Women with Chronic and Episodic Migraine Exhibit Similar Widespread Pressure Pain Sensitivity

Palacios‐Ceña, María; Florêncio, Lidiane Lima; Ferracini, Gabriela Natália; Barón, Johanna; Peral, Á.L. Guerrero; Ordás-Bandera, Carlos; Arendt-Nielsen, Lars; Fernández‐de‐las‐Peñas, César

doi:10.1093/pm/pnw056

Cited by 46 publications

(73 citation statements)

References 26 publications

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“…The findings of lower PPT values in people with migraine compared to healthy participants in the interictal phase in the cephalic region are in line with previous systematic reviews [15,16]. A few studies evaluated PPTs in the extra-cephalic region in the interictal phase [32,33]. One of these studies also found lower PPTs in the interictal phase in extracephalic regions (tibialis anterior muscle and second metacarpal) in people with migraine compared to healthy participants [33].…”

Section: Discussionsupporting

confidence: 86%

“…A few studies evaluated PPTs in the extra-cephalic region in the interictal phase [32,33]. One of these studies also found lower PPTs in the interictal phase in extracephalic regions (tibialis anterior muscle and second metacarpal) in people with migraine compared to healthy participants [33]. The other study measured PPTs at the forearm in the interictal phase in women with menstrual migraine and found no significant differences compared to healthy participants [32].…”

Section: Discussionmentioning

confidence: 99%

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Fluctuations in local and widespread mechanical sensitivity throughout the migraine cycle: a prospective longitudinal study

et al. 2020

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Background: People with migraine have localised (i.e., cephalic) mechanical sensitivity. There is uncertainty regarding widespread (i.e., extra-cephalic) mechanical sensitivity and variations in mechanical sensitivity throughout the migraine cycle. Therefore, this study aimed (1) to comprehensively assess mechanical sensitivity in both cephalic and extra-cephalic regions during the preictal, ictal, postictal and interictal phases; and (2) to compare these findings with mechanical sensitivity at corresponding time-points and locations in healthy participants. Methods: According to sample size calculations, 19 people with migraine and 19 matched healthy volunteers participated in a prospective longitudinal study. Pressure pain thresholds were evaluated in three cephalic regions (temporalis, upper trapezius and C1 paraspinal muscles) and two extra-cephalic regions (extensor carpi radialis and tibialis anterior muscle) with a digital algometer during the four phases of the migraine cycle in people with migraine and at corresponding intervals and locations in healthy participants. Linear mixed model analyses with a random intercept were used. Results: People with migraine had increased mechanical sensitivity in cephalic and extra-cephalic regions in all phases of the migraine cycle compared to healthy participants. Furthermore, this mechanical sensitivity was more severe in the preictal, ictal and postictal phase compared to the interictal phase in cephalic and extra-cephalic regions. Conclusion: People with migraine have localised as well as widespread mechanical sensitivity compared to healthy participants. This sensitivity is even more pronounced immediately before, during and after a migraine attack.

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Section: Discussionsupporting

confidence: 86%

Section: Discussionmentioning

confidence: 99%

Fluctuations in local and widespread mechanical sensitivity throughout the migraine cycle: a prospective longitudinal study

et al. 2020

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“…Several studies have reported that people with migraine may exhibit pressure pain hyperalgesia within the trigemino-cervical area as a clinical manifestation of central nervous system hyper-excitability [4][5][6][7] . A recent study has also confirmed the presence of widespread pressure pain hypersensitivity over trigeminal and extra-trigeminal areas in individuals with episodic and chronic migraine suggesting that the sensitization process is present from the onset of the condition 8 .…”

Section: Introductionmentioning

confidence: 79%

Perceived Pain Extent is Not Associated With Widespread Pressure Pain Sensitivity, Clinical Features, Related Disability, Anxiety, or Depression in Women With Episodic Migraine

Fernández‐de‐las‐Peñas

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Palacios‐Ceña

et al. 2018

The Clinical Journal of Pain

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“…We used a clinical subgrouping for headache frequency, mostly based on identification of infrequent episodic, frequent episodic, or chronic migraine. The lack of classification based on the frequency of migraine attacks may be related to the fact that some of the outcomes included in our study (eg, PPTs, active CROM, JPSE, or migraine pain reproduction with passive accessory intervertebral motions) have not been found to be significantly different between individuals with episodic or chronic migraine, whereas the differences in others (eg, FRT score) are small. It is also possible that the small number of patients within the chronic migraine group, as reported in the Results section, would lead to an unpowered subgrouping.…”

Section: Discussionmentioning

confidence: 81%

Subgrouping Factors Influencing Migraine Intensity in Women: A Semi‐automatic Methodology Based on Machine Learning and Information Geometry

et al. 2019

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Background Migraine is a heterogeneous condition with multiple clinical manifestations. Machine learning algorithms permit the identification of population groups, providing analytical advantages over other modeling techniques. Objective The aim of this study was to analyze critical features that permit the differentiation of subgroups of patients with migraine according to the intensity and frequency of attacks by using machine learning algorithms. Methods Sixty‐seven women with migraine participated. Clinical features of migraine, related disability (Migraine Disability Assessment Scale), anxiety/depressive levels (Hospital Anxiety and Depression Scale), anxiety state/trait levels (State‐Trait Anxiety Inventory), and pressure pain thresholds (PPTs) over the temporalis, neck, second metacarpal, and tibialis anterior were collected. Physical examination included the flexion‐rotation test, cervical range of cervical motion, forward head position while sitting and standing, passive accessory intervertebral movements (PAIVMs) with headache reproduction, and joint positioning sense error. Subgrouping was based on machine learning algorithms by using the nearest neighbors algorithm, multisource variability assessment, and random forest model. Results For migraine intensity, group 2 (women with a regular migraine headache intensity score of 7 on an 11‐point Numeric Pain Rating Scale [where 0 = no pain and 10 = maximum pain]) were younger and had lower joint positioning sense error in cervical rotation, greater cervical mobility in rotation and flexion, lower flexion‐rotation test scores, positive PAIVMs reproducing migraine, normal PPTs over the tibialis anterior, shorter migraine history, and lower cranio‐vertebral angles while standing than the remaining migraine intensity subgroups. The most discriminative variable was the flexion‐rotation test score of the symptomatic side. For migraine frequency, no model was able to identify differences between groups (ie, patients with episodic or chronic migraine). Conclusions A subgroup of women with migraine who had common migraine intensity was identified with machine learning algorithms.

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Women with Chronic and Episodic Migraine Exhibit Similar Widespread Pressure Pain Sensitivity

Abstract: This study found similar widespread pressure hypersensitivity in women with episodic or chronic migraine suggesting that central manifestations are involved both in episodic and chronic migraine.

Cited by 46 publications

References 26 publications

Fluctuations in local and widespread mechanical sensitivity throughout the migraine cycle: a prospective longitudinal study

Fluctuations in local and widespread mechanical sensitivity throughout the migraine cycle: a prospective longitudinal study

Perceived Pain Extent is Not Associated With Widespread Pressure Pain Sensitivity, Clinical Features, Related Disability, Anxiety, or Depression in Women With Episodic Migraine

Subgrouping Factors Influencing Migraine Intensity in Women: A Semi‐automatic Methodology Based on Machine Learning and Information Geometry

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