Is phonophobia associated with cutaneous allodynia in migraine?

Abstract

Objective To determine whether phonophobia and dynamic mechanical (brush) allodynia are associated in episodic migraine (EM). Methods Adult patients with EM were prospectively recruited. A structured questionnaire was used to obtain demographic and migraine related data. Phonophobia was tested quantitatively using a real time sound processor and psychoacoustic software. Sound stimuli were pure tones at frequencies of 1000 Hz, 4000 Hz and 8000 Hz, delivered to both ears at increasing intensities, until an aversive level was reached. Allodynia was assessed by brushing the patient’s skin with a gauze pad at different areas. Patients were tested both between and during acute attacks. Sound aversion thresholds (SATs) in allodynic and non-allodynic patients were compared. Results Between attacks, SATs were lower in allodynic compared with non-allodynic patients, with an average difference of −5.7 dB (p=0.04). During acute attacks, the corresponding average SAT difference (allodynic-non-allodynic) was −15.7 dB (p=0.0008). There was a significant negative correlation between allodynia scores and SATs, both within and between attacks. Conclusions The results support an association between phonophobia and cutaneous allodynia in migraine.

Acetate Causes Alcohol Hangover Headache in Rats

“…This phenomenon is consistent with human data [4], [56]. Our laboratory has also shown increased sensitivity to sound or phonophobia following repeated dura stimulation, which has been demonstrated in humans both during and between migraine attacks [57], [58], [59]. As described in the current study, our model is sensitive to common headache triggers including ethanol and nitroglycerin.…”

Allodynia in Cluster Headache

“…A recent study suggests an association between allodynia and phonophobia in migraine [21]. Because phonophobia is not likely to be mediated through spinal mechanisms, these results raise the hypothesis that the mechanisms of allodynia in headache disorders are more complex, possibly involving neuronal dysfunction at higher (cortical) centers as well.…”

A Review of Hyperacusis and Future Directions: Part I. Definitions and Manifestations

“…About 40% of migraine sufferers reported allodynia and fear hyperacusis (Ashkenazi, Yang, Mushtaq, & Oshinsky, 2010). Allodynia, like hyperacusis, is often associated with migraine.…”

“…The sound levels that result in hyperacusis are reportedly lower during migraine attacks and occur without changes of hearing thresholds in most cases (Woodhouse & Drummond, 1993). Importantly, people with migraine combined with allodynia have lower LDLs than people with migraine alone (Ashkenazi et al, 2010).…”