medalphabetМедицинский алфавитMedical alphabet2078-56312949-2807ООО «Альфмед»10.33667/2078-5631-2026-2-55-61medalphabet-5035Research ArticleСтатьиВзаимосвязь биомеханических особенностей шейного отдела позвоночника и мигрениThe relationship between the biomechanical features of the cervical spine and migrainehttps://orcid.org/0000-0003-4204-2279НаприенкоМ. В.NaprienkoM. V.

Наприенко Маргарита Валентиновна, д. м.н, проф. кафедры спортивной медицины и медицинской реабилитации

Москва

Naprienko Margarita V., Dr Med Sci (habil.), professor at Dept of Sports Medicine and Medical Rehabilitation

Moscow

mv_naprienko@mail.ruhttps://orcid.org/0000-0002-6537-8659ЖарашуеваЛ. А.ZharashuevaL. A.

Жарашуева Лейля Артуровна, ординатор-аспирант 1-го года

Москва

Zharashueva Leyla A., 1st year resident-postgraduate student

Moscow

https://orcid.org/0000-0002-2219-9589СмекалкинаЛ. В.SmekalkinaL. V.

Смекалкина Лариса Викторовна, д. м.н, проф. кафедры спортивной медицины и медицинской реабилитации

Москва

Smekalkina Larisa V., Dr Med Sci (habil.), professor at Dept of Sports Medicine and Medical Rehabilitation

Moscow

https://orcid.org/0009-0006-9962-1078МаскаевВ. А.MaskaevV. A.

Маскаев Владислав Александрович, студент 6-го курса, педиатрический факультет

Москва

Maskaev Vladislav A., 6th year student at Faculty of Pediatrics

Moscow

ФГАОУ ВО «Первый Московский государственный медицинский университет им. И. М. Сеченова» Минздрава России (Сеченовский университет)РоссияI. M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationФГАОУ ВО «Российский национальный исследовательский медицинский университет имени Н. И. Пирогова» Минздрава России (Пироговский университет)РоссияN. I. Pirogov Russian National Research Medical University (Pirogov University)Russian Federation20261305202602Неврология и психиатрия (1)5561Copyright © Наприенко М.В., Жарашуева Л.А., Смекалкина Л.В., Маскаев В.А., 20262026Наприенко М.В., Жарашуева Л.А., Смекалкина Л.В., Маскаев В.А.Naprienko M.V., Zharashueva L.A., Smekalkina L.V., Maskaev V.A.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-alphabet.com/jour/article/view/5035Актуальность

Актуальность. Мигрень часто сочетается с болью в шее, однако биомеханические нарушения шейного отдела позвоночника при этом фенотипе остаются недостаточно изученными.

Цель

Цель. Оценить взаимосвязь биомеханических характеристик шейного отдела позвоночника с клиническими проявлениями у пациентов с мигренью и односторонней головной болью.

Материалы и методы

Материалы и методы. В кросс-секционное исследование включены 54 пациента с верифицированной мигренью (77,8% женщин, средний возраст 33,2 года). Проведены клиническая оценка (цервикалгия, провокация боли, психоэмоциональные факторы) и гониометрия активных движений шеи (флексия, экстензия, латерофлексия, ротация).

Результаты

Результаты. Ограничение подвижности выявлено у 50 % пациентов, преимущественно ротации. Цервикалгия, провокация головной боли движениями в шее и совпадение стороны боли коррелировали с ограничением ротации (r=0,323–0,398; p<0,05). Вегетативные симптомы и психоэмоциональные факторы значимых связей с подвижностью не показали. Асимметрия плечевого пояса достоверно чаще встречалась при ограничении движений (χ²=34,9, p<0,001; OR=156).

Выводы

Выводы. У половины пациентов с мигренью и односторонней болью выявлен обособленный цервикальный механический компонент, проявляющийся ограничением ротации, ассоциированным с болью в шее и ее провокацией. Оценка ротации и положения плеч может иметь значение для выделения подгруппы, нуждающейся в физической реабилитации.

Background

Background. Migraine frequently co-occurs with neck pain, but biomechanical impairments of the cervical spine in this phenotype remain underexplored.

Objective

Objective. To assess the relationship between cervical spine biomechanical characteristics and clinical manifestations in patients with migraine and unilateral headache.

Materials and methods

Materials and methods. This cross-sectional study included 54 patients with verified migraine (77.8% women, mean age 33.2 years). Clinical assessment (neck pain, pain provocation, psychoemotional factors) and goniometry of active cervical movements (flexion, extension, lateroflexion, rotation) were performed.

Results

Results. Mobility restrictions were found in 50% of patients, predominantly in rotation. Neck pain, headache provocation by neck movements, and side concordance correlated with rotation restriction (r=0.323–0.398; p<0.05). Autonomic symptoms and psychoemotional factors showed no significant associations with mobility. Shoulder girdle asymmetry was significantly more frequent in patients with movement restriction (χ²=34.9, p><0.001; OR=156).><0.05). Autonomic symptoms and psychoemotional factors showed no significant associations with mobility. Shoulder girdle asymmetry was significantly more frequent in patients with movement restriction (χ²=34.9, p<0.001; OR=156).

Conclusions

Conclusions. Half of patients with migraine and unilateral headache exhibit a distinct cervical mechanical component characterized by rotation restriction associated with neck pain and its provocation. Assessment of rotation and shoulder position may help identify a subgroup that could benefit from physical rehabilitation.

мигреньболь в шеешейный отдел позвоночникаограничение ротацииреабилитацияmigraineneck paincervical spinerotation restrictionrehabilitationReferencesAl-Khazali H.M., Younis S., Al-Sayegh Z. et al. Prevalence of neck pain in migraine: a systematic review and meta-analysis. Cephalalgia. 2022; (7): 663–673. https://doi.org/10.1177/03331024221083608Al-Khazali H.M., Younis S., Al-Sayegh Z. et al. Prevalence of neck pain in migraine: a systematic review and meta-analysis. Cephalalgia. 2022; (7): 663–673. https://doi.org/10.1177/03331024221083608Ashina S., Bendtsen L., Lyngberg A.C. et al. Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia. 2015; (3): 211–219. https://doi.org/10.1177/0333102414535110Ashina S., Bendtsen L., Lyngberg A.C. et al. Prevalence of neck pain in migraine and tension-type headache: a population study. Cephalalgia. 2015; (3): 211–219. https://doi.org/10.1177/0333102414535110Bartsch T., Goadsby P.J. The trigeminocervical complex and migraine: current concepts and synthesis. Curr Pain Headache Rep. 2003; (5): 371–376. https://doi.org/10.1007/s11916-003-0038-9Bartsch T., Goadsby P.J. The trigeminocervical complex and migraine: current concepts and synthesis. Curr Pain Headache Rep. 2003; (5): 371–376. https://doi.org/10.1007/s11916-003-0038-9Bartsch T., Goadsby P.J. Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater. Brain. 2003; (8): 1801–1813. https://doi.org/10.1093/brain/awg190Bartsch T., Goadsby P.J. Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater. Brain. 2003; (8): 1801–1813. https://doi.org/10.1093/brain/awg190Di Antonio S., Arendt-Nielsen L., Ponzano M. et al. Cervical musculoskeletal impairments in the 4 phases of the migraine cycle in episodic migraine patients. Cephalalgia. 2022; (9): 827–845. https://doi.org/10.1177/03331024221093236Di Antonio S., Arendt-Nielsen L., Ponzano M. et al. Cervical musculoskeletal impairments in the 4 phases of the migraine cycle in episodic migraine patients. Cephalalgia. 2022; (9): 827–845. https://doi.org/10.1177/03331024221093236Liang Z., Galea O., Thomas L. et al. Cervical musculoskeletal impairments in migraine and tension type headache: a systematic review and meta-analysis. Musculoskelet Sci Pract. 2019; (42): 67–83. https://doi.org/10.1016/j.msksp.2019.04.005Liang Z., Galea O., Thomas L. et al. Cervical musculoskeletal impairments in migraine and tension type headache: a systematic review and meta-analysis. Musculoskelet Sci Pract. 2019; (42): 67–83. https://doi.org/10.1016/j.msksp.2019.04.005Szikszay T. M., Hoenick S., von Korn K. et al. Which examination tests detect differences in cervical musculoskeletal impairments in people with migraine? A systematic review and meta-analysis. Phys Ther. 2019; (5): 549–569. https://doi.org/10.1093/ptj/pzz012Szikszay T. M., Hoenick S., von Korn K. et al. Which examination tests detect differences in cervical musculoskeletal impairments in people with migraine? A systematic review and meta-analysis. Phys Ther. 2019; (5): 549–569. https://doi.org/10.1093/ptj/pzz012Luedtke K., Starke W., May A. Musculoskeletal dysfunction in migraine patients. Cephalalgia. 2018; (5): 865–875. https://doi.org/10.1177/0333102417716934Luedtke K., Starke W., May A. Musculoskeletal dysfunction in migraine patients. Cephalalgia. 2018; (5): 865–875. https://doi.org/10.1177/0333102417716934Florencio L.L., de Oliveira A.S., Carvalho G.F. et al. Cervical muscle strength and muscle coactivation during isometric contractions in patients with migraine: a cross-sectional study. Headache. 2015; (10): 1312–1322. https://doi.org/10.1111/head.12656Florencio L.L., de Oliveira A.S., Carvalho G.F. et al. Cervical muscle strength and muscle coactivation during isometric contractions in patients with migraine: a cross-sectional study. Headache. 2015; (10): 1312–1322. https://doi.org/10.1111/head.12656Florencio L.L., Ferracini G.N., Chaves T.C. et al. Active trigger points in the cervical musculature determine the altered activation of superficial neck and extensor muscles in women with migraine. Clin J Pain. 2017; (3): 238–245. https://doi.org/10.1097/AJP.0000000000000396Florencio L.L., Ferracini G.N., Chaves T.C. et al. Active trigger points in the cervical musculature determine the altered activation of superficial neck and extensor muscles in women with migraine. Clin J Pain. 2017; (3): 238–245. https://doi.org/10.1097/AJP.0000000000000396Bragatto M.M., Bevilaqua-Grossi D., Benatto M.T. et al. Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? Cephalalgia. 2019; (12): 1500–1508. https://doi.org/10.1177/0333102419856608Bragatto M.M., Bevilaqua-Grossi D., Benatto M.T. et al. Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? Cephalalgia. 2019; (12): 1500–1508. https://doi.org/10.1177/0333102419856608Luedtke K., May A. Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. J Headache Pain. 2017; (1): 97. https://doi.org/10.1186/s10194-017-0804-1Luedtke K., May A. Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. J Headache Pain. 2017; (1): 97. https://doi.org/10.1186/s10194-017-0804-1La Touche R., García-Pastor T., Reina-Varona A. et al. General physical impairments in migraine patients beyond cervical function. Sci Rep. 2024; (1): 30916. https://doi.org/10.1038/s41598-024-30916-3La Touche R., García-Pastor T., Reina-Varona A. et al. General physical impairments in migraine patients beyond cervical function. Sci Rep. 2024; (1): 30916. https://doi.org/10.1038/s41598-024-30916-3Madsen B. K., Søgaard K., Andersen L. L. et al. Efficacy of strength training on tension-type headache: a randomised controlled study. Cephalalgia. 2018; (6): 1071–1080. https://doi.org/10.1177/0333102417736994Madsen B. K., Søgaard K., Andersen L. L. et al. Efficacy of strength training on tension-type headache: a randomised controlled study. Cephalalgia. 2018; (6): 1071–1080. https://doi.org/10.1177/0333102417736994Jull G.A., O’Leary S.P., Falla D.L. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008; (7): 525–533. https://doi.org/10.1016/j.jmpt.2008.08.003Jull G.A., O’Leary S.P., Falla D.L. Clinical assessment of the deep cervical flexor muscles: the craniocervical flexion test. J Manipulative Physiol Ther. 2008; (7): 525–533. https://doi.org/10.1016/j.jmpt.2008.08.003Lipton R.B., Dodick D., Sadovsky R. et al. A self-administered screener for migraine in primary care: The ID Migraine validation study. Neurology. 2003; (3): 375–382. https://doi.org/10.1212/01.WNL.0000078940.53438.83Lipton R.B., Dodick D., Sadovsky R. et al. A self-administered screener for migraine in primary care: The ID Migraine validation study. Neurology. 2003; (3): 375–382. https://doi.org/10.1212/01.WNL.0000078940.53438.83Embaby E., Khalil A.A., Mansour A. et al. The relationship between myofascial trigger points sensitivity, cervical postural abnormality, and clinical tension-type headache parameters. J Man Manip Ther. 2024; (4): 390–399. https://doi.org/10.1080/10669817.2023.2245703Embaby E., Khalil A.A., Mansour A. et al. The relationship between myofascial trigger points sensitivity, cervical postural abnormality, and clinical tension-type headache parameters. J Man Manip Ther. 2024; (4): 390–399. https://doi.org/10.1080/10669817.2023.2245703Do T. P., Heldarskard G. F., Kolding L. T. et al. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. 2018; (1): 84. https://doi.org/10.1186/s10194-018-0903-8Do T. P., Heldarskard G. F., Kolding L. T. et al. Myofascial trigger points in migraine and tension-type headache. J Headache Pain. 2018; (1): 84. https://doi.org/10.1186/s10194-018-0903-8Di Antonio S., Arendt-Nielsen L., Ponzano M. et al. Profiling migraine patients according to clinical and psychophysical characteristics. Neurol Sci. 2024; (3): 1185–1200. https://doi.org/10.1007/s10072-023-07049-2Di Antonio S., Arendt-Nielsen L., Ponzano M. et al. Profiling migraine patients according to clinical and psychophysical characteristics. Neurol Sci. 2024; (3): 1185–1200. https://doi.org/10.1007/s10072-023-07049-2Ashina S., Bendtsen L., Burstein R. et al. Pain sensitivity in relation to frequency of migraine and tension-type headache with or without coexistent neck pain. Scand J Pain. 2022; (1): 76–87. https://doi.org/10.1515/sjpain-2021-0097Ashina S., Bendtsen L., Burstein R. et al. Pain sensitivity in relation to frequency of migraine and tension-type headache with or without coexistent neck pain. Scand J Pain. 2022; (1): 76–87. https://doi.org/10.1515/sjpain-2021-0097Rasmussen-Barr E., Halvorsen M., Bohman T. et al. Effects of different exercise types in chronic neck pain: a systematic review. BMC Musculoskelet Disord. 2023; (1): 806. https://doi.org/10.1186/s12891-023-06806-7Rasmussen-Barr E., Halvorsen M., Bohman T. et al. Effects of different exercise types in chronic neck pain: a systematic review. BMC Musculoskelet Disord. 2023; (1): 806. https://doi.org/10.1186/s12891-023-06806-7Liang Z., Thomas L., Jull G. et al. Cervical musculoskeletal impairments in migraine. Arch Physiother. 2021; (1): 27. https://doi.org/10.1186/s40945-021-00115-6Liang Z., Thomas L., Jull G. et al. Cervical musculoskeletal impairments in migraine. Arch Physiother. 2021; (1): 27. https://doi.org/10.1186/s40945-021-00115-6Onan D., Martelletti P. Does the intensity of the headache differ according to the level of neck disability in chronic migraine patients? Int J Environ Res Public Health. 2022; (23): 16307. https://doi.org/10.3390/ijerph192316307Onan D., Martelletti P. Does the intensity of the headache differ according to the level of neck disability in chronic migraine patients? Int J Environ Res Public Health. 2022; (23): 16307. https://doi.org/10.3390/ijerph192316307Castien R., De Hertogh W. A neuroscience perspective of physical treatment of headache and neck pain. Front Neurol. 2019; (10): 276. https://doi.org/10.3389/fneur.2019.00276Castien R., De Hertogh W. A neuroscience perspective of physical treatment of headache and neck pain. Front Neurol. 2019; (10): 276. https://doi.org/10.3389/fneur.2019.00276Lampl C., Rudolph M., Deligianni C. I. et al. Neck pain in episodic migraine: premonitory symptom or part of the attack? J Headache Pain. 2015; (566): 1–6. https://doi.org/10.1186/s10194-015-0566-0Lampl C., Rudolph M., Deligianni C. I. et al. Neck pain in episodic migraine: premonitory symptom or part of the attack? J Headache Pain. 2015; (566): 1–6. https://doi.org/10.1186/s10194-015-0566-0

The authors declare that there are no conflicts of interest present.