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Cycling sensitivity across migraine phases: A longitudinal case-control study.

Kuan-Po Peng¹, Arne May¹

¹Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.

European Journal of Pain (London, England)

|November 23, 2024

Summary

Migraine attacks are preceded by changes in trigeminal somatosensory function up to 48 hours before headache onset. These pre-migraine sensory alterations correlate with brain activity changes, offering new insights into migraine mechanisms.

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Area of Science:

Neuroscience
Pain Research
Migraine Pathophysiology

Background:

Functional neuroimaging suggests trigeminal pain pathways activate 48 hours before migraine headaches.
The relationship between these cyclic changes and somatosensory alterations is not fully understood.

Purpose of the Study:

To investigate the temporal progression of somatosensory alterations before migraine onset.
To compare these changes in patients with menstrually related migraine and healthy controls.

Main Methods:

Consecutive daily quantitative sensory testing over 7-11 days in 10 migraine patients and 13 controls.
Testing commenced 6 days prior to expected migraine and menstruation onset.

Main Results:

Migraine patients showed a phase-dependent decline in electrical, heat, and cold pain thresholds 48 hours before headache.
Pain thresholds further decreased during the ictal phase, with electrical pain showing statistical significance.
Healthy controls exhibited stable pain thresholds throughout the study period.

Conclusions:

A trigeminal somatosensory alteration exists in the preictal phase of migraine, occurring up to 48 hours before headache.
These findings correlate with pre-migraine brain activation seen in neuroimaging studies.
Future research should combine pain threshold measurements with functional neuroimaging to identify the source of sensory fluctuations.