Clinical Unit of Neurology, Department of Medicine, Surgery and Health Sciences, Cattinara University Hospital ASUGI, University of Trieste, Trieste, Italy.
THERMOSENSELAB, Skin Health Research Group, School of Health Sciences, University of Southampton, Southampton, UK.
Headache. 2022 Jun;62(6):737-747. doi: 10.1111/head.14323. Epub 2022 Jun 7.
The objective of this study was to evaluate skin wetness perception and thermal sensitivity in people with migraine and similar healthy controls.
Environmental triggers, such as cold and humidity, are known triggers for pain in people with migraine. Sensory inputs might be implicated in such heightened responses to cold-humid environments, such that a migraine-induced hypersensitivity to cold wetness could be present in people with migraine. However, we lack empirical evidence on skin thermal and wetness sensitivity across skin sites commonly associated with reported pain in migraine, such as the forehead.
This prospective cross-sectional observational study, conducted in a university hospital setting, evaluated skin wetness perceptions and thermal sensations to wet non-noxious warm-wet, neutral-wet, and cold-wet stimuli applied to the forehead, the posterior neck, and the index finger pad of 12 patients with migraine (mean and standard deviation for age 44.5 ± 13.2 years, 7/12 [58%] women) and 36 healthy controls (mean and standard deviation for age 39.4 ± 14.6 years, 18/36 [50%] women).
On the forehead, people with migraine reported a significantly higher wetness perception than healthy controls across all thermal stimulus (15.1 mm, 95% confidence interval [CI]: 1.8 to 28.5, p = 0.027, corresponding to ~ 15% difference), whereas no significant differences were found on the posterior neck nor on the index finger pad. We found no differences among groups in overall thermal sensations (-8.3 mm, 95% CI: -24.0 to 7.3, p = 0.291; -7.8 mm, 95% CI: -25.3 to 9.7, p = 0.375; and 12.4 mm, 95% CI: -4.0 to 28.9, p = 0.133; forehead, posterior neck, and index finger, respectively).
These findings indicate that people with migraine have a heightened sensitivity to skin wetness on the forehead area only, which is where pain attacks occur. Future studies should further explore the underlying mechanisms (e.g., TRPM8-mediated cold-wet allodynia) that lead to greater perception of wetness in people with migraine to better understand the role of environmental triggers in migraine.
本研究旨在评估偏头痛患者与相似健康对照者的皮肤湿润感和热敏感性。
已知环境诱因（如寒冷和潮湿）是偏头痛患者疼痛的触发因素。感觉输入可能与对寒冷-潮湿环境的这种高反应有关，因此偏头痛患者可能存在对寒冷湿润的超敏反应。然而，我们缺乏关于偏头痛患者常见疼痛部位（如前额）皮肤热和湿润敏感性的实证证据。
这是一项在大学医院进行的前瞻性横断面观察性研究，评估了 12 名偏头痛患者（年龄为 44.5±13.2 岁，7/12[58%]为女性）和 36 名健康对照者（年龄为 39.4±14.6 岁，18/36[50%]为女性）的前额、后颈部和食指垫对湿润非伤害性温热、中性湿润和寒冷湿润刺激的皮肤湿润感知和热感觉。
在前额，与健康对照组相比，偏头痛患者在所有热刺激下的湿润感明显更高（15.1mm，95%置信区间[CI]：1.8 至 28.5，p=0.027，对应约 15%的差异），而后颈部和食指垫则无显著差异。我们发现三组之间的整体热感觉无差异（-8.3mm，95%CI：-24.0 至 7.3，p=0.291；-7.8mm，95%CI：-25.3 至 9.7，p=0.375；12.4mm，95%CI：-4.0 至 28.9，p=0.133；前额、后颈部和食指垫分别）。
这些发现表明，偏头痛患者仅在前额区域对皮肤湿润的敏感性增加，而疼痛发作就在这个区域。未来的研究应进一步探讨导致偏头痛患者对湿润感的感知增强的潜在机制（例如，TRPM8 介导的寒冷-湿润性痛觉过敏），以更好地理解环境触发因素在偏头痛中的作用。
