Relationship Between Changes in Cranio-Cervical Extensor Muscles and Quality of Life: A Single-Center Study of 15 Patients with Chronic Tension-Type Headache

BACKGROUND: This single-center study of 15 patients with chronic tension-type headache aimed to compare the cranio-cervical extensor muscles between patients with chronic tension-type headache and healthy individuals and to explore the relationship between changes in cranio-cervical extensor muscles and quality of life (QoL). MATERIAL/METHODS: We recruited 15 patients with chronic tension-type headache and 15 healthy individuals. Patients with chronic tension-type headache were diagnosed by 2 neurologists according to the diagnostic criteria in the International Classification of Headache Disorders, 3(rd) edition (ICHD-3). Morphological changes in the cranio-cervical extensor muscle were detected using magnetic resonance imaging (MRI). QoL and the degree of neck dysfunction were assessed using the Headache Impact Test-6 (HIT-6) and Neck Disability Index (NDI), respectively. RESULTS: The relative cross-sectional areas (rCSAs) of the rectus capitis posterior minor (RCPmin) were lower in patients with chronic tension-type headache than in healthy individuals. The HIT-6 scores (r=−0.93, P<0.001 and r=−0.85, P<0.001 for RCPmin right side and left side, respectively) and NDI scores (r=−0.75, P<0.001 and r=−0.70, P<0.001 for RCPmin right side and left side, respectively) were negatively associated with the rCSA of RCPmin in the chronic tension-type headache group. CONCLUSIONS: Most patients with chronic tension-type headache experience RCPmin atrophy. The more evident the RCPmin atrophy, the worse the QoL of the patients with chronic tension-type headache.