Il s’avère que les migraineux souffrant de cervicalgie lors des crises ont un tonus musculaire plus élevé que chez les migraineux sans cervicalgie ainsi que chez les sujets contrôles, autant pendant les crises qu’entre les crises [297]. Ceci n’est pas surprenant si l’on considère que les migraineux ont un certain niveau d’hyperexcitabilité centrale. En effet, une étude récente suggère que la sensibilisation centrale contribue non seulement à la chronicisation des douleurs, mais également la fonction motrice [298].
Abstract
Background: Ictal neck pain is a frequent symptom reported by half of migraine patients. It is unknown if neck pain is caused by peripheral or central mechanisms. Neck muscle stiffness can be investigated with ultrasound shear wave elastography. Objectives: To determine if migraine patients with ictal neck pain have stiffer neck muscles interictally compared with patients without ictal neck pain and controls. Methods: This was a cross-sectional study investigating neck muscle stiffness, pressure pain thresholds and neck pain symptoms in 100 migraine patients recruited from a tertiary headache center and 46 controls. Results: Patients with ictal neck pain had increased mean neck muscle stiffness interictally compared to both migraine patients without ictal neck pain (p = 0.018) and controls (p = 0.036). Muscle stiffness was negatively correlated with pressure pain thresholds in the neck in migraine patients with ictal neck pain (r = -0.292, p = 0.042). There were no differences in mean pressure pain thresholds between migraine subgroups. Conclusions: Migraine patients with ictal neck pain have stiffer neck muscles interictally compared with migraine patients without ictal neck pain and controls measured with ultrasound shear wave elastography. The increased stiffness could be due to local alterations in the neck muscles.
Références
- [297] Hvedstrup J, Kolding LT, Ashina M, Schytz W. Increased neck muscle stiffness in migraine patients with ictal neck pain: A shear wave elastography study. Cephalalgia 2020;40:565-574.
- [298] Stefanik JJ, Frey-Law L, Segal NA, et al. The relation of peripheral and central sensitization to muscle co-contraction: The MOST study. Osteoarthritis Cartilage 2020;S1063-4584(20)31053.