Impact of migraine on fibromyalgia symptoms

The Journal of Headache and Pain

Research Article

Andrea Negro¹  Paolo Martelletti¹  Martina Curto¹  Domenico Lapenna²  Cosima Schiavone²  Luisa Stellin²  Giannapia Affaitati³  Francesco Cipollone³  Maria Adele Giamberardino³  Raffaele Costantini⁴  Claudio Tana⁵ 

[1] Department of Clinical and Molecular Medicine, Regional Referral Headache Centre, “Sant’Andrea” Hospital, “Sapienza” University, Rome, Italy;Department of Medicine and Science of Aging, “G. D’Annunzio” University of Chieti, Chieti, Italy;Fibromyalgia and Headache Center, Geriatrics Clinics, Department of Medicine and Science of Aging and Ce.S.I., “G. D’Annunzio” University of Chieti, via dei Vestini s.n., 66100, Chieti, Italy;Institute of Surgical Pathology, “G. D’Annunzio” University of Chieti, Chieti, Italy;Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Reggio Emilia, Italy;

关键词: Migraine;    Fibromyalgia;    Pain thresholds;    Tender points;    Hyperalgesia;    Central sensitization;   

DOI  :  10.1186/s10194-016-0619-8

 received in 2015-12-31, accepted in 2016-03-17,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundFibromyalgia (FMS) and high frequency episodic/chronic migraine (M) very frequently co-occur, suggesting common pathophysiological mechanisms; both conditions display generalized somatic hyperalgesia. In FMS-M comorbidity we assessed if: a different level of hyperalgesia is present compared to one condition only; hyperalgesia is a function of migraine frequency; migraine attacks trigger FMS symptoms.MethodsFemale patients with fibromyalgia (FMS)(n.40), high frequency episodic migraine (M1)(n.41), chronic migraine (M2)(n.40), FMS + M1 (n.42) and FMS + M2 (n.40) underwent recording of: −electrical pain thresholds in skin, subcutis and muscle and pressure pain thresholds in control sites, −pressure pain thresholds in tender points (TePs), −number of monthly migraine attacks and fibromyalgia flares (3-month diary). Migraine and FMS parameters were evaluated before and after migraine prophylaxis, or no prophylaxis, for 3 months with calcium-channel blockers, in two further FMS + H1 groups (n.49, n.39). 1-way ANOVA was applied to test trends among groups, Student’s t-test for paired samples was used to compare pre and post-treatment values.ResultsThe lowest electrical and pressure thresholds at all sites and tissues were found in FMS + M2, followed by FMS + H1, FMS, M2 and M1 (trend: p < 0.0001). FMS monthly flares were progressively higher in FMS, FMS + M1 and FMS + M2 (p < 0.0001); most flares (86–87 %) occurred within 12 h from a migraine attack in co-morbid patients (p < 0.0001). Effective migraine prophylaxis vs no prophylaxis also produced a significant improvement of FMS symptoms (decreased monthly flares, increased pain thresholds)(0.0001 < p < 0.003).ConclusionsCo-morbidity between fibromyalgia and migraine involves heightened somatic hyperalgesia compared to one condition only. Increased migraine frequency – with shift towards chronicity – enhances both hyperalgesia and spontaneous FMS pain, which is reversed by effective migraine prophylaxis. These results suggest different levels of central sensitization in patients with migraine, fibromyalgia or both conditions and a role for migraine as a triggering factor for FMS.

【 授权许可】

CC BY   
© Giamberardino et al. 2016