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Published on: June 2, 2014
Altered pain processing in children with migraine: an evoked potential study
Katrin Zohsel1, Johanna Hohmeister, Herta Flor
1Department of Clinical and Cognitive Neuroscience, Ruprecht-Karls-University of Heidelberg, Central Institute of Mental Health, Square J5 D-68159 Mannheim, Germany.
Insights
Children with migraine show an attentional bias towards painful stimuli. This altered processing of somatosensory stimuli may contribute to migraine chronicity in pediatric patients.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Pain Research
Background:
- Migraine in adults is linked to altered pain processing and attention.
- Understanding pain processing in pediatric migraine is crucial but limited.
Purpose of the Study:
- To investigate altered pain processing and attentional mechanisms in children with migraine.
- To compare somatosensory evoked potentials (SEPs) between children with and without migraine.
Main Methods:
- An oddball standards task was used with 15 children with migraine and 15 controls (ages 10-15).
- Participants responded to auditory targets while ignoring painful or non-painful mechanical stimuli.
- Somatosensory evoked potentials (SEPs) and reaction times were recorded.
Main Results:
- Both groups showed larger N150, P260, and P300 SEP components for painful versus non-painful stimuli.
- Children with migraine exhibited larger P300 amplitudes and shorter latencies for both painful and non-painful stimuli.
- No significant differences were found in pain perception, target evoked potentials, or habituation between groups.
Conclusions:
- Children with migraine may have an automatic attentional bias towards somatosensory stimuli, including painful ones.
- This attentional bias could be a key mechanism in the development of chronic migraine in pediatric populations.
- Findings support the psychobiological perspective of chronic pain in understanding migraine.
Abstract:
In adults, evidence is accumulating that migraine is associated with altered central processing of pain stimuli and, possibly, changes in the allocation of attentional resources to such stimuli. In pediatric migraine, however, little is known about altered pain processing. We examined 15 children with migraine and 15 controls (age 10-15) in an oddball standards task. Children had to respond to rare targets (tones) and ignore frequent painful (pain threshold) or non-painful mechanical standard stimuli while evoked potentials were obtained. Painful as compared to non-painful stimuli elicited significantly larger N150, P260 and P300 components of the somatosensory evoked potential in all children. The pain-evoked N150 and P260 components did not differ significantly between groups. However, in children with migraine, both painful and non-painful standard stimuli were associated with significantly larger P300 amplitudes at significantly shorter latencies. Perceived intensity of the painful and non-painful stimuli was comparable in both groups. The evoked potentials and reaction times to the target tones did not differ significantly between groups. Habituation across trials was similar in both groups. Hence, children with migraine may display an automatic attentional bias towards painful and potentially painful somatosensory stimuli. Consistent with the psychobiological perspective of chronic pain, such an attentional bias could constitute an important mechanism for migraine becoming a chronic problem.
