Human assumed central sensitization in interictal migraine: a systematic review and meta-analysis

This study aimed to evaluate the presence of human assumed central sensitization in interictal episodic and chronic migraine patients.

A comprehensive literature search was conducted in September 2024 across three databases. Studies evaluating human assumed central sensitization using static or dynamic quantitative sensory testing in adults with interictal migraine were included. Two independent, blinded reviewers performed study selection, data extraction, and assessments of risk of bias and evidence quality. Meta-analyses were conducted using Review Manager. Sixty-two studies were included in the qualitative synthesis, with 37 contributing to the meta-analysis.

Findings, categorized by headache frequency and testing modality, revealed reduced pressure pain thresholds in trigeminal, extra-trigeminal, and pain-free areas in episodic and chronic migraine patients. Other static sensory testing outcomes were inconsistent. Altered defensive reflexes were observed in both groups. No significant differences were found between episodic and chronic migraine regardless of testing method used.

These findings support the presence of human assumed central sensitization in interictal episodic and chronic migraine, highlighting the potential benefit of multimodal treatment approaches aimed at central nervous system desensitization. Although different quantitative sensory testing profiles may influence the development of human assumed central sensitization, headache frequency appears to have a limited impact.