Allodynia in migraine: Frequent random association or unavoidable consequence?

Carlo Lovati, Domenico D'Amico, Pierluigi Bertora

Research output: Contribution to journalArticle

Abstract

Allodynia, the perception of pain induced by a non-painful stimulus, is frequently associated with migraine, especially when chronic, and mainly in the aura subtype. Among migraineurs, allodynia is thought to be caused by the headache and the activation of nociceptors with the development of central sensitization in subjects with an altered regulation of the central nociceptive pathway. The persistence of pain sensation seems to be able to induce central sensitization in the caudal nucleus of the trigeminal nerve by lowering the neuronal pain threshold. Different pathogenetic mechanisms may be involved and genetic, environmental and psychological elements should be considered. The complaint of allodynia is more frequent during the headache attack (acute allodynia) than in-between attacks (interictal allodynia). Acute allodynia is generally referred to the painful region but may diffuse to other areas, cephalic or even extracephalic. Extracephalic allodynia could not be mediated by nucleus caudalis as its neurons do not express whole-body receptive fields. The likely mechanism is thalamic sensitization. This symptom must be carefully assessed because it may be as annoying and limiting in daily activities as pain itself, and because its presence seems to reduce the efficacy of drugs used for migraine attacks. Instrumental measures may be applied, and clinical questionnaires to assess the presence of allodynic symptoms have also been developed and validated. All these aspects will be discussed.

Original languageEnglish
Pages (from-to)395-408
Number of pages14
JournalExpert Review of Neurotherapeutics
Volume9
Issue number3
DOIs
Publication statusPublished - Mar 2009

Fingerprint

Hyperalgesia
Migraine Disorders
Central Nervous System Sensitization
Headache
Pain
Nociceptors
Pain Perception
Trigeminal Nerve
Pain Threshold
Epilepsy
Head
Psychology
Neurons
Pharmaceutical Preparations

Keywords

  • Allodynia
  • Aura
  • Headache
  • Migraine
  • Pain
  • Sensitization
  • Triptans

ASJC Scopus subject areas

  • Clinical Neurology
  • Neuroscience(all)
  • Pharmacology (medical)

Cite this

Allodynia in migraine : Frequent random association or unavoidable consequence? / Lovati, Carlo; D'Amico, Domenico; Bertora, Pierluigi.

In: Expert Review of Neurotherapeutics, Vol. 9, No. 3, 03.2009, p. 395-408.

Research output: Contribution to journalArticle

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