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Open Access 01-12-2018 | Research article

Upper cervical two-point discrimination thresholds in migraine patients and headache-free controls

Authors: Kerstin Luedtke, Waclaw Adamczyk, Katrin Mehrtens, Inken Moeller, Louisa Rosenbaum, Axel Schaefer, Janine Schroeder, Tibor Szikszay, Christian Zimmer, Bettina Wollesen

Published in: The Journal of Headache and Pain | Issue 1/2018

Abstract

Background

Chronic pain including migraine is associated with structural and functional changes in the somatosensory cortex. Previous reports proposed two-point discrimination (TPD) as a measurement for cortical alterations. Limited evidence exists for tactile acuity in the neck and no data is available for migraine.

Methods

To introduce a standardized protocol for the measurement of TPD in the upper cervical spine, 51 healthy participants were investigated with a newly developed paradigm which was evaluated for intra-rater reliability. The same protocol was applied by two further examiners to 28 migraine patients and 21 age-, and gender-matched healthy controls to investigate inter-rater reliability and between group differences.

Results

Results indicated excellent intra-rater (right ICC_(2,4) = 0.82, left ICC_(2,4) = 0.83) and good inter-rater reliability (right ICC_(2,4) = 0.70, left ICC_(2,4) = 0.75). Migraine patients had larger TPD thresholds (26.86 ± 7.21) than healthy controls (23.30 ± 6.17) but these became only statistically significant for the right side of the neck (p = 0.02). There was a significant, moderate association with age for the right side (r = 0.42 p = 0.002, n = 51), and less strong association for the left side (r = 0.34, p = 0.14) in healthy individuals. TPD did not correlate with headache days per month or the dominant headache side in migraine patients.

Conclusions

Surprisingly, migraine patients showed increased TPD thresholds in the upper cervical spine interictally. Although a body of evidence supports that hypersensitivity is part of the migraine attack, the current report indicates that interictally, migraine patients showed worse tactile acuity similar to other chronic pain populations. This has been hypothesized to indicate structural and functional re-organisation of the somatosensory cortex.

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Title: Upper cervical two-point discrimination thresholds in migraine patients and headache-free controls
Authors: Kerstin Luedtke
Waclaw Adamczyk
Katrin Mehrtens
Inken Moeller
Louisa Rosenbaum
Axel Schaefer
Janine Schroeder
Tibor Szikszay
Christian Zimmer
Bettina Wollesen
Publication date: 01-12-2018
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2018
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-018-0873-z

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Upper cervical two-point discrimination thresholds in migraine patients and headache-free controls

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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