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Allodynia Is Most Common in Transformed Migraine

BY DIANA MAHONEY
Elsevier Global Medical News

BOSTON (EGMN) - The prevalence of cutaneous allodynia among headache sufferers is significantly higher in those with transformed migraine and migraine than in patients with other types of headaches, Dr. Sait Ashina reported on May 2 at the annual meeting of the American Academy of Neurology.

Cutaneous allodynia - pain that results from an innocuous stimulus to normal skin or to scalp that occurs with some headache types - is a marker of sensitization of central nociceptive pathways. In a study designed to measure its prevalence in various types of headache in the general population, Dr. Ashina of the Montefiore Medical Center in New York, and colleagues mailed the validated 12-item Allodynia Symptom Checklist (ASC) to 24,000 severe headache sufferers culled from a larger household sample representative of the U.S. population that had responded to a previous screening questionnaire. Completed checklists were returned by 16,577 of the respondents with severe headaches, Dr. Ashina said.

The ASC rates each allodynia symptom on a four-point scale based on frequency. A symptom that occurs 0-2 times is designated as none, 3-5 times is mild, 6-8 times is moderate, and 9 or more is severe, explained Dr. Ashina.

For the purpose of the study, headache diagnoses were classified into subtypes according to the International Classification of Headache Disorders and the Silberstein-Lipton criteria for transformed migraine. Based on these criteria, migraine was diagnosed in 11,388 individuals and probable migraine was diagnosed in 2,999. Episodic tension-type headache was observed in 1,395, transformed migraine in 655, and chronic tension-type headache in 165, according to Dr. Ashina.

The mean ASC scores by headache subgroup were 9.0 for transformed migraine, 7.6 for migraine, 3.5 for probable migraine, 2.7 for chronic tension-type headache, and 2.0 for episodic tension-type headache, Dr. Ashina said, noting that the mean proportions with cutaneous allodynia by group were 74% in the transformed migraine group, 69% in the migraineurs, 43% in the probable migraine group, and 37% and 24% chronic and episodic tension-type groups, respectively.

The results also demonstrated that individuals with severe allodynia experienced significantly more disability days based on the Migraine Disability Assessment than did those with moderate to no allodynia, Dr. Ashina reported.

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