Abstract
Cutaneous allodynia may be observed in patients with migraine and this reflects the central sensitization of the trigeminal neurons. We aimed to investigate the frequency of cutaneous allodynia in patients with episodic migraine and to compare clinical characteristics of migraine patients with and without allodynia. One hundred and eighty-six consecutive patients with episodic migraine attacks were prospectively included in the study. The cutaneous allodynia symptoms that occurred during headache attacks were documented using a questionnaire for assessing cephalic and extracephalic cutaneous allodynia. One hundred and fourteen patients (61.3 %) were observed to develop allodynia during migraine attacks and the ratio of the female gender was found higher among the patients with allodynia (p < 0.001). Migraine disease duration was longer (p = 0.004) and accompanying nausea and phonophobia were more common (p = 0.003 and p = 0.005, respectively) in the patients with allodynia. Menstrually related migraine was found to be associated with both allodynia (p = 0.049) and its severity (p = 0.003). The results of present study revealed that cutaneous allodynia was rather frequent in episodic migraine, particularly in patients having longer disease duration. Higher frequency of allodynia in women and its association with menstrually related migraine may be related to the effects of hormonal factors on cutaneous pain thresholds and central sensitization. Association of nausea and phonophobia with allodynia may be interpreted as the common pathways are shared in the development of these symptoms.
Similar content being viewed by others
References
Goadsby PJ (2005) Migraine, allodynia, sensitisation and all of that…. Eur Neurol 53(1):10–16
Lipton RB, Bigal ME, Ashina S, Burstein R, Silberstein S, Reed ML, Serrano D, Stewart WF; American Migraine Prevalence Prevention Advisory Group (2008) Cutaneous allodynia in the migraine population. Ann Neurol 63(2):148–158
Lovati C, D’Amico D, Rosa S, Suardelli M, Mailland E, Bertora P, Pomati S, Mariani C, Bussone G (2007) Allodynia in different forms of migraine. Neurol Sci 28(Suppl 2):S220–S221
LoPinto C, Young WB, Ashkenazi A (2006) Comparison of dynamic (brush) and static (pressure) mechanical allodynia in migraine. Cephalalgia 26(7):852–856
Bigal ME, Ashina S, Burstein R, Reed ML, Buse D, Serrano D, Lipton RB; AMPP Group (2008) Prevalence and characteristics of allodynia in headache sufferers: a population study. Neurology 70(17):1525–1533
Lovati C, D’Amico D, Bertora P (2009) Allodynia in migraine: frequent random association or unavoidable consequence? Expert Rev Neurother 9(3):395–408
Tietjen GE, Brandes JL, Peterlin BL, Eloff A, Dafer RM, Stein MR, Drexler E, Martin VT, Hutchinson S, Aurora SK, Recober A, Herial NA, Utley C, White L, Khuder SA (2009) Allodynia in migraine: associated with comorbid pain conditions. Headache 49(9):1333–1344
Lovati C, D’Amico D, Bertora P, Raimondi E, Rosa S, Zardoni M, Bussone G, Mariani C (2010) Correlation between presence of allodynia and sleep quality in migraineurs. Neurol Sci 31(Suppl 1):S155–S158
d’Agostino VC, Francia E, Licursi V, Cerbo R (2010) Clinical and personality features of allodynic migraine. Neurol Sci 31(1):S159–S161
Lovati C, D’Amico D, Bertora P, Rosa S, Suardelli M, Mailland E, Mariani C, Bussone G (2008) Acute and interictal allodynia in patients with different headache forms: an Italian pilot study. Headache 48(2):272–277
Jakubowski M, Silberstein S, Ashkenazi A, Burstein R (2005) Can allodynic migraine patients be identified interictally using a questionnaire? Neurology 65(9):1419–1422
Ashkenazi A, Sholtzow M, Shaw JW, Burstein R, Young WB (2007) Identifying cutaneous allodynia in chronic migraine using a practical clinical method. Cephalalgia 27(2):111–117
Mathew NT, Kailasam J, Seifert T (2004) Clinical recognition of allodynia in migraine. Neurology 63(5):848–852
Burstein R, Yarnitsky D, Goor-Aryeh I, Ransil BJ, Bajwa ZH (2000) An association between migraine and cutaneous allodynia. Ann Neurol 47(5):614–624
Guy N, Marques AR, Orliaguet T, Lanteri-Minet M, Dallel R, Clavelou P (2010) Are there differences between cephalic and extracephalic cutaneous allodynia in migraine patients? Cephalalgia 30(7):881–886
Schürks M, Diener HC (2008) Migraine, allodynia, and implications for treatment. Eur J Neurol 15(12):1279–1285
Burstein R, Jakubowski M, Garcia-Nicas E, Kainz V, Bajwa Z, Hargreaves R, Becerra L, Borsook D (2010) Thalamic sensitization transforms localized pain into widespread allodynia. Ann Neurol 68(1):81–91
Landy S, Rice K, Lobo B (2004) Central sensitisation and cutaneous allodynia in migraine: implications for treatment. CNS Drugs 18(6):337–342
Goadsby PJ (2007) Recent advances in understanding migraine mechanisms, molecules and therapeutics. Trends Mol Med 13(1):39–44
Bigal ME, Lipton RB (2011) Migraine chronification. Curr Neurol Neurosci Rep 11(2):139–148
Aurora SK, Kulthia A, Barrodale PM (2011) Mechanism of chronic migraine. Curr Pain Headache Rep 15(1):57–63
Edelmayer RM, Vanderah TW, Majuta L, Zhang ET, Fioramanti B, De Felice M, Chichorro JG, Ossipov MH, King T, Lai J, Kori SH, Nelsen AC, Cannon KE, Heinricher MM, Porreca F (2009) Medullary pain facilitating neurons mediate allodynia in headache-related pain. Ann Neurol 65(2):184–193
Burstein R (2009) Almotriptan efficacy in migraine with developing allodynia is as high as the efficacy in migraine without allodynia–but is it the same in migraine with established allodynia? Headache 49(3):364–365
Burstein R, Jakubowski M (2010) Managing migraine associated with sensitization. Handb Clin Neurol 97:207–215
Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders: 2nd edition. Cephalalgia 24(Suppl 1):9–160
Young WB, Richardson ES, Shukla P (2005) Brush allodynia in hospitalized headache patients. Headache 45(8):999–1003
Ashkenazi A, Silberstein S, Jakubowski M, Burstein R (2007) Improved identification of allodynic migraine patients using a questionnaire. Cephalalgia 27(4):325–329
Gazerani P, Andersen OK, Arendt-Nielsen L (2005) A human experimental capsaicin model for trigeminal sensitization. gender-specific differences. Pain 118(1–2):155–163
Palmeira CC, Ashmawi HA, Posso Ide P (2011) Sex and pain perception and analgesia. Rev Bras Anestesiol 61(6):814–828
Matos R, Wang K, Jensen JD, Jensen T, Neuman B, Svensson P, Arendt-Nielsen L (2011) Quantitative sensory testing in the trigeminal regions: site and gender differences. J Orofac Pain 25(2):161–169
Aguggia M, Saracco MG (2010) Pathophysiology of migraine chronification. Neurol Sci 31(Suppl 1):S15–S17
Kelman L, Tanis D (2006) The relationship between migraine pain and other associated symptoms. Cephalalgia 26(5):548–553
Ruggiero DA, Underwood MD, Mann JJ, Anwar M, Arango V (2000) The human nucleus of the solitary tract: visceral pathways revealed with an “in vitro” postmortem tracing method. J Auton Nerv Syst 79(2–3):181–190
Ashkenazi A, Yang I, Mushtag A, Oshinsky ML (2010) Is phonophobia associated with cutaneous allodynia in migraine? J Neurol Neurosurg Psychiatry 81(11):1256–1260
Bolay H, Reuter U, Dunn AK, Huang Z, Boas DA, Moskowitz MA (2002) Intrinsic brain activity triggers trigeminal meningeal afferents in a migraine model. Nat Med 8(2):136–142
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Güven, H., Çilliler, A.E. & Çomoğlu, S.S. Cutaneous allodynia in patients with episodic migraine. Neurol Sci 34, 1397–1402 (2013). https://doi.org/10.1007/s10072-012-1249-9
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-012-1249-9