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Observational Study
. 2024 Aug;45(8):3923-3929.
doi: 10.1007/s10072-024-07372-4. Epub 2024 Feb 24.

Instrumental assessment of pressure pain threshold over trigeminal and extra-trigeminal area in people with episodic and chronic migraine: a cross-sectional observational study

Manuela Deodato  1   2 , Antonio Granato  3   4 , Miriam Martini  3   4 , Raffaele Sabot  3 , Alex Buoite Stella  3 , Paolo Manganotti  3   4
Affiliations
Observational Study

Instrumental assessment of pressure pain threshold over trigeminal and extra-trigeminal area in people with episodic and chronic migraine: a cross-sectional observational study

Manuela Deodato et al. Neurol Sci. 2024 Aug.

Abstract

Background: Central and peripheral sensitization are characterized by widespread hyperalgesia that is manifested by larger pain extent area and reduction in pressure pain threshold (PPT). PPT decreases in patients with migraine not only over the trigeminal cervical complex but also throughout the body.

Methods: A cross-sectional study was adopted to assess the local and widespread hyperalgesia in chronic and episodic migraine patients respect to healthy controls. The guidelines of Andersen's were used to evaluate the PPT bilaterally over 3 muscles in the trigemino-cervical complex (temporalis, sub-occipitalis, trapezius) and over 1 muscle far from this area (tensor fasciae latae).

Results: Thirty subjects with episodic migraine (35.8 ± 2.82 years), 30 with chronic migraine (53.03 ± 19.79 years), and 30 healthy controls (29.06 ± 14.03 years) were enrolled. The interaction effect was present for the trapezius muscle with a significant difference between the right and the left side in episodic group (p = 0.003). A group effect was highlighted in all four muscles analyzed such as suboccipital (p < 0.001), temporalis (p > 0.001), trapezius (p < 0.001), and TFL (p < 0.001). PPT was usually higher in the control group than in the episodic group which in turn was characterized by higher PPT values than the chronic group.

Conclusions: People with chronic and episodic migraine presented lower PPT than healthy controls both in the trigeminal and in the extra-trigeminal area. People with chronic migraine presented lower PPT than episodic migraine only in the trigeminal area. Temporalis and sub-occipitalis are the most sensitive muscles in people with chronic and episodic migraine.

Keywords: Hyperalgesia; Migraine; Pressure pain threshold; Sensitization; Trigemino-cervical complex; Widespread pain.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Pressure pain threshold (PPT) values of a suboccipital, b temporalis, c trapezius, and d tensor fasciae latae (TFL) muscles in episodic (n = 30), chronic (n = 30), and control (n = 30) groups. *p < 0.05; **p < 0.01; p < 0.001***. Post hoc significance values for side and group main effects at the mixed-factors ANOVA
See this image and copyright information in PMC

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