Table 1.
Pain threshold findings from experimental studies during noxious stimulation in migraine patients.
| References | Subjects | Migraine phase | Stimulus | Area of stimulation | Main findings in migraine |
|---|---|---|---|---|---|
| Sand et al. (10) | Episodic migraine patients (N = 41) and HCs (N = 28) | Preictal | Heat and cold | Trigeminal and extratrigeminal | Subclinical reduced PT compared to baseline |
| Burstein et al. (2) | Episodic migraine patients with (N = 33) and without (N = 9) CA | Ictal and interictal | Heat, cold and pressure | Trigeminal and extratrigeminal | Reduced PT in facial skin (79%) and forearm (67%). The authors found a positive correlation between frequency of headache and extension of low PT area |
| Burstein et al. (11) | One episodic migraine patient with CA | Ictal and interictal | Heat, cold, mechanical and pressure | Trigeminal and extratrigeminal | Progressive lowering of PT in the facial skin and of ipsilateral forearm skin during the pain acme |
| Uglem et al. (12) | Episodic migraine patients (N = 49) and HCs (N = 31) | Ictal and interictal | Heat and cold | Trigeminal and extratrigeminal | Reduced cold PT in the ictal phase compared to the interictal, preictal and postictal phases. No differences in heat PT |
| De Tommaso et al. (13–16) | Episodic migraine patients (N = 10, N = 18, N = 9, N = 18) | Interictal and ictal | CO2-laser | Trigeminal and extratrigeminal | Reduced PT during the migraine attack compared with baseline and related with duration of illness |
| Engstrøm et al. (17) | Episodic migraine patients with and without aura (N = 50), and HCs (N = 34) | Interictal phase | Heat, cold and pressure | Trigeminal and extratrigeminal | Lower thermal PT in migraine patients compared to HC. Lower PT seems related to increased sleep pressure |
| Schwedt et al. (18) | Chronic and episodic migraine patients (N = 112) and HCs (N = 75) | Interictal phase | Heat | Trigeminal and extratrigeminal | Lower heat PT in migraine patients compared to HC |
| Schoenen et al. (19) | Episodic female migraine patients without aura (N = 10) and HCs (N = 20) | Interictal phase | Pressure | Trigeminal | Lower forehead PT in migraine patients compared to HC |
| Sandrini et al. (20) | Episodic migraine patients without aura (N = 48) and HCs (N = 24) | Interictal phase | Electrical | Trigeminal (cornea) | Lower corneal pain thresholds in migraine patients compared to HC; the lowest values were observed on the symptomatic side of unilateral migraine patients |
| Fernández-de-Las-Peñas et al. (21) | Episodic migraine patients with unilateral pain (N = 25) and HCs (N = 25) | Interictal phase | Pressure | Trigeminal (temporalis and trapezius muscles) | Lower pressure PT on the symptomatic side as compared with the non-symptomatic side and to either side in controls; no significant differences between the non-symptomatic side and HC |
| Fernández-de-las-Peñas et al. (22) | Episodic migraine patients (N = 15) and HCs (N = 15) | Interictal phase | Pressure | Trigeminal (nine points of the temporalis muscle) | Lower pressure PT than HC. Lower PPT in the center compared with the posterior part of the muscle |
| Fernández-de-las-Peñas et al. (23) | Episodic migraine patients (N = 20) and HCs (N = 20) | Interictal phase | Pressure | Trapezius muscle (eleven points of the trapezius muscle) | Lower pressure PT levels in the trapezius muscle region compared with HC |
| Zappaterra et al. (24) | Chronic (N = 44) and episodic (N = 21) migraine patients and HCs (N = 26) | Interictal phase | Pressure | Trigeminal (temple, cheekbone, and cervical areas) | Lower pressure PT in chronic migraine patients and medications overuse; no difference of mechanical PT in episodic migraine patients |
| Grossi et al. (25) | Chronic (N = 14) and episodic (N = 15) migraine patients and HCs (N = 15) | Interictal phase | Pressure | Trigeminal (frontalis, temporalis, masseter) and extratrigeminal (trapezius and sternocleidomastoid) | Decreased PPT in women with migraine relative to HC; no significant PPT values differences between episodic migraine patients and chronic migraine patients |
| Schwedt et al. (26) | Chronic (N = 20) and episodic (N = 20) migraine patients and HCs (N = 20) | Interictal phase | Heat, cold and pressure | Trigeminal (forehead) and extratrigeminal (ventral forearms) | Lower thermal PT in both chronic and episodic migraine patients compared to HC; no difference in the mechanical PT |
| Florencio et al. (27) | Episodic migraine patients (N = 30) and HCs (N = 30) | Interictal phase | Pressure | Trigeminal (sternocleidomastoid, suboccipital, trapezius, scalene) | Lower pressure PT in all muscles compared with controls |
| Palacios-Ceña et al. (28) | Chronic (N = 52) and episodic (N = 51) female migraine patients and HCs (N = 52) | Interictal phase | Pressure | Trigeminal (temporalis muscle), extratrigeminal (second metacarpal, tibialis anterior muscle) | Lower pressure PT over trigeminal and extra-trigeminal points |
| Bovim (29) | Episodic migraine patients with and without aura (N = 26) and HCs (N = 20) | Interictal phase | Pressure | Trigeminal twenty-two specified points (11 on each side of the head) | No significant side-to-side differences in the pressure PT in patients with strict unilateral migraine, between migraine patients and HC |
| Göbel et al. (30) | Episodic migraine patients with migraine without aura (N = 23) and HCs (N = 29) | Interictal phase | Pressure | Trigeminal | No significant differences in pain sensitivity of pericranial musculature |
| Bishop et al. (31) | Episodic migraine patients with migraine without aura (N = 27) and HCs (N = 27) | Interictal phase | Cold | Extratrigeminal (non-dominant hand) | No significant difference in the cold pressor test |
| Weissman-Fogel et al. (32) | Episodic migraine patients with and without aura (N = 34) and HCs (N = 28) | Interictal phase | Heat and electric | Trigeminal (periorbital area) and extratrigeminal (forearm) | No significant differences in mean heat, mechanical, and electrical PT between migraineurs and controls |
| Katsarava et al. (33) | Episodic migraine patients (N = 17) and HCs (N = 15) | Ictal and interictal phase | Electric (nociceptive blink reflex) | Trigeminal | |
| Ayzenberg et al. (34) | Chronic (N = 29) and episodic (N = 16) migraine patients and HCs (N = 15) | Electric (nociceptive blink reflex) | Trigeminal (periorbital area) and extratrigeminal (hand) | No significant differences between HC and patients with episodic migraine and depression without headache | |
| Buchgreitz et al. (35) | Episodic migraine patients (N = 60) and HCs (N = 294) | Interictal phase | Pressure | Trigeminal (dorsum of the second finger) and extratrigeminal (anterior part of the temporal muscle) | No significance differences in pressure PT |
| Coppola et al. (36) | Episodic migraine patients without aura (N = 14) and HCs (N = 15) | Interictal phase | Electric (nociceptive blink reflex) | Trigeminal (supraorbital area) and extratrigeminal (index finger) | No significant differences between migraine patients and HC for pain threshold |
| Gierse-Plogmeier et al. (37) | Episodic female migraine patients with (N = 10) and without (N = 10) aura and HCs (N = 20) | Interictal phase | Electrical | Trigeminal (masseter region) and extratrigeminal (tibial region) | No differences respect to pure sensory and pain electric thresholds neither for the peripheral nor for the trigeminal stimulation |
| Perrotta et al. (38) | Patients with MOH (N = 31), episodic (N = 28) migraine patients and HCs (N = 23) | Interictal phase | Cold | Extratrigeminal | Significantly reduced mean electric PT in the MOH patients (both bWT and aWT) compared with HC; and in the MOH patients bWT compared with both the MOH patients aWT and the EM patients. |
| Teepker et al. (39) | Episodic female migraine patients with and without aura (N = 26), HCs (N = 13) | Interictal phase | Heat, cold, pressure and electrical | Extratrigeminal | No significant differences in PT; no relationship between PT and oral contraceptives assumption |
| Zohsel et al. (40) | Children affected by migraine with and without aura (N = 25), HCs (N = 28) | Interictal phase | Heat, pressure | Trigeminal (upper cheek) and extratrigeminal (thenar eminence) | Heat PT was not significantly different between the two groups. However, the child migraineurs showed significantly lower mechanical PT |
| De Tommaso et al. (41) | Children affected by migraine without aura (N = 34) and HCs (N = 17) | Interictal phase | Laser | Trigeminal (supraorbital area) and extratrigeminal (hand) | Laser PT was significantly reduced in child migraineurs compared to HC at the hand level, but this difference was not significant at the trigeminal site |
| Ferracini et al. (42) | Children affected by migraine without aura (N = 50) and HCs (N = 50) | Interictal phase | Pressure | Trigeminal and extratrigeminal | The pressure PT did not differ between children with migraine and children without headache; |
| Anttila et al. (43) | Children affected by migraine without aura (N = 59) and HCs (N = 59) | Interictal phase | Pressure | Trigeminal and extratrigeminal (seven pericranial and neck-shoulder tender points) | The mean pressure PT did not differ among the groups |
| Metsahonkala et al. (44) | Children affected by migraine without aura (N = 48) and HCs (N = 59) | Interictal phase | Pressure | Trigeminal and extratrigeminal (seven cephalic and three extracephalic points) | The mean pressure PT did not differ among the groups of the study |
| Uthaikhup et al. (45) | Elders affected by migraine without aura (N = 26) and HCs (N = 44) | Interictal phase | Heat, cold, and pressure | Trigeminal (forehead and upper neck) and extratrigeminal (tibialis anterior) | No significant differences between the headache groups and HC in pressure and cold PT |
| Cooke et al. (46) | Chronic migraine female patients (N = 15) and HCs (N = 15) | Interictal phase | Pressure | Trigeminal and extratrigeminal | The pressure PT was significantly lower in migraine patients than in HC subjects for the 1st and 2nd division of the trigeminal nerve |
| Kitaj and Klink (47) | Episodic migraine patients (N = 40) and patients with transformed migraine (N = 41) | Interictal phase | Heat, cold, mechanical, and pressure | Trigeminal (forehead, maxillae) and extratrigeminal (C4 dermatome, and forearms) | Significantly lower pain thresholds in patients with transformed migraine compared to episodic migraine patients |
| De Tommaso et al. (48) | Chronic migraine patients (N = 25), migraine patients without aura (N = 15) and HCs (N = 15) | Interictal phase | CO2-laser thermalstimulation | Trigeminal (face) and extratrigeminal (hand) | No significant differences in PT at both the hand and the face between the three groups |
| De Tommaso et al. (49) | Chronic migraine patients (N = 16), migraine patients with aura (N = 10) and HCs (N = 15) | Interictal phase | CO2-laser pulses | Trigeminal | No significant differences in the PT; prevalent activation of the rostral portion of the ACC in patients with chronic migraine |
| De Tommaso et al. (50) | Chronic migraine patients (N = 16) and HCs (N = 16) | Interictal phase | CO2-laser | Extratrigeminal | No significant differences in the PT; different modulation of bilateral parietal cortical areas and superior frontal and cingulate girus induced by different virtual reality in patients with CM compared to HC |
| Ferraro et al. (51) | Patients with MOH (N = 14) and HC (N = 14) | Interictal phase | Laser | Trigeminal and extratrigeminal | No significant differences in the PT; deficient habituation of the vertex N2/P2 complex partly restored after successful treatment of MOH |
CA, cutaneous allodynia; HCs, healthy controls; MOH, medication overuse headache; PT, pain threshold.