5yr
Investigating the relationships between the burden of multiple sensory hypersensitivity symptoms and headache-related disability in patents with migraine - The Journal of Headache and Pain
Source : https://thejournalofheadacheandpain.biomedcentral.com/articles/10.1186/s10194-021-01294-8
Objective Sensory hypersensitivities such as photophobia, phonophobia, and osmophobia are common in patients with migraine. We investigated the burden of these multiple sensory hypersensitivities in migraine. Methods In this cross-sectional study, 187 consecutive patients with migraine (26 men/161 women; age, 45.9 ± 13.2 years) were included.
Key Points
• Conclusion/Relevance: “Our study showed that sensory hypersensitivities commonly occur and overlap in patients with migraine and that multiple sensory hypersensitivity symptoms have a significant impact on headache-related disability.”
• In the current study, researchers examined the effects of sensory hypersensitivities such as photophobia, phonophobia, and osmophobia in migraine patients.
• In 75.4%, 76.5% and 55.1% of patients photophobia, phonophobia and osmophobia were demonstrated in those with migraine, respectively. The researchers noted overlaps in sensory hypersensitivities, with the number of patients with two coexisting sensory hypersensitivities being 33.2% and those with three coexisting sensory hypersensitivities 41.7%. The Migraine Disability Assessment (MIDAS) score was highest in those with three sensory hypersensitivity symptoms. Younger age, more migraine days per month, and a higher Kessler Psychological Distress Scale (K6) score were related elevated MIDAS scores.
• The authors wrote, “Sensory hypersensitivity to stimuli is most prominent during headache attacks but may also be present during interictal periods. Beyond merely accompanying headache attacks, hypersensitivities to light, sound, and smell have also been reported as premonitory symptoms or triggers before a headache attack. This observation suggests that these sensory hypersensitivity symptoms may reflect abnormal brain activity at the earliest stage of a migraine attack in the absence of pain.”
• The authors found that psychological distress and number of migraine days determined headache-related disability. Specifically, chronic stress can trigger migraines and increase intensity secondary to a hyperalgesic state related to central sensitization or through the activation of N-methyl-D-aspartate (NMDA) receptors or opioid receptors.
• Limitations of the current study include its cross-sectional design and lack of controls. Furthermore, hypersensitivity symptoms were self-reported, and were not assessed via cutoffs or frequency of severity. Lastly, patients with usually severe presentations were selected from an outpatient headache, thus possibly contributing to bias.