Response of the autonomic activity to stress provocation in females with cervicogenic headache compared to asymptomatic controls: a cross-sectional study

Abstract

BACKGROUND: Because abnormal activity of the autonomic nervous system is associated with chronification of pain, early detection of such dysfunction is important.AIM: Although several studies highlight autonomic dysfunction in the chronification of headache, no study discussed its role in episodic cervicogenic headache.DESIGN: Case-controlled cross-sectional single-blind comparative study between women with episodic cervicogenic headache and matched controls.SETTING: Outpatient setting, Hasselt University.POPULATION: Autonomic activity of 17 females with episodic cervicogenic headache (26.6111.6 years) was compared with 17 age, gender and socio-economic matched asymptomatic controls (26.8 +/- 11.9 years).METHODS: Autonomic activity was compared via repeated measures of the activity of the dermal sweat glands (mu mho), peripheral circulation (%), electrical activity of the bilateral upper trapezius (mu V) before, during and after cognitive stress provocation.RESULTS: Whereas the autonomic parameters of the control group behaved as expected, participants in the headache group showed: 1) to stress provocation a significant lower dermal sweat gland activity (3.03 +/- 0.44 vs. 4.19 +/- 0.91 mu mho, P<0.0001), higher vasodilatation (-5.56th1.45% vs. -5.61 +/- 1.85%, P 0.03), lower activity of the left upper trapezius (0.21 +/- 0.44 vs. 0.89 +/- 0.59 mu V, P=0.03), significant less recuperation of the dermal sweat gland activity (-2.57 +/- 0.40 vs. -3.29 +/- 0.84 mu mho, P<0.0001); 2) no recuperation of the activity (mu V) of the left (P=0.83) and right (P4/.99) upper trapezius; 3) from stress provocation to recuperation a significant negative correlation (rho=0.69, P=0.04) between dermal sweat gland and right upper trapezius activity.CONCLUSIONS: Females with episodic cervicogenic headache reacted less to cognitive stress provocation. Recuperation after such provocation was absent. More research is needed to associate autonomous responses with a possible chronification process.CLINICAL REHABILITATION IMPACT: A dysfunctional reaction to cognitive stress could be a threat to allostasis.