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Extracranial Hemodynamic Responses to a Noxious Cold Pressor Task Differ Between Persistent Post-Traumatic Headache
Aaron W Parr1,2, David B Berry3, Bahar Shahidi3
1Joint Doctoral Program in Public Health, University of California San Diego, 9500 Gilman Dr., San Diego, CA 92093, USA.
Journal of Personalized Medicine
|December 24, 2025
Summary
Individuals with persistent post-traumatic headache (pPTH) exhibit heightened systemic hemodynamic responses to cold stimuli, unlike healthy controls. Dorsomedial prefrontal cortex activity correlates with pain intensity in both groups.
Area of Science:
- Neuroscience
- Pain Research
- Traumatic Brain Injury
Background:
- Headache is a common consequence of traumatic brain injury (TBI), often persisting and linked to significant disability.
- Altered pain processing in persistent post-traumatic headache (pPTH) necessitates understanding its physiological underpinnings for targeted treatments.
Purpose of the Study:
- To investigate differences in extra- and intracranial hemodynamic responses to a cold pressor task (CPT) between individuals with pPTH and healthy controls (HC).
- To explore the relationship between pain intensity and hemodynamic responses in the medial prefrontal cortex (PFC) during nociceptive stimulation.
Main Methods:
- A case-control study comparing 10 individuals with pPTH and 10 HC using functional near-infrared spectroscopy (fNIRS).
- fNIRS measured hemodynamic responses in the medial PFC during tepid and cold water immersion (CPT).
- Pain intensity was assessed using numeric ratings, and linear mixed effects models analyzed group and pain effects on hemodynamics.
Main Results:
- Individuals with pPTH showed significantly greater extracranial hemodynamic responses to the CPT compared to HC.
- No significant differences in intracranial PFC hemodynamic responses were observed between the groups.
- Increased pain intensity during CPT correlated with heightened hemodynamic responses in the dorsomedial PFC, irrespective of group.
Conclusions:
- Individuals with pPTH exhibit elevated autonomic nervous system-regulated systemic hemodynamic responses to noxious cold stimuli.
- Dorsomedial PFC hemodynamic responses are associated with evoked pain intensity, suggesting potential as a biomarker for cortical pain processing variations in both healthy and clinical populations.
