Cervical musculature may play an important role in the genesis of tension-type headache. However, there are no reports on a possible association between the morphometrical features of the neck flexion and extension muscles and adolescence headache.

To examine differences in neck flexion and extension muscles cross-sectional area (CSA) in adolescents with and without headache.

A population-based sample of 17-year-old adolescents with migraine (N=19), tension-type headache (N=24) and healthy controls without headache (N=22) was examined. CSA of the neck muscles was measured from axial T1-weighted magnetic resonance images (MRI).

Boys with tension-type headache showed significantly smaller CSA of right sternocleidomastoid muscle than boys with migraine and girls with tension-type headache showed significantly smaller CSA of combined right sternocleidomastoid and scalenus muscles than girls with migraine. In addition, boys with migraine had significantly larger CSA of both right sternocleidomastoid and combined right sternocleidomastoid and scalenus muscles, and left semispinalis capitis muscle and combined left semispinalis and splenius muscles than boys without headache. In boys and girls no other significant differences were observed in the CSA of neck flexion or extension muscles.

This preliminary work demonstrates that both girls and boys with tension-type headache and migraine have differences in the size of neck flexion muscles, especially unilaterally. In boys, unilaterally increased size of neck flexion and extension muscles is associated with migraine. These findings, if confirmed in further studies, may have important diagnostic and therapeutic implications for rehabilitation of adolescents with headache.