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Quantitative sensory testing in patients with migraine: a systematic review and meta-analysis

Nahman-Averbuch, Hadasa,*; Shefi, Tomb; Schneider, Victor J. IIa; Li, Danc; Ding, Lilic; King, Christopher D.a; Coghill, Robert C.a

doi: 10.1097/j.pain.0000000000001231
Systematic Reviews and Meta-Analysis
Global Year 2018

Quantitative sensory testing (QST) is widely used to assess somatosensory function by application of controlled stimuli across a variety of modalities. The aim of the present meta-analysis is to synthesize QST results across a wide array of studies of patients with migraine to identify the QST parameters that are reliably different between patients with migraine and healthy controls. In addition, we aimed to determine whether such differences vary according to stimulus location. A comprehensive literature search (up to January 2017) was conducted, which included studies comparing QST parameters between patients with migraine and healthy controls. For each QST modality, we calculated up to 3 meta-analyses for combined (combined data from multiple testing locations), local (head and neck), and nonlocal (outside the head or neck) locations. A total of 65 studies were included in the meta-analyses. Lower heat and pressure pain thresholds were observed in patients with migraine compared with healthy controls in the combined locations. Importantly, lower pressure pain threshold in patients with migraine was found in local areas but not in nonlocal areas. In addition, patients with migraine had higher pain ratings to cold suprathreshold stimuli for combined and nonlocal areas, and higher pain ratings to electrical suprathreshold stimuli for nonlocal areas. This meta-analysis indicates that the alterations in nociceptive processing of patients with migraine may be modality, measure, and location specific. These results provide researchers and clinicians the evidence to choose QST parameters optimally suited for differentiating patients with migraine and healthy controls.

aDepartment of Anesthesia, Cincinnati Children's Hospital, Cincinnati, OH, United States

bThe Laboratory of Clinical Neurophysiology, The Rappaport Faculty of Medicine, Technion—Israel Institute of Technology, Haifa, Israel

cDivision of Biostatistics and Epidemiology, Cincinnati Children's Hospital, Cincinnati, OH, United States

Corresponding author. Address: Department of Anesthesia, Cincinnati Children's Hospital, 3333 Burnet Ave, Cincinnati, OH 45229-3026, United States. Tel.: +1 513-560-3135. E-mail address: (H. Nahman-Averbuch).

Sponsorships or competing interests that may be relevant to content are disclosed at the end of this article.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Web site (

Received September 11, 2017

Received in revised form March 21, 2018

Accepted March 28, 2018

© 2018 International Association for the Study of Pain
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