Thermal pain thresholds are decreased in the migraine preattack phase
Thermal pain thresholds are decreased in the migraine preattack phase
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DOI：
10.1111/j.1468-1331.2008.02276.x
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发表时间：
2008-11-01
影响因子：
5.1
通讯作者：
Stovner, L. J.
中科院分区：
文献类型：
--
作者：
Sand, T.;Zhitniy, N.;Stovner, L. J.
背景和目的：偏头痛患者在发作时可能出现皮肤异常性疼痛。为了研究疼痛生理学在发作前阶段是否发生变化，我们对41例偏头痛患者和28例对照者在三个不同的日期进行了热痛和冷痛检测阈值（HPT和CPT）的测定。方法：在双侧四个部位：前额、面部、颈部和手部使用热电极。一个亚组的11名偏头痛患者进行了测试，在24小时内，在他们的下一次攻击之前，并在发作间期阶段。结果如下：在发作前阶段，HPT低于手（44.8 ℃ vs. 45.9 ℃，P = 0.009）、颈部（46.8 ℃ vs. 48.2 ℃，P = 0.02）和前额（45.1 ℃ vs. 46.3 ℃，P = 0.02）的成对发作间期记录。颈部和手部CPT在发作前阶段高于发作间期（分别为10 ℃ vs. 7.3 ℃，P = 0.01和11.6 ℃ vs. 9.4 ℃，P = 0.06）。发作前前额的变化在随后发作的头痛侧最明显。讨论：亚临床发作前热痛超敏反应似乎是导致偏头痛发作的过程的一个特征。
Background and purpose: Migraine patients may have cutaneous allodynia during attacks. In order to investigate if pain physiology changes in the preattack phase we estimated heat pain and cold pain detection threshold (HPT and CPT) on three different days in 41 migraine patients and 28 controls. Methods: A thermode was applied at four sites bilaterally: forehead, face, neck, and hand. A subgroup of 11 migraine patients had been tested within 24 h before their next attack and in the interictal phase. Results: In the preattack phase, HPT was lower compared with the paired interictal recording for the hand (44.8 degrees C vs. 45.9 degrees C, P = 0.009), neck (46.8 degrees C vs. 48.2 degrees C, P = 0.02), and forehead (45.1 degrees C vs. 46.3 degrees C, P = 0.02). Neck and hand CPT were higher in the preattack phase than interictally (10 degrees C vs. 7.3 degrees C, P = 0.01 and 11.6 degrees C vs. 9.4 degrees C, P = 0.06, respectively). Preattack forehead changes were most apparent on the headache side of the subsequent attack. Discussion: Subclinical preattack thermal pain hypersensitivity seems to be a feature of the process that leads to a migraine attack.