TY - JOUR
T1 - Predictors of allodynia in persons with migraine
T2 - Results from the Migraine in America Symptoms and Treatment (MAST) study
AU - Dodick, David W.
AU - Reed, Michael L.
AU - Fanning, Kristina M.
AU - Munjal, Sagar
AU - Alam, Aftab
AU - Buse, Dawn C.
AU - Schwedt, Todd J.
AU - Lipton, Richard B.
N1 - Funding Information:
MLR is an employee of Vedanta Research, which has received support funded by Allergan, Amgen, Colucid, Dr. Reddy’s Laboratories, Eli Lilly, NuPathe, Novartis, and Ortho-McNeil, via grants to the National Headache Foundation.
Funding Information:
KMF is an employee of Vedanta Research, which has received support funded by Allergan, Amgen, Colucid, Dr. Reddy’s Laboratories, Eli Lilly, NuPathe, Novartis, and Ortho-McNeil, via grants to the National Headache Foundation.
Funding Information:
RBL has received grant support from the National Institutes of Health, the National Headache Foundation, and the Migraine Research Fund. He serves as consultant, serves as an advisory board member, or has received honoraria from Alder, Allergan, American Headache Society, Autonomic Technologies, Biohaven, Eli Lilly, eNeura Therapeutics, Merck, Novartis, Pfizer, and Teva, Inc. He receives royalties from Wolff’s Headache, 8th Edition (Oxford University Press, 2009). He holds stock options in eNeura Therapeutics and Biohaven.
Funding Information:
TJS has received grant support from the National Institutes of Health, the United States Department of Defense, the Patient Centered Outcomes Research Institute, the American Migraine Foundation, the Mayo Clinic, and Arizona State University. He is a consultant for Alder, Allergan, Amgen, ATI, Avanir, Eli Lilly, Ispen Bioscience, Nocira, Novartis, Promius Pharma, and Teva. He holds stock options in Aural Analytics, Nocira, and Second Opinion. He receives royalties from UpToDate. He serves on the editorial boards for Headache, Pain Medicine, and Cephalalgia, and is on the Board of Directors of the American Headache Society and the International Headache Society.
Publisher Copyright:
© International Headache Society 2019.
PY - 2019/6/1
Y1 - 2019/6/1
N2 - Background: Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression. Objective: Identify factors associated with allodynia in a sample of adults with migraine. Methods: An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95% confidence intervals (CI) were calculated. Results: In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0% were female, and 81.0% were Caucasian. Allodynia was present in 39.9%. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model. Conclusion: In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.
AB - Background: Cutaneous allodynia is a common clinical feature of migraine that has been associated with reduced efficacy of acute migraine treatments and an increased risk of disease progression. Objective: Identify factors associated with allodynia in a sample of adults with migraine. Methods: An online survey panel was used to identify adults with migraine who averaged at least 1 monthly headache day over the previous 3 months. Data on sociodemographics, headache frequency, headache pain intensity, migraine symptom severity, medication use, depression and anxiety, and cutaneous allodynia (via the Allodynia Symptom Checklist) were obtained. Binary logistic modeling predicted the presence of allodynia. Odds ratios and 95% confidence intervals (CI) were calculated. Results: In total, 15,133 individuals with migraine met the eligibility criteria. Mean age was 43.1 years, 73.0% were female, and 81.0% were Caucasian. Allodynia was present in 39.9%. The fully adjusted model, controlling for sociodemographics and headache features, demonstrated that allodynia was significantly associated with a higher migraine symptom severity score (odds ratio 1.17, confidence interval 1.15, 1.19) and more severe pain intensity (odds ratio 1.11, confidence interval 1.08, 1.14); probable depression and/or anxiety (odds ratio 1.83, confidence interval 1.67, 2.00); and overuse of acute medication (odds ratio 1.23, confidence interval 1.09, 1.38). A higher number of monthly headache days increased the likelihood of allodynia, but the effect was attenuated in the fully adjusted model. Conclusion: In a representative sample of US adults with migraine, there were significant associations between allodynia and headache frequency and intensity, anxiety and/or depression, symptom severity, and acute medication overuse.
KW - Migraine
KW - acute medication overuse
KW - anxiety
KW - cutaneous allodynia
KW - depression
KW - epidemiology
KW - headache frequency
KW - headache pain intensity
KW - migraine symptom severity
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U2 - 10.1177/0333102418825346
DO - 10.1177/0333102418825346
M3 - Article
C2 - 30732460
AN - SCOPUS:85061927441
SN - 0333-1024
VL - 39
SP - 873
EP - 882
JO - Cephalalgia
JF - Cephalalgia
IS - 7
ER -