Aim: Experimental studies suggest that central sensititization plays important role in pathophysiology of chronic pain and chronic
tension-type headache (CTTH). Studies on pro-inflammatory cytokines, interleukin (IL)-1Î² and tumor necrosis factor (TNF)-Î±
serum levels during headache attack showed inconsistent results. This study was aimed to see the serum levels of TNF-Î±, IL-1,
IL-6 in patients with CTTH and its correlation with pain intensity.
Methodology: This cross sectional study was conducted at the Adam Malik Hospital and Bukit Barisan II Army Hospital from
January 2013 to June 2014 after approved by the Ethics Committee for Health Research University of North Sumatera School
of Medicine. The subjects were recruited consecutively from study population and agree to participate in this study. Diagnosis of
CTTH was conducted through anamnesis, physical and neurological examination and based on the diagnostic criteria as stated
in the ICH X. Subjects underwent physical and neurological examination, including assessment of pain intensity by using the
Numeric Rating Scale ( NRS ) for pain. Furthermore, venous blood was taken to measure serum levels of TNF-Î± , IL-1, and IL-6.
Results: The mean of TNF-Î± serum level is 1.81528 pg/dl (SD ± 0.890686), whereas the mean of IL–1 serum level is 0.20226
pg/dl (SD ± 0.193930), and the mean value of IL-6 serum level is 1.45089 pg/dl (SD ± 1.189502). There was very weak positive
correlation (r=0.035) and non significant (p=0.806) between NRS scores and TNF-Î± serum level. There was non significant
(p=0.793) and very weak negative correlation (r =-0037) between NRS scores and IL-1 serum level. NRS scores have a very
weak negative correlation (r=-0.107) and also not statistically significant (p=0.447) with IL-6 serum level.
Conclusions: Previous studies showed positive correlation between NRS score and levels of TNF-Î±, IL-1 and IL-6. The higher
NRS score, the higher serum level of TNF-Î±, IL-1 and IL-6. This study shows weak negative correlation between NRS scores
and IL-1 and IL-6 serum level. The positive weak correlation only found between NRS scores and TNF-Î± serum level. All of
these correlation were statistically non significant. These findings perhaps because the sample from serum did not describe the
biological mechanisms that occur in the brain.
Chronic tension-type headache, Cytokines, TNF-Î±, IL-1, IL-6