Intra-oral orthosis vs amitriptyline in chronic tension-type headache: a clinical and laser evoked potentials study. Head Face Med 2:15

Neurological and Psychiatric Sciences Department University of Bari, Bari, Italy.
Head & Face Medicine (Impact Factor: 0.85). 02/2006; 2:15. DOI: 10.1186/1746-160X-2-15
Source: PubMed


In the present study, we examined clinical and laser-evoked potentials (LEP) features in two groups of chronic tension-type headache (CTTH) patients treated with two different approaches: intra-oral appliance of prosthesis, aiming to reduce muscular tenderness, and 10 mg daily amitriptyline.
Eighteen patients with diagnosed CTTH participated in this open label, controlled study. A baseline evaluation was performed for clinical features, Total Tenderness Score (TTS) and a topographic analysis of LEPs obtained manually and the pericranial points stimulation in all patients vs. healthy subjects. Thereafter, patients were randomly assigned to a two-month treatment by either amitriptyline or intra-oral appliance.
Both the intra-oral appliance and amitriptyline significantly reduced headache frequency. The TTS was significantly reduced in the group treated with the appliance. The amplitude of P2 response elicited by stimulation of pericranial zones showed a reduction after amitriptyline treatment.Both therapies were effective in reducing headache severity, the appliance with a prevalent action on the pericranial muscular tenderness, amitriptyline reducing the activity of the central cortical structures subtending pain elaboration
The results of this study may suggest that in CTTH both the interventions at the peripheral and central levels improve the outcome of headache.

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Available from: Paolo Lamberti, Oct 08, 2015
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    • "The authors concluded that amitriptyline seemed to elicit its analgesic effect in chronic myofascial pain by reducing the transmission of painful stimuli from myofascial tissues rather than by reducing overall pain sensitivity, probably for a segmental reduction of central sensitization in combination with a peripheral anti-nociceptive action [61]. In a more recent study [62], we obtained results that were not consistent with the above mentioned study, evaluating the effects of intra-oral appliances which are thought to reduce headache by correcting the dental bite and reducing pericranial muscle tenderness , in a cohort of chronic tension type headache patients (CTTH). The pericranial tenderness was significantly reduced in the group treated with the appliance. "
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