Central Sensitization and Neuropathic Pain in Cervicogenic Headache

NCT07292181 | Completed

• 1 other identifier: 2025-GOKAEK-2513_2025.07.02_50
• Study Type: observational
• Target: 72
• Locations: 1 country
• Sites: 1

Brief Summary

Cervicogenic headache is a type of secondary headache that originates from the structures of the neck and can spread toward the head and facial regions. It is often one-sided and may be triggered by neck movement or sustained posture. The underlying mechanisms are thought to include abnormal processing of pain signals in the cervical spine and brainstem. This case-control study was designed to examine whether individuals with cervicogenic headache show higher levels of central nervous system hypersensitivity and nerve-related pain compared with healthy individuals. The study also aimed to identify how these pain mechanisms are related to sleep, mood, and functional capacity. The research was conducted at the Departments of Physical Medicine and Rehabilitation and Neurology of Yozgat Bozok University. Adults between 18 and 65 years of age who met the diagnostic criteria for cervicogenic headache were included. Age- and sex-matched healthy volunteers without chronic pain or neurological disorders were recruited as the control group. Participants completed face-to-face interviews that included sociodemographic questions and a series of validated assessment tools measuring pain characteristics, psychological state, sleep quality, and quality of life. Ethical approval was obtained from the institutional review board, and all participants provided written informed consent prior to participation.

Conditions

Neuropathic Pain; Cervicogenic Headache; Central Sensitization

Keywords

Headache Disorders; Neck Pain; Pain Mechanisms; Psychological Distress; Sleep Quality; Quality of Life; Pain Assessment; Case-Control Study

Outcome Measures

Primary Outcomes (2)

• Central Sensitization Inventory

  Description: A 25-item self-report questionnaire that evaluates symptoms associated with central sensitization, including hypersensitivity, sleep disturbance, and emotional complaints. Scoring: Total score range 0-100. A score of 40 or higher suggests the presence of central sensitization. Turkish validation and reliability study: Conducted in 2021

  At baseline

• PainDETECT Questionnaire

  Description: A self-administered screening tool for identifying neuropathic pain characteristics. Scoring: Total score range -1 to 38. Scores ≤12 indicate neuropathic pain is unlikely; scores ≥19 indicate neuropathic pain is likely; 13-18 indicates unclear classification. Turkish validation and reliability study: Conducted in 2013.

  At baseline.

Secondary Outcomes (5)

• Headache Impact Test (6 items)

  At baseline

• Neck Disability Index

  At baseline

• Hospital Anxiety and Depression Scale

  At baseline

• Jenkins Sleep Scale

  At baseline

• Short Form-36 Health Survey

  At baseline

Study Arms (2)

Patient group

Age range: 18 to 65 years Diagnosis of cervicogenic headache established according to the International Classification of Headache Disorders, 3rd edition criteria Recruited from outpatient clinics of Physical Medicine and Rehabilitation and Neurology Exclusion criteria: younger than 18 or older than 65, inability to communicate, illiteracy, refusal to participate, diabetes mellitus, hypothyroidism, chronic kidney disease, malignancy, neurological diseases associated with neuropathic pain, and rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, or fibromyalgia

Other: Clinical assessment with standardized questionnaires

Healthy Control Group

Age range: 18 to 65 years No diagnosis of cervicogenic headache or chronic pain conditions Age- and sex-matched to the patient group Voluntary participation Exclusion criteria: illiteracy, refusal to participate, diabetes mellitus, hypothyroidism, chronic kidney disease, malignancy, neurological diseases associated with neuropathic pain, and rheumatic diseases such as rheumatoid arthritis, ankylosing spondylitis, or fibromyalgia

Other: Clinical assessment with standardized questionnaires

Interventions

Clinical assessment with standardized questionnaires OTHER

Participants in both the patient group and the healthy control group underwent a structured clinical assessment using validated instruments. The evaluation included measures of central sensitization, neuropathic pain features, headache-related disability, cervical functional impairment, psychological distress, sleep quality, and health-related quality of life. The instruments administered were the Central Sensitization Inventory, PainDETECT Questionnaire, Headache Impact Test, Neck Disability Index, Hospital Anxiety and Depression Scale, Jenkins Sleep Scale, and Short Form-36. No pharmacological or procedural intervention was applied as part of the study; the primary focus was on comparative assessment between groups.

Healthy Control Group; Patient group

Eligibility Criteria

• Age: 18 Years - 65 Years
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

The study population included 106 adult patients with cervicogenic headache and 106 age- and sex-matched healthy controls. Patients were recruited from outpatient clinics of Physical Medicine and Rehabilitation and Neurology at Bozok University, Turkey. Healthy volunteers were selected from the community and hospital staff who met the eligibility criteria.

You may qualify if:

• Adults aged 18 to 65 years
• Patient group: Clinical diagnosis of cervicogenic headache according to the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria
• Healthy control group: Age- and sex-matched individuals without cervicogenic headache or other chronic pain conditions
• Adequate cognitive function and literacy to complete questionnaires
• Voluntary participation with written informed consent

You may not qualify if:

• Age younger than 18 years or older than 65 years
• Inability to communicate effectively
• Illiteracy
• Refusal to participate
• Presence of systemic diseases including diabetes mellitus, hypothyroidism, chronic kidney disease, or malignancy
• Neurological diseases associated with neuropathic pain
• Rheumatologic diseases including rheumatoid arthritis, ankylosing spondylitis, or fibromyalgia
• Withdrawal of consent or incomplete data during the study

Sponsors & Collaborators

• Gulseren Demir Karakilic: lead

Study Sites (1)

Yozgat Bozok University Faculty of Medicine, Department of Physical Medicine and Rehabilitation

Yozgat, Yozgat, 66100, Turkey (Türkiye)

Location

Related Publications (8)

• Kocyigit, H., Turkish validity and reliability of short-form 36. Drug Treat, 1999. 12: p. 102-106.

  BACKGROUND

• Duruoz MT, Erdem D, Gencer K, Ulutatar F, Baklacioglu HS. Validity and reliability of the Turkish version of the Jenkins Sleep Scale in psoriatic arthritis. Rheumatol Int. 2018 Feb;38(2):261-265. doi: 10.1007/s00296-017-3911-2. Epub 2017 Dec 18.

  PMID: 29250729 BACKGROUND

• Duzce Keles E, Birtane M, Ekuklu G, Kilincer C, Caliyurt O, Tastekin N, Is EE, Ketenci A, Neblett R. Validity and reliability of the Turkish version of the central sensitization inventory. Arch Rheumatol. 2021 Oct 18;36(4):518-526. doi: 10.46497/ArchRheumatol.2022.8665. eCollection 2021 Dec.

  PMID: 35382371 BACKGROUND

• Alkan H, Ardic F, Erdogan C, Sahin F, Sarsan A, Findikoglu G. Turkish version of the painDETECT questionnaire in the assessment of neuropathic pain: a validity and reliability study. Pain Med. 2013 Dec;14(12):1933-43. doi: 10.1111/pme.12222. Epub 2013 Aug 7.

  PMID: 23924395 BACKGROUND

• Aydemir, O., Hastane anksiyete ve depresyon olcegi Turkce formunun gecerlilik ve guvenilirligi. Turk Psikiyatri Derg., 1997. 8: p. 187-280.

  BACKGROUND

• Telci EA, Karaduman A, Yakut Y, Aras B, Simsek IE, Yagli N. The cultural adaptation, reliability, and validity of neck disability index in patients with neck pain: a Turkish version study. Spine (Phila Pa 1976). 2009 Jul 15;34(16):1732-5. doi: 10.1097/BRS.0b013e3181ac9055.

  PMID: 19770615 BACKGROUND

• Dikmen PY, Bozdag M, Gunes M, Kosak S, Tasdelen B, Uluduz D, Ozge A. Reliability and Validity of Turkish Version of Headache Impact Test (HIT-6) in Patients with Migraine. Noro Psikiyatr Ars. 2020 Apr 24;58(4):300-307. doi: 10.29399/npa.24956. eCollection 2021.

  PMID: 34924791 BACKGROUND

• Demir Karakilic G, Unluel H. Prevalence of clinical sensitization phenotype and neuropathic-like pain features in patients with cervicogenic headache: a case-control study. Neurol Res. 2026 Mar;48(3):402-417. doi: 10.1080/01616412.2026.2628609. Epub 2026 Feb 14.

  PMID: 41689387 DERIVED

MeSH Terms

Conditions

Post-Traumatic Headache; Neuralgia; Headache Disorders; Neck Pain; Sleep Initiation and Maintenance Disorders

Condition Hierarchy (Ancestors)

Headache Disorders, Secondary; Brain Diseases; Central Nervous System Diseases; Nervous System Diseases; Peripheral Nervous System Diseases; Neuromuscular Diseases; Pain; Neurologic Manifestations; Signs and Symptoms; Pathological Conditions, Signs and Symptoms; Sleep Disorders, Intrinsic; Dyssomnias; Sleep Wake Disorders; Mental Disorders

Study Officials

• Gülseren Demir Karakılıç, Assistant Professor

  Yozgat Bozok University

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: observational
• Observational Model: CASE CONTROL
• Time Perspective: CROSS SECTIONAL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: Assistant Professor, Principal Investigator

Study Record Dates

• First Submitted: December 5, 2025
• First Posted: December 18, 2025
• Study Start: July 3, 2025
• Primary Completion: October 3, 2025
• Study Completion: October 3, 2025
• Last Updated: December 23, 2025

Record last verified: 2025-12

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP, ANALYTIC CODE
• Time Frame: IPD and supporting documents will be shared upon request following the publication of the study and will be available for up to 5 years.
• Access Criteria: De-identified IPD and supporting documents will be provided to researchers who submit a methodologically sound research proposal. Requests should be made via email to the corresponding author and, once approved, data will be shared through a secure file transfer.

Locations

TU (1)