1 Headache Unit, Hospital Clínico Universitario de Valladolid, Spain.
2 Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, Alcorcón, Spain.
Cephalalgia. 2018 Jun;38(7):1257-1266. doi: 10.1177/0333102417729114. Epub 2017 Aug 31.
Objectives To explore the validity of the roller pressure algometer as a new tool for evaluating dynamic pressure sensitivity by assessing its association with pain features and widespread pressure pain sensitivity in migraine women, and also to determine whether dynamic pressure algometry differentiates between episodic and chronic migraine. Methods One hundred and twenty women with migraine (42% chronic, 58% episodic) participated. Dynamic pressure sensitivity was assessed with a set of roller pressure algometers (Aalborg University, Denmark®) consisting of 11 rollers with fixed pressure levels from 500 to 5300 g. Each roller was moved at a speed of 0.5 cm/sec over a 60 mm horizontal line covering the temporalis muscle. The dynamic pain threshold (the pressure level of the first painful roller) and pain elicited during the pain threshold (roller evoked pain) were determined. Static pressure pain thresholds were assessed over the temporalis muscle, C5/C6 joint, second metacarpal, and tibialis anterior. Results Side-to-side consistency between dynamic pain threshold (r = 0.769, p < 0.001) and roller evoked pain (r = 0.597; p < 0.001) were found. Women with chronic migraine exhibited bilateral lower dynamic pain thresholds ( p < 0.01), but similar widespread pressure pain thresholds (all, p > 0.284) than those with episodic migraine. Dynamic pain threshold was moderately positively associated with widespread pressure pain thresholds (0.358 > r > 0.700, all p < 0.001). This association was slightly stronger in chronic migraine. Pain during dynamic pain threshold was negatively associated with widespread pressure pain thresholds (-0.336 < r < -0.235, all p < 0.01). Conclusions Roller pressure algometry was valid for assessing dynamic pressure sensitivity in migraine in the trigeminal area and is consistent with widespread static pressure pain sensitivity. Roller, but not static, pressure algometry differentiated between episodic and chronic migraine. Assessing static and dynamic deep somatic tissue sensitivity may provide new opportunities for evaluating treatment outcomes.
目的 通过评估滚轮压力测痛仪与偏头痛女性的疼痛特征和广泛压痛敏感性之间的相关性，以及确定其是否能区分发作性和慢性偏头痛，来探究滚轮压力测痛仪作为一种新的评估动态压力敏感性的工具的有效性。
方法 共有 120 名偏头痛女性（42%为慢性偏头痛，58%为发作性偏头痛）参与了该研究。使用一套由 11 个滚轮组成的滚轮压力测痛仪（丹麦奥胡斯大学®）来评估动态压力敏感性，这些滚轮的压力水平固定在 500 至 5300g 之间。每个滚轮以 0.5cm/sec 的速度在一条 60mm 长的水平线上移动，这条线覆盖了颞肌。确定动态疼痛阈值（第一个疼痛滚轮的压力水平）和疼痛阈值时的疼痛（滚轮诱发疼痛）。在颞肌、C5/C6 关节、第二掌骨和胫骨前肌上评估静态压痛阈值。
结果 发现动态疼痛阈值（r=0.769，p<0.001）和滚轮诱发疼痛（r=0.597；p<0.001）之间存在双侧一致性。慢性偏头痛女性的双侧动态疼痛阈值较低（p<0.01），但与发作性偏头痛女性的广泛压痛阈值相似（均为 p>0.284）。动态疼痛阈值与广泛压痛阈值呈中度正相关（0.358>r>0.700，均为 p<0.001）。这种相关性在慢性偏头痛中略强。动态疼痛阈值时的疼痛与广泛压痛阈值呈负相关（-0.336<r<-0.235，均为 p<0.01）。
结论 滚轮压力测痛仪可有效评估偏头痛患者三叉神经区域的动态压力敏感性，与广泛的静态压痛敏感性一致。滚轮压力测痛仪（而非静态压力测痛仪）可区分发作性和慢性偏头痛。评估静态和动态深部躯体组织敏感性可能为评估治疗效果提供新机会。
