Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache
Leistad, Rune Bang; Sand, Trond; Nilsen, Kristian Bernhard; Westgaard, Rolf Harald; Stovner, Lars Jacob
Abstract
Background: The purpose of this study was to investigate the temporal relationship between
autonomic changes and pain activation in migraine and tension-type headache induced by stress in
a model relevant for everyday office-work.
Methods: We measured pain, blood pressure (BP), heart rate (HR) and skin blood flow (BF)
during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free
periods, 18 patients with tension-type headache (TTH) and 44 healthy controls. The stress lasted
for one hour and was followed by 30 minutes of relaxation.
Results: Cardiovascular responses to cognitive stress in migraine did not differ from those in
control subjects. In TTH patients HR was maintained during stress, whereas it decreased for
migraineurs and controls. A trend towards a delayed systolic BP response during stress was also
observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was
associated with less vasoconstriction in TTH during recovery.
Conclusion: It is hypothesized that TTH patients have different stress adaptive mechanisms than
controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control
system inhibition.