van Welie Floor Clarissa, Dahan Albert, van Velzen Monique, Terwindt Gisela Marie
Department of Neurology, Leiden University Medical Center, P.O. 9600, Leiden, 2300 WB, The Netherlands.
Department of Anesthesiology, Leiden University Medical Center, Leiden, The Netherlands.
J Headache Pain. 2024 Dec 19;25(1):224. doi: 10.1186/s10194-024-01932-x.
The aim of this systematic review is to identify pain profiling parameters that are reliably different between patients with migraine and healthy controls, using Quantitative Sensory Testing (QST) including Temporal Summation (TS), Conditioned Pain Modulation (CPM), and Corneal Confocal Microscopy (CCM).
A comprehensive literature search was conducted (up to 23 May 2024). The quality of the research was assessed using the Newcastle-Ottawa Scale (NOS) for non-randomized studies.
Twenty-eight studies were included after screening. The QST studies indicate that migraine patients exhibit lower pressure pain thresholds (PPT), particularly in the trigeminal region. A previous meta-analysis reported lower heat pain thresholds (HPT). CPM studies suggest a (mild) inhibitory or absent response in migraine patients, not different from controls. High-frequency and chronic migraine patients may exhibit a facilitatory CPM response. With repeated executions of CPM, migraine patients display a diminishing CPM response, a phenomenon not observed in control subjects. CCM investigations in migraine patients revealed conflicting outcomes, likely as a result of small sample sizes and limited characterization of migraine features.
Pain profiling migraine patients varies due to sensory modality, applied methods, anatomical sites, and migraine features. Understanding pain profiling offers insights into migraine pathophysiology, requiring careful selection of parameters and differentiation among migraine subtypes.
本系统评价旨在通过定量感觉测试（QST），包括时间总和（TS）、条件性疼痛调制（CPM）和角膜共聚焦显微镜检查（CCM），确定偏头痛患者与健康对照者之间存在可靠差异的疼痛特征参数。
进行了全面的文献检索（截至2024年5月23日）。使用纽卡斯尔-渥太华量表（NOS）对非随机研究的研究质量进行评估。
筛选后纳入28项研究。QST研究表明，偏头痛患者表现出较低的压力疼痛阈值（PPT），尤其是在三叉神经区域。先前的一项荟萃分析报告了较低的热痛阈值（HPT）。CPM研究表明，偏头痛患者有（轻度）抑制性反应或无反应，与对照组无差异。高频和慢性偏头痛患者可能表现出促进性CPM反应。随着CPM的重复执行，偏头痛患者的CPM反应逐渐减弱，这一现象在对照受试者中未观察到。对偏头痛患者的CCM研究结果相互矛盾，可能是由于样本量小和偏头痛特征的表征有限。
偏头痛患者的疼痛特征因感觉方式、应用方法、解剖部位和偏头痛特征而异。了解疼痛特征有助于深入了解偏头痛的病理生理学，需要仔细选择参数并区分偏头痛亚型。
