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April 21, 2008

Prevalence and characteristics of allodynia in headache sufferers
A population study

M. E. Bigal, MD, PhD, S. Ashina, MD, R. Burstein, M. L. Reed, PhD, D. Buse, PhD, D. Serrano, MA, R. B. Lipton, MD, and On behalf of the AMPP GroupAuthors Info & Affiliations

April 22, 2008 issue

70 (17) 1525-1533

https://doi.org/10.1212/01.wnl.0000310645.31020.b1

Abstract

Objective: The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population.

Methods: We mailed questionnaires to a random sample of 24,000 headache sufferers previously identified from the population. The questionnaire included the validated Allodynia Symptom Checklist (ASC) as well as measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids.

Results: Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity (ASC score ≥3) varied with headache type. Prevalence was significantly higher in transformed migraine (TM, 68.3%) than in episodic migraine (63.2%, p < 0.01) and significantly elevated in both of these groups compared with probable migraine (42.6%), other chronic daily headaches (36.8%), and severe episodic tension-type headache (36.7%). The prevalence of severe CA (ASC score ≥9) was also highest in TM (28.5%) followed by migraine (20.4%), probable migraine (12.3%), other chronic daily headaches (6.2%), and severe episodic tension-type headache (5.1%). In the migraine and TM groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index. In all groups, ASC scores were higher in individuals with major depression.

Conclusions: Cutaneous allodynia (CA) is more common and more severe in transformed migraine and migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.

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Information & Authors

Information

Published In

Neurology^®

Volume 70 • Number 17 • April 22, 2008

Pages: 1525-1533

PubMed: 18427069

Copyright

© 2008.

Publication History

Published online: April 21, 2008

Published in print: April 22, 2008

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Authors

Affiliations & Disclosures

M. E. Bigal, MD, PhD

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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S. Ashina, MD

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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R. Burstein

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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M. L. Reed, PhD

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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D. Buse, PhD

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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D. Serrano, MA

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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R. B. Lipton, MD

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

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On behalf of the AMPP Group

From the Departments of Neurology (M.E.B., S.A., D.B., R.B.L.) and Epidemiology and Population Health (R.B.L.), Albert Einstein College of Medicine, Bronx; The Montefiore Headache Center (M.E.B., R.B.L.), Bronx, NY; The New England Center for Headache (M.E.B.), Stamford, CT; Harvard Medical School (R.B.), Cambridge, MA; Vedanta Research (M.L.R., D.S.), Chapel Hill, NC; and Merck Research Laboratories (M.E.B.), Whitehouse Station, NJ.

Notes

Address correspondence and reprint requests to Dr. Marcelo E. Bigal, Global Director, Scientific Affairs, Neuroscience, One Merck Drive, P.O. Box 100, Whitehouse Station, NJ 08889-0100 [email protected]

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