Altered pain processing in children with migraine: An evoked potential study

Abstract

In adults, evidence is accumulating that migraine is associated with altered central processing of pain stimuli and, possibly, changes in the allocation of attentional resources to such stimuli. In pediatric migraine, however, little is known about altered pain processing. We examined 15 children with migraine and 15 controls (age 10-15) in an oddball standards task. Children had to respond to rare targets (tones) and ignore frequent painful (pain threshold) or non-painful mechanical standard stimuli while evoked potentials were obtained. Painful as compared to non-painful stimuli elicited significantly larger N150, P260 and P300 components of the somatosensory evoked potential in all children. The pain-evoked N150 and P260 components did not differ significantly between groups. However, in children with migraine, both painful and non-painful standard stimuli were associated with significantly larger P300 amplitudes at significantly shorter latencies. Perceived intensity of the painful and non-painful stimuli was comparable in both groups. The evoked potentials and reaction times to the target tones did not differ significantly between groups. Habituation across trials was similar in both groups. Hence, children with migraine may display an automatic attentional bias towards painful and potentially painful somatosensory stimuli. Consistent with the psychobiological perspective of chronic pain, such an attentional bias could constitute an important mechanism for migraine becoming a chronic problem.

Decreased Pain Threshold in Juvenile Idiopathic Arthritis: A Cross-sectional Study

“…Previous studies have reported lower pain threshold (PT) in children with chronic pain conditions, even in body areas not affected by disease 5,6,7,8,9 , supporting the theory that chronic pain conditions alter central nervous system pain perception and sensitization 10 .…”

Sensitization to Acute Procedural Pain in Pediatric Sickle Cell Disease: Modulation by Painful Vaso-occlusive Episodes, Age, and Endothelin-1

“…The impact of early and repeated childhood pain on future pain experiences has been studied in several pediatric populations aside from sickle cell disease (SCD) 11, 20, 21, 25, 27, 37, 43, 46–49, 54, 55, 57 . Pain sensitization in childhood is a complex phenomenon, dependent on the type of painful insult 2 , the developmental stage of the child 13 , and the child’s cumulative experience with pain 48 .…”

“…Beyond infancy, accumulating literature suggests that severe or frequent childhood pain can increase the risk for adult chronic pain 21, 24–27 . Additionally, clinical literature suggests that children with chronic pain may exhibit increased pain sensitivity between attacks 57 as well as attentional bias to painful stimuli 55, 56 . With regard to pain from medical procedures, research also suggests greater sensitivity to procedural pain in younger versus older children 4, 13, 45, 48 .…”

Applications of laboratory pain methodologies in research with children and adolescents: Emerging research trends

“…Recent research in clinical pediatric samples has found evidence of wind-up in children with complex regional pain syndrome (CRPS) [28], migraine [40], and abdominal pain [38]. Additionally, chronic pain during childhood predicts wind-up to heat pain in adult women [10].…”

“…Electroencephalogram (EEG) responses in children with migraines have been shown to have longer amplitude and shorter latency compared to healthy youth during a QST perceptual sensitization task [38], suggesting youth with pain conditions may demonstrate an attentional bias to pain. Another study examining cortical responses in youth with abdominal pain achieved similar results [19].…”