Cutaneous allodynia in the migraine population

Richard B. Lipton, Marcelo E. Bigal, Sait Ashina, Rami Burstein, Stephen Silberstein, Michael L. Reed, Daniel Serrano, Walter F. Stewart

Research output: Contribution to journalArticle

269 Citations (Scopus)

Abstract

Objective: To develop and validate a questionnaire for assessing cutaneous allodynia (CA), and to estimate the prevalence and severity of CA in the migraine population. Methods: Migraineurs (n = 11,388) completed the Allodynia Symptom Checklist, assessing the frequency of allodynia symptoms during headache. Response options were never (0), rarely (0), less than 50% of the time (1), ≥50% of the time (2), and none (0). We used item response theory to explore how well each item discriminated CA. The relations of CA to headache features were examined. Results: All 12 questions had excellent item properties. The greatest discrimination occurred with CA during "taking a shower" (discrimination = 2.54), wearing a necklace (2.39) or ring (2.31), and exposure to heat (2.1) or cold (2.0). The factor analysis demonstrated three factors: thermal, mechanical static, and mechanical dynamic. Based on the psychometrics, we developed a scale distinguishing no CA (scores 0-2), mild (3-5), moderate (6-8), and severe (S9). The prevalence of allodynia among migraineurs was 63.2%. Severe CA occurred in 20.4% of migraineurs. CA was associated with migraine defining features (eg, unilateral pain: odds ratio, 2.3; 95% confidence interval, 2.0-2.4; throbbing pain: odds ratio, 2.3; 95% confidence interval, 2.1-2.6; nausea: odds ratio, 2.3; 95% confidence interval, 2.1-2.6), as well as illness duration, attack frequency, and disability. Interpretation: The Allodynia Symptom Checklist measures overall allodynia and subtypes. CA affects 63% of migraineurs in the population and is associated with frequency, severity, disability, and associated symptoms of migraine. CA maps onto migraine biology.

Original languageEnglish (US)
Pages (from-to)148-158
Number of pages11
JournalAnnals of Neurology
Volume63
Issue number2
DOIs
StatePublished - Feb 2008

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Hyperalgesia
Migraine Disorders
Skin
Population
Odds Ratio
Confidence Intervals
Checklist
Headache
Hot Temperature
Pain
Psychometrics
Nausea
Statistical Factor Analysis

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Lipton, R. B., Bigal, M. E., Ashina, S., Burstein, R., Silberstein, S., Reed, M. L., ... Stewart, W. F. (2008). Cutaneous allodynia in the migraine population. Annals of Neurology, 63(2), 148-158. https://doi.org/10.1002/ana.21211

Cutaneous allodynia in the migraine population. / Lipton, Richard B.; Bigal, Marcelo E.; Ashina, Sait; Burstein, Rami; Silberstein, Stephen; Reed, Michael L.; Serrano, Daniel; Stewart, Walter F.

In: Annals of Neurology, Vol. 63, No. 2, 02.2008, p. 148-158.

Research output: Contribution to journalArticle

Lipton, RB, Bigal, ME, Ashina, S, Burstein, R, Silberstein, S, Reed, ML, Serrano, D & Stewart, WF 2008, 'Cutaneous allodynia in the migraine population', Annals of Neurology, vol. 63, no. 2, pp. 148-158. https://doi.org/10.1002/ana.21211
Lipton RB, Bigal ME, Ashina S, Burstein R, Silberstein S, Reed ML et al. Cutaneous allodynia in the migraine population. Annals of Neurology. 2008 Feb;63(2):148-158. https://doi.org/10.1002/ana.21211
Lipton, Richard B. ; Bigal, Marcelo E. ; Ashina, Sait ; Burstein, Rami ; Silberstein, Stephen ; Reed, Michael L. ; Serrano, Daniel ; Stewart, Walter F. / Cutaneous allodynia in the migraine population. In: Annals of Neurology. 2008 ; Vol. 63, No. 2. pp. 148-158.
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abstract = "Objective: To develop and validate a questionnaire for assessing cutaneous allodynia (CA), and to estimate the prevalence and severity of CA in the migraine population. Methods: Migraineurs (n = 11,388) completed the Allodynia Symptom Checklist, assessing the frequency of allodynia symptoms during headache. Response options were never (0), rarely (0), less than 50{\%} of the time (1), ≥50{\%} of the time (2), and none (0). We used item response theory to explore how well each item discriminated CA. The relations of CA to headache features were examined. Results: All 12 questions had excellent item properties. The greatest discrimination occurred with CA during {"}taking a shower{"} (discrimination = 2.54), wearing a necklace (2.39) or ring (2.31), and exposure to heat (2.1) or cold (2.0). The factor analysis demonstrated three factors: thermal, mechanical static, and mechanical dynamic. Based on the psychometrics, we developed a scale distinguishing no CA (scores 0-2), mild (3-5), moderate (6-8), and severe (S9). The prevalence of allodynia among migraineurs was 63.2{\%}. Severe CA occurred in 20.4{\%} of migraineurs. CA was associated with migraine defining features (eg, unilateral pain: odds ratio, 2.3; 95{\%} confidence interval, 2.0-2.4; throbbing pain: odds ratio, 2.3; 95{\%} confidence interval, 2.1-2.6; nausea: odds ratio, 2.3; 95{\%} confidence interval, 2.1-2.6), as well as illness duration, attack frequency, and disability. Interpretation: The Allodynia Symptom Checklist measures overall allodynia and subtypes. CA affects 63{\%} of migraineurs in the population and is associated with frequency, severity, disability, and associated symptoms of migraine. CA maps onto migraine biology.",
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AU - Lipton, Richard B.

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AB - Objective: To develop and validate a questionnaire for assessing cutaneous allodynia (CA), and to estimate the prevalence and severity of CA in the migraine population. Methods: Migraineurs (n = 11,388) completed the Allodynia Symptom Checklist, assessing the frequency of allodynia symptoms during headache. Response options were never (0), rarely (0), less than 50% of the time (1), ≥50% of the time (2), and none (0). We used item response theory to explore how well each item discriminated CA. The relations of CA to headache features were examined. Results: All 12 questions had excellent item properties. The greatest discrimination occurred with CA during "taking a shower" (discrimination = 2.54), wearing a necklace (2.39) or ring (2.31), and exposure to heat (2.1) or cold (2.0). The factor analysis demonstrated three factors: thermal, mechanical static, and mechanical dynamic. Based on the psychometrics, we developed a scale distinguishing no CA (scores 0-2), mild (3-5), moderate (6-8), and severe (S9). The prevalence of allodynia among migraineurs was 63.2%. Severe CA occurred in 20.4% of migraineurs. CA was associated with migraine defining features (eg, unilateral pain: odds ratio, 2.3; 95% confidence interval, 2.0-2.4; throbbing pain: odds ratio, 2.3; 95% confidence interval, 2.1-2.6; nausea: odds ratio, 2.3; 95% confidence interval, 2.1-2.6), as well as illness duration, attack frequency, and disability. Interpretation: The Allodynia Symptom Checklist measures overall allodynia and subtypes. CA affects 63% of migraineurs in the population and is associated with frequency, severity, disability, and associated symptoms of migraine. CA maps onto migraine biology.

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