Deodato Manuela, Granato Antonio, Martini Miriam, Sabot Raffaele, Buoite Stella Alex, Manganotti Paolo
Department of Medical, Surgical and Health Sciences, University of Trieste, Via Pascoli 31, 34100, Trieste, Italy.
Azienda Sanitaria Universitaria Giuliano Isontina, Via Pascoli 31, 34100, Trieste, Italy.
Neurol Sci. 2024 Aug;45(8):3923-3929. doi: 10.1007/s10072-024-07372-4. Epub 2024 Feb 24.
Central and peripheral sensitization are characterized by widespread hyperalgesia that is manifested by larger pain extent area and reduction in pressure pain threshold (PPT). PPT decreases in patients with migraine not only over the trigeminal cervical complex but also throughout the body.
A cross-sectional study was adopted to assess the local and widespread hyperalgesia in chronic and episodic migraine patients respect to healthy controls. The guidelines of Andersen's were used to evaluate the PPT bilaterally over 3 muscles in the trigemino-cervical complex (temporalis, sub-occipitalis, trapezius) and over 1 muscle far from this area (tensor fasciae latae).
Thirty subjects with episodic migraine (35.8 ± 2.82 years), 30 with chronic migraine (53.03 ± 19.79 years), and 30 healthy controls (29.06 ± 14.03 years) were enrolled. The interaction effect was present for the trapezius muscle with a significant difference between the right and the left side in episodic group (p = 0.003). A group effect was highlighted in all four muscles analyzed such as suboccipital (p < 0.001), temporalis (p > 0.001), trapezius (p < 0.001), and TFL (p < 0.001). PPT was usually higher in the control group than in the episodic group which in turn was characterized by higher PPT values than the chronic group.
People with chronic and episodic migraine presented lower PPT than healthy controls both in the trigeminal and in the extra-trigeminal area. People with chronic migraine presented lower PPT than episodic migraine only in the trigeminal area. Temporalis and sub-occipitalis are the most sensitive muscles in people with chronic and episodic migraine.
中枢敏化和外周敏化的特征是广泛的痛觉过敏，表现为疼痛范围扩大和压力痛阈（PPT）降低。偏头痛患者的PPT不仅在三叉神经颈复合体区域降低，而且在全身都降低。
采用横断面研究评估慢性和发作性偏头痛患者相对于健康对照者的局部和广泛痛觉过敏。使用安德森指南双侧评估三叉神经颈复合体的3块肌肉（颞肌、枕下肌、斜方肌）和远离该区域的1块肌肉（阔筋膜张肌）的PPT。
纳入了30名发作性偏头痛患者（35.8±2.82岁）、30名慢性偏头痛患者（53.03±19.79岁）和30名健康对照者（29.06±14.03岁）。斜方肌存在交互作用效应，发作性组左右两侧有显著差异（p = 0.003）。在分析的所有四块肌肉中均突出显示了组效应，如枕下肌（p < 0.001）、颞肌（p > 0.001）、斜方肌（p < 0.001）和阔筋膜张肌（p < 0.001）。对照组的PPT通常高于发作性组，而发作性组的PPT值又高于慢性组。
慢性和发作性偏头痛患者在三叉神经区域和三叉神经外区域的PPT均低于健康对照者。仅在三叉神经区域，慢性偏头痛患者的PPT低于发作性偏头痛患者。颞肌和枕下肌是慢性和发作性偏头痛患者中最敏感的肌肉。
