Archives of physical medicine and rehabilitation · 2025
Microdialysis Evaluation of Blood Flow, Lactate, and Glucose in Active Trigger Points of Tension-Type Headache Patients and Latent Trigger Points in Healthy Muscle.
СтатьяНаблюдательное исследованиеПоддержка NIH: внешняя программаНазвание и аннотация: Перевод в очереди
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Moraska Albert F, Wang Yue, Hickner Robert C, Lynn Rachael Rzasa, Hebert Jonathan R, Kohrt Wendy M
Аннотация
OBJECTIVE: To assess nutritive blood flow, lactate, and glucose within active and latent trigger points (TrPs) compared with non-TrP muscle.
DESIGN: Case-controlled observational study.
SETTING: A university-based clinical and translational research center.
PARTICIPANTS: Active TrPs were identified through palpation of the upper trapezius muscle of individuals with episodic or chronic tension-type headache (TTH). Latent TrPs and muscle without TrPs were identified in age- and sex-matched subjects without a history of headache. A total of 64 individuals participated in the study.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Nutritive blood flow, and interstitial lactate and glucose concentrations were determined at 12-20 minutes intervals over 160 minutes through microdialysis sampling of interstitial fluid.
RESULTS: Subjects were 33.8±10.8 years, 64.1% women, and 73.4% white, with no statistical differences between active, latent, and no TrP groups on demographic or baseline variables (P>.05). Subjects with TTH reported a median of 4 headaches/mo and had experienced headaches for a median of 120 months. Active TrPs exhibit higher nutritive blood flow than anatomically matched no TrP muscle (P=.026) but were not different from latent TrPs (P=.554). There were no global differences between the 3 groups for lactate (P=.329) or glucose (P=.231).
CONCLUSIONS: This study provides in vivo evidence of higher nutritive blood flow in active TrPs from individuals with TTH but no difference in lactate and glucose compared with non-TrP muscle. Our data do not support the TrP as a tightly contracted, ischemic region within skeletal muscle. Interventions designed to relax muscle contraction or increase blood flow may have limited benefits in alleviating active trigger points.
DESIGN: Case-controlled observational study.
SETTING: A university-based clinical and translational research center.
PARTICIPANTS: Active TrPs were identified through palpation of the upper trapezius muscle of individuals with episodic or chronic tension-type headache (TTH). Latent TrPs and muscle without TrPs were identified in age- and sex-matched subjects without a history of headache. A total of 64 individuals participated in the study.
INTERVENTIONS: Not applicable.
MAIN OUTCOME MEASURES: Nutritive blood flow, and interstitial lactate and glucose concentrations were determined at 12-20 minutes intervals over 160 minutes through microdialysis sampling of interstitial fluid.
RESULTS: Subjects were 33.8±10.8 years, 64.1% women, and 73.4% white, with no statistical differences between active, latent, and no TrP groups on demographic or baseline variables (P>.05). Subjects with TTH reported a median of 4 headaches/mo and had experienced headaches for a median of 120 months. Active TrPs exhibit higher nutritive blood flow than anatomically matched no TrP muscle (P=.026) but were not different from latent TrPs (P=.554). There were no global differences between the 3 groups for lactate (P=.329) or glucose (P=.231).
CONCLUSIONS: This study provides in vivo evidence of higher nutritive blood flow in active TrPs from individuals with TTH but no difference in lactate and glucose compared with non-TrP muscle. Our data do not support the TrP as a tightly contracted, ischemic region within skeletal muscle. Interventions designed to relax muscle contraction or increase blood flow may have limited benefits in alleviating active trigger points.