Title : Increased pain sensitivity and musculoskeletal impairments in migraine patients
Abstract:
This presentation is based on the scientific debate on whether increased pain sensitivity (IPS) and cervical musculoskeletal impairments (CMI) can be considered a psychophysical manifestation of migraine, and how these characteristics could be used to identify thereby different migraine phenotypes. The identification of these migraine phenotypes could justify a more individualized treatment approach in the future justifying physiotherapy interventions1. In the first part, the results of a cross-sectional observational study investigating IPS and CMIs during the four phases of the migraine cycle will be presented2,3. Migraine patients showed an increased pain sensitivity (IPS) and higher prevalence of CMIs in all phases of the migraine cycle that further increased during the ictal phase. Thus, IPS and CMIs could be considered psychophysical manifestations of migraine. Moreover, the role of neck pain and its relationship with IPS and CMIs will be discussed, and results of studies assessing IPS and CMIs in migraine patients with neck pain will be presented4. Then it will be discussed how IPS and CMIs, together with clinical characteristics, could be used to identify different migraine phenotypes. The results of two recent papers5,6 identifying distinct migraine phenotypes according to IPS and CMIs would be discussed.
Finally, it will be discussed how the identification of different migraine phenotypes could be used to perform a more individualized multidisciplinary approach to reducing IPS and CMIs.
- Di Antonio S, Arendt-Nielsen L, Castaldo M. Cervical musculoskeletal impairments and pain sensitivity in migraine patients. Musculoskelet Sci Pract. 2023 Aug;66:102817. doi: 10.1016/j.msksp.2023.102817. Epub 2023 Jul 6. PMID: 37451884.
- Di Antonio S, Castaldo M, Ponzano M, et al. Trigeminal and cervical sensitization during the four phases of the migraine cycle in patients with episodic migraine. 2022;(July 2021):1-15. doi:10.1111/head.14261
- Di Antonio S, Arend-Nielsen L, Ponzano M, et al. Cervical musculoskeletal impairments in the 4 phases of the migraine cycle in episodic migraine patients. Manuscript accepted by Cephalalgia - CHA-00609-OA-2021.R1
- Di Antonio S, Arendt-Nielsen L, Ponzano M, Bovis F, Torelli P, Pelosin E, Finocchi C, Castaldo M. Migraine patients with and without neck pain: Differences in clinical characteristics, sensitization, musculoskeletal impairments, and psychological burden. Musculoskelet Sci Pract. 2023 Aug;66:102800. doi: 10.1016/j.msksp.2023.102800. Epub 2023 Jun 14. PMID: 37344290.
- Di Antonio S, Arend-Nielsen L, Ponzano M, et al. Phenotyping migraine patients according to psychophysical characteristics. Poster Number: PTU342 -IASP 2022 word congress of pain
- Di Antonio S, Arendt-Nielsen L, Ponzano M, Bovis F, Torelli P, Elisa P, Finocchi C, Castaldo M. Profiling migraine patients according to clinical and psychophysical characteristics: clinical validity of distinct migraine clusters. Neurol Sci. 2024 Mar;45(3):1185-1200. doi: 10.1007/s10072-023-07118-8. Epub 2023 Oct 13. PMID: 37833507; PMCID: PMC10858147
