Chen Wei-Ta, Hsiao Fu-Jung, Coppola Gianluca, Wang Shuu-Jiun
Brain Research Center, National Yang Ming Chiao Tung University, 155, Linong Street Sec 2, Taipei, 112, Taiwan.
School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
J Headache Pain. 2024 Mar 11;25(1):33. doi: 10.1186/s10194-024-01742-1.
The present study used the Facial Action Coding System (FACS) to analyse changes in facial activities in individuals with migraine during resting conditions to determine the potential of facial expressions to convey information about pain during headache episodes.
Facial activity was recorded in calm and resting conditions by using a camera for both healthy controls (HC) and patients with episodic migraine (EM) and chronic migraine (CM). The FACS was employed to analyse the collected facial images, and intensity scores for each of the 20 action units (AUs) representing expressions were generated. The groups and headache pain conditions were then examined for each AU.
The study involved 304 participants, that is, 46 HCs, 174 patients with EM, and 84 patients with CM. Elevated headache pain levels were associated with increased lid tightener activity and reduced mouth stretch. In the CM group, moderate to severe headache attacks exhibited decreased activation in the mouth stretch, alongside increased activation in the lid tightener, nose wrinkle, and cheek raiser, compared to mild headache attacks (all corrected p < 0.05). Notably, lid tightener activation was positively correlated with the Numeric Rating Scale (NRS) level of headache (p = 0.012). Moreover, the lip corner depressor was identified to be indicative of emotional depression severity (p < 0.001).
Facial expressions, particularly lid tightener actions, served as inherent indicators of headache intensity in individuals with migraine, even during resting conditions. This indicates that the proposed approach holds promise for providing a subjective evaluation of headaches, offering the benefits of real-time assessment and convenience for patients with migraine.
本研究使用面部动作编码系统（FACS）分析偏头痛患者在静息状态下面部活动的变化，以确定面部表情在头痛发作期间传达疼痛信息的潜力。
通过摄像头在平静和静息状态下记录健康对照者（HC）、发作性偏头痛（EM）患者和慢性偏头痛（CM）患者的面部活动。采用FACS分析收集到的面部图像，并生成代表表情的20个动作单元（AU）中每个单元的强度得分。然后针对每个AU检查分组和头痛疼痛情况。
该研究纳入了304名参与者，即46名健康对照者、174名发作性偏头痛患者和84名慢性偏头痛患者。头痛疼痛水平升高与眼睑收紧活动增加和口部伸展减少有关。在慢性偏头痛组中，与轻度头痛发作相比，中度至重度头痛发作时口部伸展的激活减少，同时眼睑收紧、鼻皱和提颊肌的激活增加（所有校正p<0.05）。值得注意的是，眼睑收紧激活与头痛的数字评分量表（NRS）水平呈正相关（p = 0.012）。此外，唇角下压肌被确定为情绪抑郁严重程度的指标（p<0.001）。
面部表情，特别是眼睑收紧动作，即使在静息状态下也是偏头痛患者头痛强度的内在指标。这表明所提出的方法有望提供头痛的主观评估，为偏头痛患者带来实时评估的益处和便利。
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