Predictors of allodynia in persons with migraine: Results from the Migraine in America Symptoms and Treatment (MAST) study

David W. Dodick, Michael L. Reed, Kristina M. Fanning, Sagar Munjal, Aftab Alam, Dawn C. Buse, Todd J. Schwedt, Richard B. Lipton

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background: Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression. Objective: Identify factors associated with allodynia in a sample of adults with migraine. Methods: An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95% confidence intervals (CI) were calculated. Results: In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0% were female, and 81.0% were Caucasian. Allodynia was present in 39.9%. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model. Conclusion: In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.

Original languageEnglish (US)
JournalCephalalgia
DOIs
StatePublished - Jan 1 2019

Fingerprint

Hyperalgesia
Migraine Disorders
Headache
Odds Ratio
Confidence Intervals
Therapeutics
Anxiety
Depression
Pain
Skin
Checklist
Disease Progression

Keywords

  • acute medication overuse
  • anxiety
  • cutaneous allodynia
  • depression
  • epidemiology
  • headache frequency
  • headache pain intensity
  • Migraine
  • migraine symptom severity

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Predictors of allodynia in persons with migraine : Results from the Migraine in America Symptoms and Treatment (MAST) study. / Dodick, David W.; Reed, Michael L.; Fanning, Kristina M.; Munjal, Sagar; Alam, Aftab; Buse, Dawn C.; Schwedt, Todd J.; Lipton, Richard B.

In: Cephalalgia, 01.01.2019.

Research output: Contribution to journalArticle

Dodick, David W. ; Reed, Michael L. ; Fanning, Kristina M. ; Munjal, Sagar ; Alam, Aftab ; Buse, Dawn C. ; Schwedt, Todd J. ; Lipton, Richard B. / Predictors of allodynia in persons with migraine : Results from the Migraine in America Symptoms and Treatment (MAST) study. In: Cephalalgia. 2019.
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abstract = "Background: Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression. Objective: Identify factors associated with allodynia in a sample of adults with migraine. Methods: An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95{\%} confidence intervals (CI) were calculated. Results: In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0{\%} were female, and 81.0{\%} were Caucasian. Allodynia was present in 39.9{\%}. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model. Conclusion: In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.",
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AU - Dodick, David W.

AU - Reed, Michael L.

AU - Fanning, Kristina M.

AU - Munjal, Sagar

AU - Alam, Aftab

AU - Buse, Dawn C.

AU - Schwedt, Todd J.

AU - Lipton, Richard B.

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N2 - Background: Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression. Objective: Identify factors associated with allodynia in a sample of adults with migraine. Methods: An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95% confidence intervals (CI) were calculated. Results: In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0% were female, and 81.0% were Caucasian. Allodynia was present in 39.9%. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model. Conclusion: In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.

AB - Background: Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression. Objective: Identify factors associated with allodynia in a sample of adults with migraine. Methods: An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95% confidence intervals (CI) were calculated. Results: In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0% were female, and 81.0% were Caucasian. Allodynia was present in 39.9%. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model. Conclusion: In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.

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KW - anxiety

KW - cutaneous allodynia

KW - depression

KW - epidemiology

KW - headache frequency

KW - headache pain intensity

KW - Migraine

KW - migraine symptom severity

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