Differences in headache characteristics, cervical musculoskeletal impairments, signs of sensitization, and psychological burden between different migraine phenotypes assessed during the ictal/perictal phase

Lars Arendt-Nielsen; Stefano Di Antonio; Matteo Castaldo

Abstract

Background and aims: Assess if district migraine phenotype identified during the ictal/perictal phase using ten simple clinical and psychophysical bedside tools are differently affected by the disease

Methods: In this observational study, healthy subjects and migraine patients(episodic/chronic) assessed in the ictal/perictal phase were included. Migraine patients were subgrouped into different clusters: Cluster 1.1 no psychophysical impairments, Cluster 1.2: increased pain sensitivity and cervical musculoskeletal impairment.
The following variables were assessed: Clinical characteristics: disease duration, diary (headache frequency/intensity); headache-disability(HDI); neck-disability(NDI); psychological burden(HADS). Psychophysical characteristics: cervical active range of motion(AROM, flexion, extension, right/left lateral flexion, right/left rotation); quantitative sensory testing(QST): static pressure-pain threshold(sPPT) and mechanical pain threshold(MPT) over temporalis, sPPT and dynamic PPT(dPPT) over the neck, sPPT and MPT over the hand, and sPPT over the leg

Results: 156 subjects were included. Cluster 1.2 had higher headache intensity (p=0.48), disability (p=0.003), neck-disability (p=0.005), and psychological burden (p=0.005) compared to Cluster 1.1. Cluster 1.2 had reduced AROM in all directions (p<0.023) and reduced values in all QST (p<0.001) compared to controls and reduced AROM in flexion, left/right lateral flexion (p<0.045), and reduced values in all QST (p<0.001), but not MPT over the hand compared to Cluster 1.1.
Cluster 1.1 had no difference in AROM and higher sPPT values over temporalis, neck, and leg (p<0.049).

Conclusions: The migraine phenotype with increased pain sensitivity and cervical musculoskeletal impairment is worse affected by the disease, showing worse clinical and psychophysical characteristics. On the other hand, a migraine phenotype with no psychophysical impairments showed sing of hypoalgesia compared to controls

Original language	English
Publication date	Sept 2023
Publication status	Published - Sept 2023
Event	13th Congress of the European Pain Federation EFIC: Personalised Pain Management: The Future is Now - Budapest, Hungary Duration: 20 Sept 2023 → 22 Sept 2023 https://europeanpainfederation.eu/efic2023/

Conference

Conference	13th Congress of the European Pain Federation EFIC
Country/Territory	Hungary
City	Budapest
Period	20/09/2023 → 22/09/2023
Internet address	https://europeanpainfederation.eu/efic2023/

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@conference{6ef46bb3fd644cf8bb05243013d066d4,

title = "Differences in headache characteristics, cervical musculoskeletal impairments, signs of sensitization, and psychological burden between different migraine phenotypes assessed during the ictal/perictal phase",

abstract = "Background and aims: Assess if district migraine phenotype identified during the ictal/perictal phase using ten simple clinical and psychophysical bedside tools are differently affected by the diseaseMethods: In this observational study, healthy subjects and migraine patients(episodic/chronic) assessed in the ictal/perictal phase were included. Migraine patients were subgrouped into different clusters: Cluster 1.1 no psychophysical impairments, Cluster 1.2: increased pain sensitivity and cervical musculoskeletal impairment.The following variables were assessed: Clinical characteristics: disease duration, diary (headache frequency/intensity); headache-disability(HDI); neck-disability(NDI); psychological burden(HADS). Psychophysical characteristics: cervical active range of motion(AROM, flexion, extension, right/left lateral flexion, right/left rotation); quantitative sensory testing(QST): static pressure-pain threshold(sPPT) and mechanical pain threshold(MPT) over temporalis, sPPT and dynamic PPT(dPPT) over the neck, sPPT and MPT over the hand, and sPPT over the legResults: 156 subjects were included. Cluster 1.2 had higher headache intensity (p=0.48), disability (p=0.003), neck-disability (p=0.005), and psychological burden (p=0.005) compared to Cluster 1.1. Cluster 1.2 had reduced AROM in all directions (p<0.023) and reduced values in all QST (p<0.001) compared to controls and reduced AROM in flexion, left/right lateral flexion (p<0.045), and reduced values in all QST (p<0.001), but not MPT over the hand compared to Cluster 1.1.Cluster 1.1 had no difference in AROM and higher sPPT values over temporalis, neck, and leg (p<0.049).Conclusions: The migraine phenotype with increased pain sensitivity and cervical musculoskeletal impairment is worse affected by the disease, showing worse clinical and psychophysical characteristics. On the other hand, a migraine phenotype with no psychophysical impairments showed sing of hypoalgesia compared to controls",

author = "Lars Arendt-Nielsen and {Di Antonio}, Stefano and Matteo Castaldo",

year = "2023",

month = sep,

language = "English",

note = "13th Congress of the European Pain Federation EFIC ; Conference date: 20-09-2023 Through 22-09-2023",

url = "https://europeanpainfederation.eu/efic2023/",

}

Differences in headache characteristics, cervical musculoskeletal impairments, signs of sensitization, and psychological burden between different migraine phenotypes assessed during the ictal/perictal phase. / Arendt-Nielsen, Lars; Di Antonio, Stefano; Castaldo, Matteo.
2023. Abstract from 13th Congress of the European Pain Federation EFIC, Budapest, Hungary.

Research output: Contribution to conference without publisher/journal › Conference abstract for conference › Research › peer-review

TY - ABST

T1 - Differences in headache characteristics, cervical musculoskeletal impairments, signs of sensitization, and psychological burden between different migraine phenotypes assessed during the ictal/perictal phase

AU - Arendt-Nielsen, Lars

AU - Di Antonio, Stefano

AU - Castaldo, Matteo

PY - 2023/9

Y1 - 2023/9

N2 - Background and aims: Assess if district migraine phenotype identified during the ictal/perictal phase using ten simple clinical and psychophysical bedside tools are differently affected by the diseaseMethods: In this observational study, healthy subjects and migraine patients(episodic/chronic) assessed in the ictal/perictal phase were included. Migraine patients were subgrouped into different clusters: Cluster 1.1 no psychophysical impairments, Cluster 1.2: increased pain sensitivity and cervical musculoskeletal impairment.The following variables were assessed: Clinical characteristics: disease duration, diary (headache frequency/intensity); headache-disability(HDI); neck-disability(NDI); psychological burden(HADS). Psychophysical characteristics: cervical active range of motion(AROM, flexion, extension, right/left lateral flexion, right/left rotation); quantitative sensory testing(QST): static pressure-pain threshold(sPPT) and mechanical pain threshold(MPT) over temporalis, sPPT and dynamic PPT(dPPT) over the neck, sPPT and MPT over the hand, and sPPT over the legResults: 156 subjects were included. Cluster 1.2 had higher headache intensity (p=0.48), disability (p=0.003), neck-disability (p=0.005), and psychological burden (p=0.005) compared to Cluster 1.1. Cluster 1.2 had reduced AROM in all directions (p<0.023) and reduced values in all QST (p<0.001) compared to controls and reduced AROM in flexion, left/right lateral flexion (p<0.045), and reduced values in all QST (p<0.001), but not MPT over the hand compared to Cluster 1.1.Cluster 1.1 had no difference in AROM and higher sPPT values over temporalis, neck, and leg (p<0.049).Conclusions: The migraine phenotype with increased pain sensitivity and cervical musculoskeletal impairment is worse affected by the disease, showing worse clinical and psychophysical characteristics. On the other hand, a migraine phenotype with no psychophysical impairments showed sing of hypoalgesia compared to controls

AB - Background and aims: Assess if district migraine phenotype identified during the ictal/perictal phase using ten simple clinical and psychophysical bedside tools are differently affected by the diseaseMethods: In this observational study, healthy subjects and migraine patients(episodic/chronic) assessed in the ictal/perictal phase were included. Migraine patients were subgrouped into different clusters: Cluster 1.1 no psychophysical impairments, Cluster 1.2: increased pain sensitivity and cervical musculoskeletal impairment.The following variables were assessed: Clinical characteristics: disease duration, diary (headache frequency/intensity); headache-disability(HDI); neck-disability(NDI); psychological burden(HADS). Psychophysical characteristics: cervical active range of motion(AROM, flexion, extension, right/left lateral flexion, right/left rotation); quantitative sensory testing(QST): static pressure-pain threshold(sPPT) and mechanical pain threshold(MPT) over temporalis, sPPT and dynamic PPT(dPPT) over the neck, sPPT and MPT over the hand, and sPPT over the legResults: 156 subjects were included. Cluster 1.2 had higher headache intensity (p=0.48), disability (p=0.003), neck-disability (p=0.005), and psychological burden (p=0.005) compared to Cluster 1.1. Cluster 1.2 had reduced AROM in all directions (p<0.023) and reduced values in all QST (p<0.001) compared to controls and reduced AROM in flexion, left/right lateral flexion (p<0.045), and reduced values in all QST (p<0.001), but not MPT over the hand compared to Cluster 1.1.Cluster 1.1 had no difference in AROM and higher sPPT values over temporalis, neck, and leg (p<0.049).Conclusions: The migraine phenotype with increased pain sensitivity and cervical musculoskeletal impairment is worse affected by the disease, showing worse clinical and psychophysical characteristics. On the other hand, a migraine phenotype with no psychophysical impairments showed sing of hypoalgesia compared to controls

UR - https://efic2023.abstractserver.com/program/#/details/presentations/316

M3 - Conference abstract for conference

T2 - 13th Congress of the European Pain Federation EFIC

Y2 - 20 September 2023 through 22 September 2023

ER -