Localized and widespread pressure pain hypersensitivity in patients with episodic or chronic migraine: A systematic review and meta-analysis.

Abstract

OBJECTIVE:

This meta-analysis compared pressure pain sensitivity in trigeminal, cervical spine and remote pain-free areas between migraine patients and headache-free controls considering diagnosis (episodic versus chronic) and sex.Databases and data treatment: Electronic databases were searched for cross-sectional or prospective case-control studies comparing pressure pain thresholds between migraine and headache-free controls. Data were extracted by two reviewers. The risk of bias and methodological quality was assessed by Newcastle-Ottawa Quality Assessment Scale. Meta-analyses of trigeminal, extra-trigeminal (cervical spine) and remote pain-free areas were compared. Frequency of migraine and sex were taken into account. Mean differences (MD) and random effects were calculated.

RESULTS:

Eighteen studies were included. Patients with migraine showed lower pressure pain thresholds than headache-free controls: trigeminal (MD -71.33 kPa, 95%CI -92.14 to -50.53), cervical spine (MD -68.50 kPa, 95%CI -84.67 to -52.33), and remote pain-free (MD -62.49 kPa, 95%CI -99.52 to -25.45) areas. Differences were consistently significant for episodic migraine in all locations, but only significant in the trigeminal area for chronic migraine (MD -67.36 kOPa, 95%CI -101.31 to -33.42). Overall, women had lower pressure pain thresholds than men. The methodological quality of most studies (66.7%) was good. The results showed a high heterogeneity.

CONCLUSION:

This meta-analysis found low to high quality evidence showing lower pressure pain thresholds in trigeminal, extra-trigeminal, and remote pain-free areas in migraine sufferers when compared with headache-free controls. Hypersensitivity to pressure pain locally and widespread was consistently observed in episodic migraine, but locally in chronic migraine as compared to headache-free controls. Women with migraine were more sensitive than men.Registration number: https://doi.org/10.17605/OSF.IO/YJTAK.

• Authors: César Fernández-de-Las-Peñas, Marcos J Navarro-Santana, Francisca Curiel-Montero, Gustavo Plaza-Manzano, Francisco Alburquerque-Sendín, Daiana P Rodrigues-de-Souza
• Journal: Cephalalgia : an international journal of headache (Cephalalgia) Vol. 42 Issue 9 Pg. 966-980 (08 2022) ISSN: 1468-2982 [Electronic] England
• PMID: 35332797 (Publication Type: Journal Article, Meta-Analysis, Systematic Review)

Topics

• Cross-Sectional Studies
• Female
• Headache
• Humans
• Male
• Migraine Disorders (complications, diagnosis)
• Pain (diagnosis)
• Pain Measurement (methods)
• Pain Threshold