Quantitative sensory testing in patients with migraine: a systematic review and meta-analysis

Abstract

Quantitative sensory testing (QST) is widely used to assess somatosensory function by application of controlled stimuli across a variety of modalities. The aim of the present meta-analysis is to synthesize QST results across a wide array of studies of patients with migraine to identify the QST parameters that are reliably different between patients with migraine and healthy controls. In addition, we aimed to determine whether such differences vary according to stimulus location. A comprehensive literature search (up to January 2017) was conducted, which included studies comparing QST parameters between patients with migraine and healthy controls. For each QST modality, we calculated up to 3 meta-analyses for combined (combined data from multiple testing locations), local (head and neck), and nonlocal (outside the head or neck) locations. A total of 65 studies were included in the meta-analyses. Lower heat and pressure pain thresholds were observed in patients with migraine compared with healthy controls in the combined locations. Importantly, lower pressure pain threshold in patients with migraine was found in local areas but not in nonlocal areas. In addition, patients with migraine had higher pain ratings to cold suprathreshold stimuli for combined and nonlocal areas, and higher pain ratings to electrical suprathreshold stimuli for nonlocal areas. This meta-analysis indicates that the alterations in nociceptive processing of patients with migraine may be modality, measure, and location specific. These results provide researchers and clinicians the evidence to choose QST parameters optimally suited for differentiating patients with migraine and healthy controls.

Sensory processing patterns affect headache severity among adolescents with migraine

“…The possible connection between migraine and sensory processing patterns as expressed in daily living scenarios among patients with migraine has only rarely been reported. Nahman-Averbuch et al [25] in a meta-analysis study, revealed a lower heat and pressure pain thresholds and higher pain ratings to cold stimuli, among patients with migraine. The perception of sensory stimuli such as sound, light, odors and somatosensory stimuli tend to be enhanced among patients with migraine [16,[26][27][28] between migraine attacks and might even be a trigger to migraine attacks.…”

Sensory Processing Difficulties Correlate With Disease Severity and Quality of Life Among Children With Migraine

“…Enhanced sensory sensitivity and habituation difficulties among patients with migraine were also observed in studies that applied quantitative sensory testing (QST) (38) noting that patients with migraine may have greater reactivity to pain. The meta analysis performed by Nahman-Averbuch et al (39) revealed that patients with migraine present lower heat and pressure pain thresholds, higher pain ratings to cold suprathreshold stimuli for combined and nonlocal areas, and higher pain ratings to electrical suprathreshold stimuli for nonlocal areas, than healthy controls. All these findings raise the hypothesis that migraineurs might have basal abnormalities in sensory processing and integration.…”

Effects of systemic inhibitors of acid‐sensing ion channels 1 (ASIC1) against acute and chronic mechanical allodynia in a rodent model of migraine

“…Subsequent sensitization of central pathways would cause the cephalic and extra‐cephalic cutaneous allodynia (Edelmayer et al ., ; Burstein et al ., ; Boyer et al ., ) reported by 70% of migrainers during migraine attacks (Lipton et al ., ). Per year, approximately 2.5% of episodic migrainers become chronic migrainers, with at least 15 days of headache per month (Bigal et al ., ; Lipton et al ., ), showing acute cutaneous allodynia during attacks but also interictal allodynia between them (Nahman‐Averbuch et al ., ). Cutaneous allodynia is now considered as a marker and a risk factor for chronic migraine (Louter et al ., ), chronic migraine onset being increased by 30% among episodic migrainers, and chronic migraine persistence being increased by 15% in chronic migrainers (Scher et al ., ).…”