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Differences in Topographical Pressure Pain Sensitivity Maps of the Scalp Between Patients With Migraine and Healthy Controls
Author(s) -
Barón Johanna,
Ruiz Marina,
PalaciosCeña María,
Madeleine Pascal,
Guerrero Ángel L.,
ArendtNielsen Lars,
FernándezdelasPeñas César
Publication year - 2017
Publication title -
headache: the journal of head and face pain
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.14
H-Index - 119
eISSN - 1526-4610
pISSN - 0017-8748
DOI - 10.1111/head.12984
Subject(s) - migraine , scalp , chronic migraine , medicine , depression (economics) , cortical spreading depression , anxiety , anesthesia , hospital anxiety and depression scale , nociception , surgery , psychiatry , economics , macroeconomics , receptor
Objective To investigate differences in topographical pressure pain sensitivity maps of the scalp between patients with migraine and healthy controls considering the chronicity (episodic/chronic) and side (strictly unilateral/bilateral) of the symptoms. Background It seems that the trigeminal area is sensitized in migraine. No study has investigated topographical pressure sensitivity maps of the scalp in patients with migraine. Methods Pressure pain thresholds (PPTs) were assessed from 21 points distributed over the scalp in 86 patients with episodic migraine, 76 with chronic migraine, and 42 healthy age and matched healthy controls in a blinded design. Topographical pressure pain sensitivity maps based on interpolation of the PPTs were constructed. Clinical features of migraine, anxiety, and depression (Hospital Anxiety and Depression Scale, HADS) were collected. Results The multivariate ANCOVA revealed significant differences in PPT between points ( F = 55.674; P < .001) and groups ( F = 5.316; P = .006), but not sides ( F = 0.880; P = .417). No significant effect of gender ( F = 0.897; P = .656), depression ( F = 1.109; P = .220), or anxiety ( F = 0.981; F = 0.569) was found. Post hoc comparisons revealed: (1) lower PPTs in both migraine groups than in healthy controls in all points ( P < .001); (2) no significant differences between chronic or episodic migraine ( P > .335) except for Fp1 ( P = .045) and Fp2 ( P = .017) points where subjects with chronic migraine had lower PPTs than those with episodic migraine; (3) no differences between bilateral/unilateral migraine ( P > .417). An anterior to posterior gradient was found, with the lowest PPTs located in frontal regions and the highest PPTs in occipital areas (all groups, P < .001). Conclusions We found that patients with migraine exhibited generalized pressure pain hypersensitivity in the head as compared to healthy controls and that hypersensitivity was similar between episodic/chronic and unilateral/bilateral migraine. Topographical pressure pain sensitivity maps revealed an anterior to posterior gradient of pressure pain sensitivity in both migraine and control groups.