Perceived pain extent is not associated with widespread pressure pain sensitivity, clinical features, related-disability, anxiety, or depression in women with episodic migraine
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2017
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Clinical Journal of Pain
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Abstract
Objective: People with migraine present with varying pain extent and an expanded distribution of
perceived pain may reflect central sensitization. The relationship between pain extent and clinical
features, psychological outcomes, related-disability and pressure pain sensitivity in migraine has
been poorly investigated. Our aim was to investigate whether the perceived pain extent, assessed
from pain drawings, relates to measures of pressure pain sensitivity, clinical, psychological
outcomes, and related-disability in women with episodic migraine. Methods: Seventy-two women
with episodic migraine completed pain drawings which were subsequently digitized allowing pain
extent to be calculated utilising novel software. Pressure pain thresholds (PPT) were assessed
bilaterally over the temporalis muscle (trigeminal area), the cervical spine (extra-trigeminal area)
and tibialis anterior muscle (distant pain-free area). Clinical features of migraine, migraine relateddisability
(migraine disability assessment questionnaire, MIDAS), anxiety and depression (Hospital
Anxiety-Depression Scale, HADS) were also assessed. Spearman rho correlation coefficients were
computed to reveal correlations between pain extent and the remaining outcomes. Results: No
significant associations were observed between pain extent and PPTs in trigeminal, extra-trigeminal
or distant pain-free areas, migraine pain features, or psychological variables including anxiety or
depression and migraine related-disability. Conclusions: Pain extent within the trigemino-cervical
area was not associated with any of the measured clinical outcomes and not related to the degree of
pressure pain sensitization in women with episodic migraine. Further research is needed to
determine if the presence of expanded pain areas outside of the trigeminal area can play a relevant
role in the sensitization processes in migraine.
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Keywords
Migraine, Pain area, Pressure pain, Anxiety, Depression, Sensitization