Tension-Type Headache, An Understudied and Undertreated Condition: Sait Ashina, MD, FAHS

WATCH TIME: 5 minutes

“Tension type headache remains a neglected primary headache disorder. We have unanswered questions about epidemiology, impact of diagnosis, pathophysiology, and treatment. Future epidemiological studies need to use vigorous methodology to make sure we don't diagnose a patient with migraine potential headaches.”

Worldwide, tension-type headache is known as the most common neurological disorder and is recognized through the recurrence of mild to moderate intensity of headaches, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity.¹ Diagnosis for the condition is based on the history of headache as well as the exclusion of alternative diagnoses according to clinical criteria. Research from the Global Burden of Disease study shows that headache disorders, like tension-type headache, are critical causes of disability globally, and need more attention in health policy.²

Sait Ashina, MD, FAHS,assistant professor of neurology at Harvard Medical School, gave a talk on tension-type headache in a plenary session at the 2023 American Headache Society (AHS) Annual Meeting, June 15-18, in Austin, Texas. In his presentation, he discussed how tension-type headache is a common condition for patients with headache and is understudied in the field.³

Ashina sat down in an interview with NeurologyLive® to provide an overview of the presentation that he gave at the meeting. He talked about the key findings regarding tension-type headache from the Global Burden of Disease study, as well as spoke about how it differentiates between chronic and episodic subtypes of migraine in terms of the impact it has on the quality of life in patients. In addition, he talked about the diagnostic criteria that are used to differentiate chronic and episodic tension-type headache, and how the criteria also relates to the diagnosis for migraine.

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REFERENCES
1. Ashina S, Mitsikostas DD, Lee MJ, et al. Tension-type headache. Nat Rev Dis Primers. 2021;7(1):24. Published 2021 Mar 25. doi:10.1038/s41572-021-00257-2
2. GBD 2016 Headache Collaborators. Global, regional, and national burden of migraine and tension-type headache, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016 [published correction appears in Lancet Neurol. 2021 Dec;20(12):e7]. Lancet Neurol. 2018;17(11):954-976. doi:10.1016/S1474-4422(18)30322-3
2. Ashina S. Tension-Type Headache: Common and Understudied. Presented at: AHS Annual Meeting, 2023; June 15-18; Austin, TX. Plenary Session.