Are there differences between cephalic and extracephalic cutaneous allodynia in migraine patients?
Are there differences between cephalic and extracephalic cutaneous allodynia in migraine patients?
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DOI：
10.1111/j.1468-2982.2009.02008.x
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发表时间：
2010-07-01
期刊：
影响因子：
4.9
通讯作者：
Clavelou, P.
中科院分区：
文献类型：
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作者：
Guy, N.;Marques, A. R.;Clavelou, P.
皮肤异常性疼痛（CA）是对无害皮肤刺激的反应，被认为是偏头痛发作期间中枢敏感化的标志。它要么局限于同侧头部的疼痛区域内，要么在头部内外延伸。此外，CA可以响应于热（热或冷）和/或机械刺激而引起。这就提出了一个问题，即头和头外CA是否具有相同的特性。我们在偏头痛发作期间使用在家中完成的问卷评估了发作性偏头痛患者的头部和头部外CA。共有67名发作性偏头痛患者（58名女性，9名男性; 40 +/- 13岁）回答了问卷中的所有问题。49名患者（73%）在偏头痛发作期间或发作后立即出现一种或多种异常性疼痛症状。几乎所有49例患者均报告了头部CA，而24例（49%）还报告了头外CA。CA的发生和扩展与头痛强度相关（P = 0.005）。头和头外CA的模式不同（卡方2 = 12.03; P = 0.002），头外CA主要是热性的（75%），而头CA主要是机械性的（92%）。这表明头和头外CA涉及不同的机制。
Cutaneous allodynia (CA), pain in response to innocuous cutaneous stimuli, is recognized as a sign of central sensitization during migraine episodes. It is either restricted within the pain area on the ipsilateral head, or extends within and outside the head. Moreover, CA can be elicited in response to thermal (heat or cold) and/or mechanical stimuli. This raises the question as to whether cephalic and extracephalic CAs share the same properties. We assessed cephalic and extracephalic CAs in migraine episodic patients using a questionnaire completed at home during migraine attacks. A total of 67 episodic migraine patients (58 women, nine men; 40 +/- 13 years old) addressed all questions in the questionnaire. Forty-nine patients (73%) cited one or more allodynic symptoms during or immediately after the migraine attack. Almost all 49 patients reported cephalic CA, whereas 24 (49%) also reported extracephalic CA. Occurrence and extension of CA correlated (P = 0.005) with headache intensity. Modalities of cephalic and extracephalic CA were different (chi(2) = 12.03; P = 0.002), extracephalic CA being mostly thermal (75%) whereas cephalic CA was mostly mechanical (92%). This suggests that cephalic and extracephalic CAs involve different mechanisms.