Prevalence and characteristics of allodynia in headache sufferers: A population study

M. E. Bigal, S. Ashina, R. Burstein, M. L. Reed, D. Buse, D. Serrano, Richard B. Lipton

Research output: Contribution to journalArticle

192 Citations (Scopus)

Abstract

OBJECTIVE: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population. METHODS: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids. RESULTS: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p < 0.01) and significantly elevated in both of these groups compared with probable migraine (42.6%), other chronic daily headaches (36.8%), and severe episodic tension-type headache (36.7%). The prevalence of severe CA (ASC score ≥9) was also highest in TM (28.5%) followed by migraine (20.4%), probable migraine (12.3%), other chronic daily headaches (6.2%), and severe episodic tension-type headache (5.1%). In the migraine and TM groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index. In all groups, ASC scores were higher in individuals with major depression. CONCLUSIONS: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.

Original languageEnglish (US)
Pages (from-to)1525-1533
Number of pages9
JournalNeurology
Volume70
Issue number17
DOIs
StatePublished - Apr 2008

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Hyperalgesia
Headache
Migraine Disorders
Population
Skin
Checklist
Tension-Type Headache
Headache Disorders
Comorbidity
Body Mass Index
Opioid Analgesics
Logistic Models
Demography

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Prevalence and characteristics of allodynia in headache sufferers : A population study. / Bigal, M. E.; Ashina, S.; Burstein, R.; Reed, M. L.; Buse, D.; Serrano, D.; Lipton, Richard B.

In: Neurology, Vol. 70, No. 17, 04.2008, p. 1525-1533.

Research output: Contribution to journalArticle

Bigal, ME, Ashina, S, Burstein, R, Reed, ML, Buse, D, Serrano, D & Lipton, RB 2008, 'Prevalence and characteristics of allodynia in headache sufferers: A population study', Neurology, vol. 70, no. 17, pp. 1525-1533. https://doi.org/10.1212/01.wnl.0000310645.31020.b1
Bigal ME, Ashina S, Burstein R, Reed ML, Buse D, Serrano D et al. Prevalence and characteristics of allodynia in headache sufferers: A population study. Neurology. 2008 Apr;70(17):1525-1533. https://doi.org/10.1212/01.wnl.0000310645.31020.b1
Bigal, M. E. ; Ashina, S. ; Burstein, R. ; Reed, M. L. ; Buse, D. ; Serrano, D. ; Lipton, Richard B. / Prevalence and characteristics of allodynia in headache sufferers : A population study. In: Neurology. 2008 ; Vol. 70, No. 17. pp. 1525-1533.
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AU - Bigal, M. E.

AU - Ashina, S.

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AU - Reed, M. L.

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AU - Serrano, D.

AU - Lipton, Richard B.

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N2 - OBJECTIVE: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population. METHODS: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids. RESULTS: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p < 0.01) and significantly elevated in both of these groups compared with probable migraine (42.6%), other chronic daily headaches (36.8%), and severe episodic tension-type headache (36.7%). The prevalence of severe CA (ASC score ≥9) was also highest in TM (28.5%) followed by migraine (20.4%), probable migraine (12.3%), other chronic daily headaches (6.2%), and severe episodic tension-type headache (5.1%). In the migraine and TM groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index. In all groups, ASC scores were higher in individuals with major depression. CONCLUSIONS: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.

AB - OBJECTIVE: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population. METHODS: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids. RESULTS: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p < 0.01) and significantly elevated in both of these groups compared with probable migraine (42.6%), other chronic daily headaches (36.8%), and severe episodic tension-type headache (36.7%). The prevalence of severe CA (ASC score ≥9) was also highest in TM (28.5%) followed by migraine (20.4%), probable migraine (12.3%), other chronic daily headaches (6.2%), and severe episodic tension-type headache (5.1%). In the migraine and TM groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index. In all groups, ASC scores were higher in individuals with major depression. CONCLUSIONS: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.

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