Pain Processing in Adults With Migraines
| Status: | Recruiting |
|---|---|
| Conditions: | Migraine Headaches |
| Therapuetic Areas: | Neurology |
| Healthy: | No |
| Age Range: | 18 - Any |
| Updated: | 11/16/2018 |
| Start Date: | January 2016 |
| End Date: | July 2020 |
| Contact: | Rebecca E Wells, MD, MPH |
| Email: | rewells@wakehealth.edu |
| Phone: | 336-716-2357 |
Primary Objective of this study: To assess experimental heat pain responses (pain intensity,
pain unpleasantness, pain catastrophizing, emotional reactivity) in migraineurs vs. healthy
controls.
The current tools of migraine pain measurement are inadequate to distinguish the overall
burden of suffering, as there is an over reliance on a single numerical pain score to
represent the entire pain experience. Measuring and targeting the affective component, in
addition to the sensory component of pain, may capture this discrepancy in disease burden.
The affective component of migraine pain may be just as important as the sensory component to
target and measure since it significantly impacts outcomes, disability, and has therapeutic
treatment implications.
Quantitative sensory testing (QST) is a robust lab paradigm (not a clinical experience) that
delivers one painful noxious thermal stimuli and asks for simultaneous pain intensity and
pain unpleasantness scores. By using this in the research, investigators will be able to
differentiate the sensory (pain quality—what the pain feels like) from the affective (how
awful/unpleasant the pain feels) components of experimental pain in normal controls vs.
migrainuers.
No previous studies have evaluated differences in experimental pain intensity vs. pain
unpleasantness in migraineurs vs. controls. As migraine pain uniquely involves many altered
sensory phenomenon (e.g., photophobia, phonophobia), it cannot be assumed that responses to
experimental pain in migraine will be the same as other clinical pain syndromes. Further,
different clinical pain syndromes have distinct responses to pain intensity vs. pain
unpleasantness.
pain unpleasantness, pain catastrophizing, emotional reactivity) in migraineurs vs. healthy
controls.
The current tools of migraine pain measurement are inadequate to distinguish the overall
burden of suffering, as there is an over reliance on a single numerical pain score to
represent the entire pain experience. Measuring and targeting the affective component, in
addition to the sensory component of pain, may capture this discrepancy in disease burden.
The affective component of migraine pain may be just as important as the sensory component to
target and measure since it significantly impacts outcomes, disability, and has therapeutic
treatment implications.
Quantitative sensory testing (QST) is a robust lab paradigm (not a clinical experience) that
delivers one painful noxious thermal stimuli and asks for simultaneous pain intensity and
pain unpleasantness scores. By using this in the research, investigators will be able to
differentiate the sensory (pain quality—what the pain feels like) from the affective (how
awful/unpleasant the pain feels) components of experimental pain in normal controls vs.
migrainuers.
No previous studies have evaluated differences in experimental pain intensity vs. pain
unpleasantness in migraineurs vs. controls. As migraine pain uniquely involves many altered
sensory phenomenon (e.g., photophobia, phonophobia), it cannot be assumed that responses to
experimental pain in migraine will be the same as other clinical pain syndromes. Further,
different clinical pain syndromes have distinct responses to pain intensity vs. pain
unpleasantness.
Investigators will conduct a cross-sectional study in migraineurs (interictally, i.e.,
between migraine attacks) and healthy controls to compare responses to experimental heat pain
intensity and unpleasantness and correlate these results to differences in emotional
reactivity and pain catastrophizing.
between migraine attacks) and healthy controls to compare responses to experimental heat pain
intensity and unpleasantness and correlate these results to differences in emotional
reactivity and pain catastrophizing.
Inclusion Criteria:
1. Inclusion criteria for Healthy Controls:
- ≥18yo;
2. Inclusion Criteria for Migraineurs:
- ≥18yo with >1 yr of migraines and currently 4-20 days/month with migraines,
although no migraine within 48 hrs of study visit.
Exclusion Criteria:
1. Any major unstable medical/psychiatric illness (e.g., hospitalization within 90 days,
suicide risk, etc.)
2. Severe clinical depression/anxiety
3. Chronic pain condition (e.g., fibromyalgia, migraines for healthy controls, etc.) or
sensory abnormalities (e.g., neuropathy, Raynaud's, etc.)
4. Diagnosis of medication overuse headache or chronic migraine.
5. Migraineurs will be studied after being headache-free for at least 48 hours
(interictally).
6. Participants may be currently taking migraine medications, as long as they do not have
a diagnosis of medication overuse headache.
7. Pregnant subjects will be excluded from all portions of the study due to possible
unknown risks of frankly noxious stimuli.
8. Due to unknown risks and potential harm to the unborn fetus, sexually active women of
childbearing potential must use a reliable method of birth control while participating
in this study
9. Volunteers with no pain ratings to frankly noxious stimuli (temperatures > 49°C) or
excessive responses to threshold temperatures (~43°C)
We found this trial at
1
site
1 Medical Center Blvd
Winston-Salem, North Carolina 27157
Winston-Salem, North Carolina 27157
336-716-2011
Phone: 336-716-2357
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