Prevalence of clinical sensitization phenotype and neuropathic-like pain features in patients with cervicogenic...

To compare clinical sensitization phenotype (CSP) and neuropathic-like pain features (NLPF) in patients with cervicogenic headache (CGH) and asymptomatic controls, and, within CGH group, to examine their associations with psychological distress, sleep quality, and health-related quality of life (HRQoL).

In this case-control study, 39 patients with CGH and 36 age- and sex-matched healthy controls were evaluated between July and October 2025. CSP and NLPF were assessed using Central Sensitization Inventory (CSI) and pain-DETECT questionnaire. Headache impact, neck disability, psychological distress, sleep quality, and HRQoL were evaluated using Headache Impact Test (HIT-6), Neck Disability Index (NDI), Hospital Anxiety and Depression Scale (HADS), Jenkins Sleep Scale (JSS), and SF-36.

CGH patients showed significantly higher CSI, HIT-6, NDI, HADS, and JSS scores than controls (all p < 0.001), indicating a pronounced CSP, greater disability, and increased psychosocial burden. Although pain-DETECT scores were higher in CGH group, between-group difference did not reach statistical significance (p = 0.074); however, a moderate effect size suggested potential clinical relevance. Within CGH group, CSI scores correlated strongly with HADS (r = 0.68), NDI (r = 0.64), and JSS (r = 0.59). Regression analyses showed that CSI scores were independently associated with pain-DETECT scores (B = 0.275, p = 0.008), while pain-DETECT (B = 0.986, p = 0.008) and JSS scores (B = 0.910, p = 0.037) were independently associated with CSI levels.

CSP and NLPF represent interrelated clinical pain phenotypes in CGH and are associated with greater disability, psychological distress, and sleep disturbance.

ClinicalTrials.gov Identifier: NCT07292181, Registration date: 3 July 2025.