Modality and Location Specific Alterations in Migraine Pain Thresholds

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Modality and Location Specific Alterations in Migraine Pain Thresholds
Key Take-Away: 

The quantitative somatosensory test has an ability to evaluate the impairments in pain pathway in accordance with different modalities like thermal and pressure. The study presented here is a comparative meta-analysis by Nahman-Averbuch H and colleagues to evaluate the differences in pain thresholds in migraine and healthy patients concerning modalities and location specific stimulus.

Quantitative sensory testing is widely used to quantify the somatosensory functions and indicates the impairments or interference in pain pathways of an individual in response to controlled stimuli across a variety of modalities including pressure and thermal.

ABSTRACT: 
Background: 

Quantitative sensory testing is widely used to quantify the somatosensory functions and indicates the impairments or interference in pain pathways of an individual in response to controlled stimuli

Quantitative sensory testing is widely used to quantify the somatosensory functions and indicates the impairments or interference in pain pathways of an individual in response to controlled stimuli across a variety of modalities including pressure and thermal.

Methods: 

A comprehensive search was conducted using the key words of 'migraine' AND ('pain,' 'threshold,' 'pressure,' 'electrical,' 'warm,' 'heat,' 'cold,' 'mechanical,’ 'quantitative sensory testing'). For pressure pain thresholds (PPT) 14 studies were included in the meta-analysis.

No significant differences between migraine and controls were found (effect size 95% CI 1.28 to 0.30, p=0.22). However, when subdivided by stimulus region, migraine patients demonstrated lower PPT compared to controls (effect size 95% CI1.5 to -0.19, p=0.01) in studies that tested PPT in the head and neck areas (local). PPT assessed outside of the head and neck region (non-local) showed no significant differences between the groups (effect size 95% CI2.04 to 2.74, p=0.77). For heat pain thresholds (HPT) 9 studies were included. No evidence for significant differences in HPT between migraine patients and controls were found (effect size 95% CI0.33 to 0.02, p=0.09). Similarly, no differences were evident when the data were divided to local (effect size 95% CI0.36 to 0.19, p=0.14) or nonlocal areas (effect size 95% CI0.34 to 0.08, p=0.11).

Results: 

This meta-analysis indicates that the alterations in the nociceptive processing of migraine patients are modality and location specific.

Symptoms associated with pressure sensations are often reported during the migraine attack and might explain why differences were found for PPT but not HPT.

Conclusion: 

In addition, sensory abnormalities appear to be somatopically localized to the head and neck areas and do not appear to indicate a pattern of generalized sensitization.

 

Source:

The Journal of Pain

Link to the source:

http://www.jpain.org/article/S1526-5900(17)30376-0/fulltext?rss=yes

The original title of the article:

Meta-Analysis Confirms Modality and Location Specific Alterations in Pain Thresholds in Migraine Patients

Authors:

H. Nahman-Averbuch et al.

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