Carotid intima-media thickness and inflammatory biomarkers in adolescents with tension-type headache

Introduction
Primary headaches are frequent complaints among adolescents. Tension-type headache (TTH), which causes symptoms influencing the patients’ quality of life, can be associated with various medical disorders.

Aim of the study
To research the reason for TTH in adolescents.

Material and methods
The study included 76 patients, aged from 14 to 17 years, diagnosed due to TTH. Patients with the carotid intima-media thickness (cIMT) in the 90th percentile (the cut-off point: 0.42 mm for boys, and 0.41 mm for girls) were included in group 1, and the rest in group 2. All the patients underwent laboratory tests with serum levels of IL-6, IL-10, TNF-α, and sICAM-1. Twenty-six (34%) patients were enrolled in group 1 and 50 (66%) in group 2.

Results
There were no significant differences in age, sex, height, BMI, and systolic and diastolic blood pressure between patients from both studied groups. The mean cIMT value (mean, SD) for all patients from the study group was 0.41 ±0.012 mm: for girls 0.39 ±0.014 mm and for boys 0.44 ±0.016 mm. In 16-year-old adolescents, the cIMT was significantly higher in boys than girls. In 17-year-old patients, cIMT was significantly higher in boys only in group 1. The significantly higher concentrations of IL-6, TNF-α, and sICAM-1 were found in patients from group 1. Whereas the IL-10 level was significantly higher in the control group. In over one-third of patients (34%) with TTH, the cIMT was in the 90th percentile, despite having normal BMI, blood pressure, and lipid profile in serum.

Conclusions
The inflammatory process in the vascular wall could be considered as the reason for the higher cIMT value and/or TTH in adolescents.