Department of Neurology, Rambam Medical Center, Haifa, Israel; The Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Department of Neurology, Rambam Medical Center, Haifa, Israel.
J Pain. 2018 Aug;19(8):943-951. doi: 10.1016/j.jpain.2018.03.008. Epub 2018 Mar 27.
Migraineurs with aura (MWA) express higher interictal response to non-noxious and noxious experimental sensory stimuli compared with migraineurs without aura (MWoA), but whether these differences also prevail in response to everyday non-noxious stimuli is not yet explored. This is a cross-sectional study testing 53 female migraineurs (30 MWA; 23 MWoA) who underwent a wide battery of noxious psychophysical testing at a pain-free phase, and completed a Sensory Responsiveness Questionnaire and pain-related psychological questionnaires. The MWA group showed higher questionnaire-based sensory over-responsiveness (P = .030), higher magnitude of pain temporal summation (P = .031) as well as higher monthly attack frequency (P = .027) compared with the MWoA group. Overall, 45% of migraineurs described abnormal sensory (hyper- or hypo-) responsiveness; its incidence was higher among MWA (19 of 30, 63%) versus MWoA (6 of 23, 27%, P = .012), with an odds ratio of 3.58 for MWA. Sensory responsiveness scores were positively correlated with attack frequency (r = .361, P = .008) and temporal summation magnitude (r = .390, P = .004), both regardless of migraine type. MWA express higher everyday sensory responsiveness than MWoA, in line with higher response to experimental noxious stimuli. Abnormal scores of sensory responsiveness characterize people with sensory modulation dysfunction, suggesting possible underlying mechanisms overlap, and possibly high incidence of both clinical entities.
This article presents findings distinguishing MWA, showing enhanced pain amplification, monthly attack frequency, and over-responsiveness to everyday sensations, compared with MWoA. Further, migraine is characterized by a high incidence of abnormal responsiveness to everyday sensation, specifically sensory over-responsiveness, that was also found related to pain.
与无先兆偏头痛患者(MWoA)相比,有先兆偏头痛患者(MWA)在间歇期对非伤害性和伤害性实验性感觉刺激的反应更高,但这些差异是否也存在于对日常非伤害性刺激的反应中尚不清楚。这是一项横断面研究,共纳入 53 名女性偏头痛患者(30 名 MWA;23 名 MWoA),在无痛期进行了广泛的伤害性心理物理学测试,并完成了感觉反应问卷和与疼痛相关的心理问卷。MWA 组在基于问卷的感觉过度反应(P = .030)、疼痛时间总和幅度(P = .031)以及每月发作频率(P = .027)方面均高于 MWoA 组。总体而言,45%的偏头痛患者存在异常感觉(超敏或低敏)反应;MWA 组中异常感觉反应发生率(19/30,63%)高于 MWoA 组(6/23,27%,P = .012),MWA 的比值比为 3.58。感觉反应评分与发作频率(r = .361,P = .008)和时间总和幅度(r = .390,P = .004)呈正相关,与偏头痛类型无关。MWA 比 MWoA 表达更高的日常感觉反应性,与更高的实验性伤害性刺激反应一致。异常感觉反应评分可表现出感觉调节功能障碍,表明可能存在重叠的潜在机制,且这两种临床实体的发生率可能较高。
本文提出了区分 MWA 的发现,与 MWoA 相比,MWA 表现出更高的疼痛放大、每月发作频率以及对日常感觉的过度反应。此外,偏头痛的特征是对日常感觉的异常反应发生率较高,特别是感觉过度反应,也发现与疼痛有关。