Allodynia has been described in migraine but has not been fully investigated for the different sensory modalities. The aim of this study was to compare the prevalence of dynamic (brush) and static (pressure) mechanical allodynia in migraine patients and to suggest a practical method of testing them in a clinical setting. Patients with International Headache Society-defined episodic migraine (EM) or with transformed migraine (TM) as defined by Silberstein and Lipton were prospectively recruited from the Jefferson Headache Center out-patient clinic. A questionnaire of migraine features and symptoms of allodynia was administered. Brush allodynia (BA) was tested by cutaneous stimulation with a gauze pad and pressure allodynia (PA) was tested using von Frey hairs (VFH). The prevalence of BA and PA in all patients and in the different subgroups was calculated and correlated with migraine features. We recruited 55 migraine patients. Twenty-five had EM and 30 had TM. BA was present in 18 (32.7%) patients and PA in 18-24 (32.7-43.6%). Allodynia to both brush and pressure was found in 13-17 (23.6-30.9%) patients. If a patient had allodynia to one modality only, it was more likely to be PA than BA. Both BA and PA were more common in patients with TM compared with those with EM [BA 46.7% vs. 16.0%; PA (differences significant for the medium and thick VFHs) 50% vs. 20% and 50% vs. 12%, respectively]. Both types of allodynia were also more common in patients with migraine with aura compared with those with migraine without aura (BA 57.1% vs. 17.6%; PA 57.1-61.9% vs. 17.6-32.7%). There was a positive correlation between allodynia score (as obtained by examination) and allodynia index (as obtained by history) for both BA and PA. The incomplete, although considerable, overlap between BA and PA suggests that allodynia to different sensory modalities is associated with sensitization of different neuronal populations. Because PA was more common than BA, it may be a more sensitive indicator of allodynia in migraine. PA can be tested clinically in a practical and systematic manner.

译文

偏头痛中已经描述了异常性疼痛,但尚未对不同的感觉方式进行充分研究。这项研究的目的是比较偏头痛患者的动态 (刷) 和静态 (压力) 机械异常性疼痛的患病率,并提出一种在临床环境中进行测试的实用方法。前瞻性地从杰斐逊头痛中心门诊招募了国际头痛协会定义的发作性偏头痛 (EM) 或Silberstein和Lipton定义的转化偏头痛 (TM) 患者。进行了偏头痛特征和异常性疼痛症状的问卷调查。通过用纱布垫进行皮肤刺激来测试刷性异常性疼痛 (BA),并使用von Frey头发 (VFH) 测试压力异常性疼痛 (PA)。计算了所有患者和不同亚组中BA和PA的患病率,并将其与偏头痛特征相关联。我们招募了55名偏头痛患者。25个有EM,30个有TM。BA存在于18 (32.7%) 例患者中,PA存在于18-24 (32.7-43.6%) 中。在13-17 (23.6-30.9%) 例患者中发现了刷和压力的异常性疼痛。如果患者仅对一种方式有异常性疼痛,则PA比BA更有可能。与EM患者相比,TM患者中BA和PA更为常见 [BA 46.7% vs. 16.0%; PA (中等和厚VFHs的差异显着) 50% 分别为20% 和50% 与12%]。与无先兆偏头痛患者相比,两种类型的异常性疼痛在先兆偏头痛患者中也更常见 (BA 57.1% vs. 17.6%; PA 57.1-61.9% vs. 17.6-32.7%)。BA和PA的异常性疼痛评分 (通过检查获得) 与异常性疼痛指数 (通过病史获得) 之间呈正相关。BA和PA之间不完整 (尽管相当大) 的重叠表明,对不同感觉方式的异常性疼痛与不同神经元群体的敏化有关。由于PA比BA更常见,因此它可能是偏头痛异常性疼痛的更敏感指标。PA可以以实用和系统的方式进行临床测试。

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