Association of depressive symptoms with allodynia in patients with migraine: A cross-sectional study

Abstract

Aims Migraine and depression have a strong association. We aimed to determine whether this relationship was particularly evident in migraineurs with allodynia. Methods A cross-sectional study was carried out of 98 consecutive patients with episodic migraine presenting for their first evaluation in an outpatient clinic. The participants completed a demographic questionnaire, the Allodynia Symptom Checklist and the Hospital Anxiety and Depression Scale (HADS). Results Among the migraineurs, 75 (77%) reported allodynia. Allodynia was associated with higher median HADS-Anxiety (9 vs. 6, p = 0.038) and HADS-Depression (6 vs. 4, p = 0.014) scores. In a multiple regression model, the HADS-Depression scores were independently associated with allodynia (odds ratio 1.236, 95% confidence interval 1.046-1.461). An increased severity of allodynia correlated with higher depression scores ( r = 0.224; p = 0.027). Conclusion Anxious and depressive symptoms are more common in migraineurs with allodynia than in those without allodynia. Further studies are necessary to clarify the relationship between depressive symptoms and allodynia, as well as its therapeutic implications in migraine.

Characterization of migraineurs presenting interictal widespread pressure hyperalgesia identified using a tender point count: a cross-sectional study

“…Consistent with previous large research studies [ 2 – 5 , 50 , 53 ], the risk factors of acute CA in the present study were female gender [ 3 , 5 , 50 , 53 ], younger age at onset [ 53 ], longer migraine history [ 3 , 5 , 53 ], presence of aura [ 2 , 5 , 53 ], higher frequency of attacks [ 2 , 3 , 50 , 53 ], severe headache impact (disability) [ 2 , 5 , 50 ], photophobia [ 2 , 5 ], phonophobia [ 2 , 5 ], and osmophobia [ 5 ]. On the other hand, although depression has frequently been reported to be associated with acute CA [ 3 , 4 , 50 , 53 , 54 ], no such association was observed in the present study. This discrepancy may have been due to the strict selection of episodic migraine in this study with exclusion of tension type headache comorbidity, chronic headache and medication overuse headache, which are well known to be associated with depression [ 55 ].…”

Migraine and depression: a comparative assessment of the efficacy and safety of antidepressants in patients with migraine

“…19 This relationship is also demonstrated by the fact that cutaneous allodynia, a clinical correlate of central sensitization, is more frequently observed in patients with chronic migraine and depression than in individuals with chronic migraine without depression. 20 Another theory that tries to explain the interrelationship between depression and the transformation to chronic migraine is the neurotrophic theory. In particular, the brain-derived neurotrophic factor (BDNF) gene polymorphism Val66Met is one of the best elucidated genetic polymorphisms responsible for the development of depression.…”

Migraine and depression: efficacy and safety of antidepressant therapy

“…Происходит снижение функции серотонинергических нейронов околоводопроводного серого вещества, что является ос-новным патофизиологическим механизмом трансфор-мации эпизодической мигрени в хроническую (цен-тральная сенситизация) [19]. Эту связь подтверждает тот факт, что у пациентов с хронической мигренью и де-прессией феномен кожной аллодинии, клинического коррелята центральной сенситизации, представлен ча-ще, чем у пациентов с хронической мигренью без де-прессии [20]. Другой теорией [21], объясняющей связь депрессии и хронификации мигрени, является нейро-трофическая теория.…”