Lower inhibitory control interacts with greater pain catastrophizing to predict greater pain intensity in women with migraine and overweight/obesity

Abstract

BackgroundPain catastrophizing (PC) is associated with more severe and disabling migraine attacks. However, factors that moderate this relationship are unknown. Failure of inhibitory control (IC), or the ability to suppress automatic or inappropriate responses, may be one such factor given previous research showing a relationship between higher PC and lower IC in non-migraine samples, and research showing reduced IC in migraine. Therefore, we examined whether lower IC interacts with increased PC to predict greater migraine severity as measured by pain intensity, attack frequency, and duration.MethodsWomen (n = 105) aged 18–50 years old (M = 38.0 ± 1.2) with overweight/obesity and migraine who were seeking behavioral treatment for weight loss and migraine reduction completed a 28-day smartphone-based headache diary assessing migraine headache severity. Participants then completed a modified computerized Stroop task as a measure of IC and self-report measures of PC (Pain Catastrophizing Scale [PCS]), anxiety, and depression. Linear regression was used to examine independent and joint associations of PC and IC with indices of migraine severity after controlling for age, body mass index (BMI) depression, and anxiety.ResultsParticipants on average had BMI of 35.1 ± 6.5 kg/m2and reported 5.3 ± 2.6 migraine attacks (8.3 ± 4.4 migraine days) over 28 days that produced moderate pain intensity (5.9 ± 1.4 out of 10) with duration of 20.0 ± 14.2 h. After adjusting for covariates, higher PCS total (β = .241, SE = .14, p = .03) and magnification subscale (β = .311, SE = .51, p < .01) scores were significant independent correlates of longer attack duration. IC interacted with total PCS (β = 1.106, SE = .001, p = .03) rumination (β = 1.098, SE = .001, p = .04), and helplessness (β = 1.026, SE = .001, p = .04) subscale scores to predict headache pain intensity, such that the association between PC and pain intensity became more positive at lower levels of IC.ConclusionsResults showed that lower IC interacted with higher PC, both overall and specific subcomponents, to predict higher pain intensity during migraine attacks. Future studies are needed to determine whether interventions to improve IC could lead to less painful migraine attacks via improvements in PC.

Decline in attentional inhibition among migraine patients: an event‐related potential study using the Stroop task

“…In this study, we used the classic color–word Stroop paradigm, which have been widely used to examine the ERP correlates of cognitive processes related to selective attention [ 17 , 20 ]. To date, no consistent or positive behavioral results have been obtained in studies investigating the attention function in migraine using the Stroop task or related paradigms [ 2 , 10 , 21 , 22 ]. Hence, we tried to elucidate this cognitive process in migraineurs in greater detail using the ERP method.…”

Catastrofização e migrânea: uma reflexão sobre o enfrentamento da dor

“…Mulheres que sofrem com migrânea apresentaram níveis excessivos de estresse, ansiedade e depressão, interferindo diretamente na sua qualidade de vida e capacidade funcional para execução das atividades do cotidiano. (3,14,(16)(17)(18) Catastrofização e crises de migrânea Na migrânea, destacada em todos os estudos, a catastrofização da dor está associada a crises mais graves e incapacitantes. Os indivíduos sofrem crises mais frequentes, com maior duração, maior sensibilidade à dor, maior impacto e menor autoeficácia da gestão da dor de cabeça.…”

<p>A systematic review of structural and functional MRI studies on pain catastrophizing</p>

“…Firstly, our starting point was pain catastrophizing (and not chronic pain as it was in Malfliet et al’s review), and we aimed to reveal potential mechanisms underlying pain catastrophizing. Therefore, as a second difference, we also included studies that exclusively used a healthy control group, and thirdly, since several papers found that pain catastrophizing is an important factor in migraine-related disability,10,11,47,48 we also included studies with migraine patients (both type of studies were excluded from Malfliet et al’s review). Migraine is characterized by recurrent headaches with moderate or severe pain49 and it has been proposed to be associated with similar structural and functional neural changes identified in other chronic pain populations 50.…”