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Spatial aspects of pain modulation are not disrupted in adolescents with migraine
Author(s) -
NahmanAverbuch Hadas,
Thomas Priya L.,
Schneider Victor J.,
Chamberlin Leigh Ann,
Peugh James L.,
Hershey Andrew D.,
Powers Scott W.,
Coghill Robert C.,
King Christopher D.
Publication year - 2021
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.14017
Subject(s) - migraine , medicine , nociception , stimulus (psychology) , summation , threshold of pain , anesthesia , physical therapy , audiology , psychology , stimulation , receptor , psychotherapist
Objective To compare spatial pain modulation capabilities between adolescents with and without migraine. Background Conditioned pain modulation (CPM) responses at the leg are similar in adolescents with versus without migraine. However, the anatomical region of testing may affect spatial pain modulation capabilities as differences in nociceptive processing between patients with migraine and healthy controls are found in local areas that are near the site of clinical pain but not in nonlocal areas. This study aimed to examine spatial pain modulation capabilities tested by the CPM paradigm using test stimulus applied to a local body area. Methods Nineteen adolescents with migraine (age 14.9 ± 2.3, mean ± SD; 16 female) and 20 healthy adolescents (age 13.8 ± 2.5, mean ± SD; 16 female) completed this case–control study at Cincinnati Children’s Hospital Medical Center. Pressure pain thresholds (PPT) were assessed at the trapezius before and during immersion of the foot in a cold water bath (8°C). Results In the migraine group (146.0 ± 79.1, mean ± SD), compared to healthy controls (248.0 ± 145.5, mean ± SD), significantly lower PPT (kilopascal) values were found (estimate = 124.28, 95% CI: 58.98, 189.59, p < 0.001; effect size: d = 1.40). No differences between the groups were found for pain intensity and unpleasantness ratings of cold‐water immersion nor the CPM response. Conclusions This study found altered ascending nociceptive processing of mechanical stimuli at the neck in adolescents with migraine. However, endogenous pain modulatory mechanisms were functional and not altered. In light of other studies, impairments in inhibitory control may not be involved in migraine pathophysiology in pediatric patients regardless of stimulus location.