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Logo of bmcneulBioMed Centralsearchsubmit a manuscriptregisterthis articleBMC Neurology
BMC Neurol. 2007; 7: 23.
Published online Aug 7, 2007. doi:  10.1186/1471-2377-7-23
PMCID: PMC2048502
Cardiovascular responses to cognitive stress in patients with migraine and tension-type headache
Rune B Leistad,corresponding author1,2 Trond Sand,1,2 Kristian B Nilsen,1,2 Rolf H Westgaard,3 and Lars Jacob Stovner1,2
1Department of Neurosciences, Norwegian University of Science and Technology, Trondheim, Norway
2Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
3Department of Industrial Economics and Technology Management, Norwegian University of Science and Technology, Trondheim, Norway
corresponding authorCorresponding author.
Rune B Leistad: rune.leistad/at/; Trond Sand: trond.sand/at/; Kristian B Nilsen: kristian.b.nilsen/at/; Rolf H Westgaard: rolf.westgaard/at/; Lars Jacob Stovner: lars.stovner/at/
Received January 22, 2007; Accepted August 7, 2007.
The purpose of this study was to investigate the temporal relationship between autonomic changes and pain activation in migraine and tension-type headache induced by stress in a model relevant for everyday office-work.
We measured pain, blood pressure (BP), heart rate (HR) and skin blood flow (BF) during and after controlled low-grade cognitive stress in 22 migraineurs during headache-free periods, 18 patients with tension-type headache (TTH) and 44 healthy controls. The stress lasted for one hour and was followed by 30 minutes of relaxation.
Cardiovascular responses to cognitive stress in migraine did not differ from those in control subjects. In TTH patients HR was maintained during stress, whereas it decreased for migraineurs and controls. A trend towards a delayed systolic BP response during stress was also observed in TTH. Finger BF recovery was delayed after stress and stress-induced pain was associated with less vasoconstriction in TTH during recovery.
It is hypothesized that TTH patients have different stress adaptive mechanisms than controls and migraineurs, involving delayed cardiovascular adaptation and reduced pain control system inhibition.
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