Effect of hypovitaminosis D on the characteristics of chronic tension-type headache in women
Abstract
There is a growing body of evidence linking hypovitaminosis D with the prevalence and severity of various pain conditions. The effect of vitamin D levels on chronic tension type headache (CTTH) is almost unexplored.
Objective: to investigate the effect of serum vitamin D levels on the clinical characteristics of CTTH.
Patients and methods. The study enrolled women with CTTH (n=161). Headache frequency (HF), headache duration (HD), headache intensity (HI), presence of chronic widespread pain (WP) and the number of its zones, severity of anxiety and depression, and sleep quality index were evaluated. The vitamin D level was assessed by the concentration of 25-hydroxyvitamin D [25(OH)D].
Results and discussion. Low 25(ОН)D-level was associated with an increase in HF, HD and the prevalence of WP. For each of the listed parameters, the values in vitamin D deficiency were higher than in its insufficiency or normal ranges (p<0,001). 25(OH)D-level was inversely correlated with HF (rS=-0,49), HD (rS=-0,51; p<0,05). Vitamin D-deficiency increased the risk of WP: compared to its insufficiency relative risk (RR) was 2.12 (95% CI 1.39–3.21), to the normal ranges – 3.67 (95% CI 1.71–7.88). In case of insufficiency and normal level of vitamin D, the values for the listed parameters did not differ. Other characteristics did not depend on 25(OH)D-level.
Conclusion. In women with CTTH hypovitaminosis D contributes to the greater disease severity. Vitamin D deficiency, which is strongly associated with an increase in pain characteristics, has great clinical significance.
About the Authors
A. A. KoloskovaRussian Federation
Alla Anatol'yevna Koloskova
86, Entuziastov Shosse, Moscow 111123, Russia
52, Geroya Vasilieva St., Nizhny Novgorod 603053, Russia
O. V. Vorobyeva
Russian Federation
86, Entuziastov Shosse, Moscow 111123, Russia
References
1. Ferrante T, Manzoni GC, Russo M, et al. Prevalence of tension-type headache in adult general population: the PACE study and review of the literature. Neurol Sci. 2013 May;34 Suppl 1:S137-8. doi: 10.1007/s10072-013-1370-4
2. Ayzenberg I, Katsarava Z, Sborowski A, et al. The prevalence of primary headache disorders in Russia: a countrywide survey. Cephalalgia. 2012 Apr;32(5):373-81. doi: 10.1177/0333102412438977. Epub 2012 Mar 6.
3. Jensen R, Stovner LJ. Epidemiology and comorbidity of headache. Lancet Neurol. 2008 Apr;7(4):354-61. doi: 10.1016/S1474-4422(08)70062-0
4. Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R. Incidence of primary headache: a Danish epidemiologic follow-up study. Am J Epidemiol. 2005 Jun 1;161(11):1066-73. doi: 10.1093/aje/kwi139
5. Zebenholzer K, Andree C, Lechner A, et al. Prevalence, management and burden of episodic and chronic headaches – a cross-sectional multicentre study in eight Austrian headache centres. J Headache Pain. 2015;16:531. doi: 10.1186/s10194-015-0531-7. Epub 2015 May 19.
6. Golovacheva VA, Parfenov VA, Zakharov VV. Treatment for chronic daily headache by using auxiliary and alternative methods. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2015;7(2):35-41. doi: 10.14412/2074-2711-2015-2-35-41 (In Russ.).
7. Global Burden of Disease Study 2013 Collaborators. Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015 Aug 22;386(9995):743-800. doi: 10.1016/S0140-6736(15)60692-4. Epub 2015 Jun 7.
8. Lips P. Worldwide status of vitamin D nutrition. J Steroid Biochem Mol Biol. 2010 Jul;121(1-2):297-300. doi: 10.1016/j.jsbmb.2010.02.021. Epub 2010 Mar 1.
9. Petrushkina AA, Pigarova EA, Rozhinskaya LYa. The prevalence of vitamin D deficiency in Russian Federation. Osteoporoz i osteopatii = Osteoporosis and Bone Diseases. 2018;21(3):15-20. doi: 10.14341/osteo10038 (In Russ.).
10. Shipton EA, Shipton EE. Vitamin D and Pain: Vitamin D and Its Role in the Aetiology and Maintenance of Chronic Pain States and Associated Comorbidities. Pain Res Treat. 2015;2015:904967. doi: 10.1155/2015/904967. Epub 2015 Apr 19.
11. Ghorbani Z, Togha M, Rafiee P, et al. Vitamin D in migraine headache: a comprehensive review on literature. Neurol Sci. 2019 Dec;40(12):2459-77. doi: 10.1007/s10072-019-04021-z. Epub 2019 Aug 3.
12. Nowaczewska M, Wicinski M, Osinski S, Kazmierczak H. The Role of Vitamin D in Primary Headache-from Potential Mechanism to Treatment. Nutrients. 2020 Jan 17;12(1):243. doi: 10.3390/nu12010243
13. Prakash S, Kumar M, Belani P, et al. Interrelationships between chronic tension-type headache, musculoskeletal pain, and vitamin D deficiency: Is osteomalacia responsible for both headache and musculoskeletal pain? Ann Indian Acad Neurol. 2013 Oct;16(4):650-8. doi: 10.4103/0972-2327.120487
14. Prakash S, Rathore C, Makwana P, et al. Vitamin D Deficiency in Patients With Chronic Tension-Type Headache: A Case-Control Study. Headache. 2017 Jul;57(7):1096-108. doi: 10.1111/head.13096. Epub 2017 May 3.
15. Headache Classification Committee of the International Headache Society (IHS). The International Classification of Headache Disorders, 3rd edition (beta version). Cephalalgia. 2013 Jul;33(9):629-808. doi: 10.1177/0333102413485658
16. Beck AT, Ward CH, Mendelson M, et al. An inventory for measuring depression. Arch Gen Psychiatry. 1961 Jun;4:561-71. doi: 10.1001/archpsyc.1961.01710120031004
17. Migraine]. Moscow: GEOTAR-Media; 2011. 624 p. (In Russ.).
18. Wolfe F, Clauw DJ, Fitzcharles MA, et al. The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Res (Hoboken). 2010 May;62(5):600-10. doi: 10.1002/acr.20140
19. Wolfe F, Smythe HA, Yunus MB, et al. The American College of Rheumatology 1990 Criteria for the Classification of Fibromyalgia. Report of the Multicenter Criteria Committee. Arthritis Rheum. 1990 Feb;33(2):160-72. doi: 10.1002/art.1780330203
20. Beck AT, Epstein N, Brown G, Steer RA. An inventory for measuring clinical anxiety: psychometric properties. J Consult Clin Psychol. 1988 Dec;56(6):893-7. doi: 10.1037//0022-006x.56.6.893
21. Buysse DJ, Reynolds CF 3rd, Monk TH, et al. The Pittsburgh Sleep Quality Index: a new instrument for psychiatric practice and research. Psychiatry Res. 1989 May;28(2):193-213. doi: 10.1016/0165-1781(89)90047-4
22. Rossijskaja associacija jendokrinologov. Deficit vitamina D u vzroslyh: diagnostika, lechenie i profilaktika. Klinicheskie rekomendacii [Russian Association of Endocrinologists. Vitamin D deficiency in adults: diagnosis, treatment and prevention. Clinical recommendations]. Moscow; 2016. 39 p. (In Russ.).
23. Rapisarda L, Mazza MR, Tosto F, et al. Relationship between severity of migraine and vitamin D deficiency: a case-control study. Neurol Sci. 2018 Jun;39(Suppl 1):167-8. doi: 10.1007/s10072-018-3384-4
24. Hussein M, Fathy W, Abd Elkareem RM. The potential role of serum vitamin D level in migraine headache: a case-control study. J Pain Res. 2019 Aug 20;12:2529-36. doi: 10.2147/JPR.S216314. eCollection 2019.
25. Hsiao MY, Hung CY, Chang KV, et al. Is Serum Hypovitaminosis D Associated with Chronic Widespread Pain Including Fibromyalgia? A Meta-analysis of Observational Studies. Pain Physician. Sep-Oct 2015;18(5):E877-87.
26. Atherton K, Berry DJ, Parsons T, et al. Vitamin D and chronic widespread pain in a white middle-aged British population: evidence from a cross-sectional population survey. Ann Rheum Dis. 2009 Jun;68(6):817-22. doi: 10.1136/ard.2008.090456. Epub 2008 Aug 12.
27. Wu Z, Malihi Z, Stewart AW, et al. The association between vitamin D concentration and pain: a systematic review and meta-analysis. Public Health Nutr. 2018 Aug;21(11):2022-37. doi: 10.1017/S1368980018000551. Epub 2018 Mar 21.
28. Von Känel R, Müller-Hartmannsgruber V, Kokinogenis G, Egloff N. Vitamin D and central hypersensitivity in patients with chronic pain. Pain Med. 2014 Sep;15(9):1609-18. doi: 10.1111/pme.12454. Epub 2014 Apr 14.
29. Lerner PP, Sharony L, Miodownik C. Association between mental disorders, cognitive disturbances and vitamin D serum level: Current state. Clin Nutr ESPEN. 2018 Feb;23:89-102. doi: 10.1016/j.clnesp.2017.11.011. Epub 2017 Dec 23.
30. Menon V, Kar SK, Suthar N, Nebhinani N. Vitamin D and Depression: A Critical Appraisal of the Evidence and Future Directions. Indian J Psychol Med. 2020 Jan 6;42(1):11-21. doi: 10.4103/IJPSYM.IJPSYM_160_19. eCollection Jan-Feb 2020.
31. Darling AL, Skene DJ, Lanham-New SA. Preliminary evidence of an association between vitamin D status and self-assessed sleep duration but not overall sleep quality: results from the D-FINES study of South Asian and Caucasian preand post-menopausal women living in Southern England. Proceedings of the Nutrition Society. Cambridge University Press. 2011;70(OCE3):E88.
32. Bendtsen L. Central and peripheral sensitization in tension-type headache. Curr Pain Headache Rep. 2003 Dec;7(6):460-5. doi: 10.1007/s11916-003-0062-9
33. Tabeyeva G.R. Fibromyalgia: development of symptoms and principles of therapy. Nevrologiya, neiropsikhiatriya, psikhosomatika = Neurology, Neuropsychiatry, Psychosomatics. 2012;4(1):23-7. doi: 10.14412/2074-2711-2012-357 (In Russ.).
34. Ji RR, Nackley A, Huh Y, et al. Neuroinflammation and Central Sensitization in Chronic and Widespread Pain. Anesthesiology. 2018 Aug;129(2):343-66. doi: 10.1097/ALN.0000000000002130
35. Hagen K, Linde M, Steiner TJ, et al. The bidirectional relationship between headache and chronic musculoskeletal complaints: an 11-year follow-up in the Nord- Trondelag Health Study (HUNT). Eur J Neurol. 2012 Nov;19(11):1447-54. doi: 10.1111/j.1468-1331.2012.03725.x. Epub 2012 Apr 23.
Review
For citations:
Koloskova A.A., Vorobyeva O.V. Effect of hypovitaminosis D on the characteristics of chronic tension-type headache in women. Neurology, Neuropsychiatry, Psychosomatics. 2022;14(2):43-48. (In Russ.) https://doi.org/10.14412/2074-2711-2022-2-43-48