Purpose of Review

Tension-type headache is often regarded as the “normal” headache due to its high prevalence and mild disability in contrast with migraine. Clinically, both headaches are common comorbidities to each other. To date there has been many studies linked migraine to a brain excitability disorder. This review summarized earlier studies on brain excitability of TTH and discuss if TTH is a separate clinical entity from migraine as suggested by the diagnostic criteria.

Recent Findings

A recent magnetoencephalographic study from our group enrolled patients with “strict-criteria” TTH (i.e., absence of any migraine characteristics and associated symptoms) to compare the somatosensory excitability with patients with migraine and controls. This study provided evidence that TTH and migraine differ in excitability profiles and the measurement of preactivation excitability was able to discriminate TTH from migraine.

Summary

Earlier studies on brain excitability of TTH yielded negative findings or a common change shared with migraine. Future studies using strict diagnostic criteria to avoid the unwanted interference from migraine comorbidity may help decipher the “true” pathophysiology of TTH, which may pave the way to a TTH-specific brain signature and treatment.

中文翻译：

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紧张型头痛中的大脑兴奋性：与偏头痛不同的实体？

审查目的

与偏头痛相比，紧张型头痛的发病率高且功能障碍较轻，因此通常被认为是“正常”头痛。在临床上，这两种头痛是彼此常见的合并症。迄今为止，已有许多研究将偏头痛与大脑兴奋性障碍联系起来。本综述总结了早期关于 TTH 脑兴奋性的研究，并讨论了 TTH 是否是诊断标准所建议的与偏头痛不同的临床实体。

最近的发现

我们小组最近的一项脑磁图研究招募了具有“严格标准”TTH（即没有任何偏头痛特征和相关症状）的患者，以比较偏头痛患者和对照组的体感兴奋性。该研究提供的证据表明，TTH 和偏头痛的兴奋性分布不同，并且激活前兴奋性的测量能够将 TTH 与偏头痛区分开来。

概括

早期关于 TTH 大脑兴奋性的研究产生了负面结果或与偏头痛共有的共同变化。未来的研究使用严格的诊断标准来避免偏头痛合并症带来的不必要的干扰，可能有助于破译 TTH 的“真实”病理生理学，这可能为 TTH 特定的大脑特征和治疗铺平道路。