OBJECTIVE To investigate whether the positional release technique (PRT) affects central sensitization in patients with chronic TTH. DESIGN Randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis. SETTING Two university neurology clinics. PARTICIPANTS 32 patients with TTH and MTrPs in their cervical muscles. INTERVENTION Patients in the PRT group received 10 treatment sessions for each of their MTrPs during 5 weeks. All participants were allowed to use ibuprofen 200 mg for their headaches during the study. MAIN OUTCOME MEASURES The primary outcome measure was brain metabolite profile and secondary outcome measures were headache frequency and intensity, McGill score, and pressure pain threshold, which were evaluated in each participant during 5 weeks with proton magnetic resonance spectroscopy, patients' self-reports, the McGill Pain Questionnaire and a pressure algometer. RESULTS Analysis of the data from 26 patients showed that headache frequency (p=0.001), headache intensity (p=0.002), McGill score (p=0.003), and local PPT (p=0.003) changed significantly after PRT. Myo-inositol/creatine concentration ratio in the somatosensory cortex (p=0.041) decreased significantly in the control group. Furthermore, there were significant differences between groups in headache frequency (p<0.001), headache intensity (p<0.001), McGill score (p<0.001), local PPT (p=0.004), distal PPT (p=0.041), and glutamate-glutamine/creatine concentration ratio in the thalamus (p=0.014). CONCLUSION These findings indicate that despite the improvement in clinical symptoms, PRT did not affect central sensitization in patients with TTH.

中文翻译：

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体位松解技术能否影响慢性紧张型头痛患者的中枢敏化？一项随机临床试验

目的 探讨体位松解技术（PRT）是否影响慢性 TTH 患者的中枢敏化。设计 具有隐藏分配、评估者盲法和意向治疗分析的随机对照试验。设置 两个大学神经病学诊所。参与者 32 名颈部肌肉有 TTH 和 MTrPs 的患者。干预 PRT 组中的患者在 5 周内为其每个 MTrP 接受了 10 个疗程。在研究期间，所有参与者都被允许使用 200 毫克布洛芬治疗头痛。主要结局指标主要结局指标是脑代谢物谱，次要结局指标是头痛频率和强度、McGill 评分和压痛阈值，在 5 周内使用质子磁共振波谱对每位参与者进行评估，患者的自我报告、麦吉尔疼痛问卷和压力计。结果 对 26 名患者的数据分析显示，PRT 后头痛频率 (p=0.001)、头痛强度 (p=0.002)、McGill 评分 (p=0.003) 和局部 PPT (p=0.003) 发生显着变化。在对照组中，躯体感觉皮层中的肌醇/肌酸浓度比 (p=0.041) 显着降低。此外，头痛频率 (p<0.001)、头痛强度 (p<0.001)、McGill 评分 (p<0.001)、局部 PPT (p=0.004)、远端 PPT (p=0.041) 和丘脑中的谷氨酸-谷氨酰胺/肌酸浓度比（p=0.014）。结论 这些发现表明，尽管临床症状有所改善，但 PRT 并未影响 TTH 患者的中枢敏化。麦吉尔疼痛问卷和压力测算仪。结果 对 26 名患者的数据分析显示，PRT 后头痛频率 (p=0.001)、头痛强度 (p=0.002)、McGill 评分 (p=0.003) 和局部 PPT (p=0.003) 发生显着变化。在对照组中，躯体感觉皮层中的肌醇/肌酸浓度比 (p=0.041) 显着降低。此外，头痛频率 (p<0.001)、头痛强度 (p<0.001)、McGill 评分 (p<0.001)、局部 PPT (p=0.004)、远端 PPT (p=0.041) 和丘脑中的谷氨酸-谷氨酰胺/肌酸浓度比（p=0.014）。结论 这些发现表明，尽管临床症状有所改善，但 PRT 并未影响 TTH 患者的中枢敏化。麦吉尔疼痛问卷和压力测算仪。结果 对 26 名患者的数据分析显示，PRT 后头痛频率 (p=0.001)、头痛强度 (p=0.002)、McGill 评分 (p=0.003) 和局部 PPT (p=0.003) 发生显着变化。在对照组中，躯体感觉皮层中的肌醇/肌酸浓度比 (p=0.041) 显着降低。此外，头痛频率 (p<0.001)、头痛强度 (p<0.001)、McGill 评分 (p<0.001)、局部 PPT (p=0.004)、远端 PPT (p=0.041) 和丘脑中的谷氨酸-谷氨酰胺/肌酸浓度比（p=0.014）。结论 这些发现表明，尽管临床症状有所改善，但 PRT 并未影响 TTH 患者的中枢敏化。