapy approaches in chronic tension-type headache: a systematic review and meta-analysis.Journal of oral & facial pain and headache · 2025Pooled it
- Efficacy of Fu's Subcutaneous Needling for chronic non-specific neck pain and its effect on muscle elasticity: a randomized controlled trial.Frontiers in medicine · 2025Trial
- Texture analysis on muscle T2 maps can reveal changes in upper trapezius muscles related to primary headache disorders.Scientific reports · 2026Article
- Tension-Type Headache: Toward an Integrative Multidimensional Framework for Clinical Stratification and Personalized Management.Journal of clinical medicine · 2026Review
- Association Between Trapezius Muscle Stiffness and Headache Severity in Patients With Tension-Type Headache.European journal of neurology · 2025Article
- Global, regional, and national burden and trends of headache disorders among children and adolescent (5-24 years old) from 1990 to 2021.BMC neurology · 2025Article
- Global, regional, and national burden and trends of tension-type headache among adolescents and young adults (15-39 years) from 1990 to 2021: findings from the Global Burden of Disease study 2021.Scientific reports · 2025Article
- The Temporal Associations of Neck Pain and Headache - Implications for the Diagnostic Approach to the Myofascial Involvement in Migraine.Journal of central nervous system disease · 2025Article
- Reduction of neck pain severity in patients with medication-overuse headache.The journal of headache and pain · 2024Article
- Influence of Sagittal Cervical and Thoracic Range of Motion on Neck Pain Severity in Young White-Collar Workers: A Cross-Sectional Study.Journal of clinical medicine · 2024Article
- Is physiotherapy in migraines known to sufferers? A cross-sectional study.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 5 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTension-type headache (TTH) is the most prevalent primary headache disorder. Neck pain is commonly associated with primary headaches and the trigemino-cervical complex (TCC) refers to the convergence of trigeminal and cervical afferents onto neurons of the brainstem, thus conceptualizes the emergence of headache in relation to neck pain. However, no objective biomarkers exist for the myofascial involvement in primary headaches. This study aimed to investigate the involvement of the trapezius muscles in primary headache disorders by quantitative magnetic resonance imaging (MRI), and to explore associations between muscle T2 values and headache frequency and neck pain.
methodsThis cohort study prospectively enrolled fifty participants (41 females, age range 20-31 years): 16 subjects with TTH only (TTH-), 12 with mixed-type TTH plus migraine (TTH+), and 22 healthy controls (HC). The participants completed fat-suppressed T2-prepared three-dimensional turbo spin-echo MRI, a headache diary (over 30 days prior to MRI), manual palpation (two weeks before MRI), and evaluation of neck pain (on the day of MRI). The bilateral trapezius muscles were manually segmented, followed by muscle T2 extraction. Associations between muscle T2 and the presence of neck pain as well as the number of days with headache (considering the 30 days prior to imaging using the headache calendar) were analyzed using regression models (adjusting for age, sex, and body mass index).
resultsThe TTH+ group demonstrated the highest muscle T2 values (right side: 31.4 ± 1.2 ms, left side: 31.4 ± 0.8 ms) as compared to the TTH- group or HC group (p < 0.001). Muscle T2 was significantly associated with the number of headache days (β-coefficient: 2.04, p = 0.04) and the presence of neck pain (odds ratio: 2.26, p = 0.04). With muscle T2 as the predictor, the area under the curve for differentiating between HC and the TTH+ group was 0.82.
conclusionsIncreased T2 of trapezius muscles may represent an objective imaging biomarker for myofascial involvement in primary headache disorders, which could help to improve patient phenotyping and therapy evaluation. Pathophysiologically, the increased muscle T2 values could be interpreted as a surrogate of neurogenic inflammation and peripheral sensitization within myofascial tissues.
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