Migraine disability, pain catastrophizing, and headache severity are associated with evoked pain and targeted by mind–body therapy

Abstract

Meta-analysis suggests that migraine patients are no more sensitive to experimentally evoked pain than healthy control subjects. At the same time, studies have linked some migraine symptoms to quantitative sensory testing (QST) profiles. Unfortunately, previous studies associating migraine symptoms and QST have important methodological shortcomings, stemming from small sample sizes, and frequent use of univariate statistics for multivariate research questions. In the current study, we seek to address these limitations by using a large sample of episodic migraine patients (n 5 103) and a multivariate analysis that associates pain ratings from many thermal intensities simultaneously with 12 clinical measures ranging from headache frequency to sleep abnormalities. We identified a single dimension of association between thermal QST and migraine symptoms that relates to pain ratings for all stimulus intensities and a subset of migraine symptoms relating to disability (Headache Impact Test 6 and Brief Pain Inventory interference), catastrophizing (Pain Catastrophizing Scale), and pain severity (average headache pain, Brief Pain Inventory severity, and Short-Form McGill Pain Questionnaire 2). Headache frequency, allodynia, affect, and sleep disturbances were unrelated to this dimension. Consistent with previous research, we did not observe any difference in QST ratings between migraine patients and healthy control subjects. Additionally, we found that the linear combination of symptoms related to QST was modified by the mind-body therapy enhanced mindfulness-based stress reduction (MBSR1). These results suggest that QST has a selective relationship with pain symptoms even in the absence of between-subjects differences between chronic pain patients and healthy control subjects.

Is mindfulness associated with lower pain reactivity and connectivity of the default mode network? A replication and extension study in healthy and episodic migraine participants

“…The stimulus order was 40,42,44,47,41,49,41,45,48,39,49,45,48,47,45,44,43, 49, 47°C. The QST protocol has also been described in previous work by our group 21 .…”

The normative values of pain thresholds in healthy Taiwanese

“…The QST protocol was specifically designed to assess the function of the primary afferent fibers, including Aβ, Aδ, and C fibers (Backonja et al., 2013 ). Beside assessing sensory functions, QST can serve as outcome predictors (Georgopoulos et al., 2019 ; Pan, Wang, Ling, et al., 2022 ; Schliessbach et al., 2018 ), observational parameters (Greenspan et al., 2020 ; Krimmel et al., 2022 ; Pan, Wang, Lai, et al., 2020 ), and so forth in disorders associated with sensory functions. Migraine is one of the most common neurological disorders that can be considered as sensory threshold disease (Peng & May, 2019 ).…”

Mechanisms for mindfulness in migraine: Does catastrophizing matter?

“…The results of this study are in alignment with several other studies showing the positive effects of mindfulness on pain catastrophizing in migraine 4‐9 . While pain catastrophizing emerged as the main mediator, neither headache days nor headache pain intensity were associated with pain catastrophizing, although this may have been impacted by participants' normal (e.g., not elevated) pain catastrophizing scores.…”