Cigarán-Mendez Margarita, Pacho-Hernández Juan C, Fernández-Palacios Francisco G, Tejera-Alonso Ángela, Valera-Calero Juan A, Gómez-Calero Cristina, Ordás-Bandera Carlos, Fernández-de-Las-Peñas César
Department of Psychology, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain.
Escuela Internacional de Doctorado, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain.
Diagnostics (Basel). 2024 Dec 13;14(24):2805. doi: 10.3390/diagnostics14242805.
Migraine diagnosis is mainly clinically based on symptomatology. The objectives of this study were (1) to determine the ability of pain thresholds to differentiate between women with and without migraines and (2) to determine the ability of clinical, psychological and psychophysical variables to differentiate between women with episodic and chronic migraines. A diagnostic accuracy study was conducted. Pressure-pain thresholds (PPTs) at one trigeminal (temporalis muscle) and one extra-trigeminal (cervical spine) and two distant-pain free (second metacarpal and tibialis anterior muscle) areas, as well as dynamic pain thresholds (DPTs), were bilaterally assessed in 100 women with migraines, recruited from tertiary hospitals (50% episodic, 50% chronic), and 50 comparable women without headaches. Migraine pain features (headache diary), migraine-associated burden (HDI), anxiety and depressive levels (HADS) and state (STAI-S)-trait (STAI-T) anxiety were also evaluated. The area under the receiver operating characteristic (ROC) curve, with optimal cut-off points, as well as the sensitivity, specificity and positive/negative likelihood ratios (LR) for each variable, were calculated. The women with migraines showed lower PPTs and DPTs than those without migraines. The women with chronic migraines showed lower PPTs in the temporalis muscle than the women with episodic migraines. No clinical, psychological or psychophysical variables exhibited acceptable ROC values (≥0.7) for differentiating between women with and without migraines or between women with episodic and chronic migraines. Although the women with migraines had widespread pressure-pain hyperalgesia, neither the clinical, psychological nor psychophysical (pain threshold) variable exhibited the proper diagnostic accuracy to distinguish between women with and without migraines or between women with episodic and chronic migraines. New studies should clarify the clinical relevance of the findings of the current study.
偏头痛的诊断主要基于临床症状。本研究的目的是：（1）确定疼痛阈值区分有偏头痛和无偏头痛女性的能力；（2）确定临床、心理和心理物理学变量区分发作性和慢性偏头痛女性的能力。进行了一项诊断准确性研究。对从三级医院招募的100名偏头痛女性（50%为发作性，50%为慢性）和50名无头痛的对照女性，双侧评估了一个三叉神经（颞肌）和一个非三叉神经（颈椎）区域以及两个无疼痛的远处区域（第二掌骨和胫骨前肌）的压力疼痛阈值（PPT）以及动态疼痛阈值（DPT）。还评估了偏头痛疼痛特征（头痛日记）、偏头痛相关负担（HDI）、焦虑和抑郁水平（HADS）以及状态（STAI-S）-特质（STAI-T）焦虑。计算了受试者操作特征（ROC）曲线下面积、最佳临界点以及每个变量的敏感性、特异性和阳性/阴性似然比（LR）。有偏头痛的女性的PPT和DPT低于无偏头痛的女性。慢性偏头痛女性颞肌的PPT低于发作性偏头痛女性。没有临床、心理或心理物理学变量在区分有偏头痛和无偏头痛女性或发作性和慢性偏头痛女性方面表现出可接受的ROC值（≥0.7）。尽管有偏头痛的女性存在广泛的压力疼痛超敏反应，但临床、心理或心理物理学（疼痛阈值）变量均未表现出区分有偏头痛和无偏头痛女性或发作性和慢性偏头痛女性的适当诊断准确性。新的研究应阐明本研究结果的临床相关性。
