Dopamine agonist treatment normalizes neck motor dyscoordination and relieves pain in chronic tension-type headache and common whiplash. A pilot study

AIMS: This open-label non-placebo clinical trial was designed as an explorative test of a recent hypothesis suggesting a causative relation between neck muscle dyssynergia and pain in patients with chronic tension-type headache (TTH) and common whiplash (WL). A Dopamine agonist was used as test-treatment. The primary aim was to improve neck muscle dyssynergia and second to observe the effect on pain. PATIENTS & METHODS: Fifteen patients, comprising 8 tension-type headache and 7 common whiplash patients, all with significant neck muscle tenderness, were started on a standard Pramipexole treatment by 0.18 mg Pramipexole daily and increased by 0.18 mg weekly to 0.18 mg × 3 daily for maintenance. Weekly visits with measurements of head laser tracking (HLT) as indicator of neck muscle dyssynergia, total neck muscle tenderness score, and self-reported daily average headache and neck pain. Head laser tracking was compared to a control group of 8 untreated healthy persons. RESULTS: HLT normalized during treatment and clinical parameters of pain significantly improved. CONCLUSION: This result provides preliminary support of the hypothesis of a pathogenetic relation between the dyssynergic neck muscle innervation and pain in TTH and common WL. CLINICAL TRIAL REGISTRATION: EudraCT 2021-003574-31.