Perceived Pain Extent is Not associated with Widespread Pressure Pain Sensitivity, Clinical Features, Related-Disability, Anxiety, or Depression in Women with Episodic Migraine

Research output: Contribution to journalArticlepeer-review


  • Cesar Fernández-de-Las-Peñas
  • María Palacios-Ceña
  • Stella Fuensalidad-Novo
  • Jose L Arias-Buría
  • Alessandro Schneebeli
  • Lars Arend-Nielsen
  • Marco Barbero

External organisations

  • Universidad Rey Juan Carlos
  • Center for Sensory-Motor Interaction
  • Department of Physical Therapy, Universidad Francisco de Vitoria
  • University of Applied Sciences and Arts of Southern Switzerland


OBJECTIVE: People with migraine present with varying pain extent and an expanded distribution of perceived pain may reflect central sensitization. The relationship between pain extent and clinical features, psychological outcomes, related-disability and pressure pain sensitivity in migraine has been poorly investigated. Our aim was to investigate whether the perceived pain extent, assessed from pain drawings, relates to measures of pressure pain sensitivity, clinical, psychological outcomes, and related-disability in women with episodic migraine.

METHODS: Seventy-two women with episodic migraine completed pain drawings which were subsequently digitized allowing pain extent to be calculated utilising novel software. Pressure pain thresholds (PPT) were assessed bilaterally over the temporalis muscle (trigeminal area), the cervical spine (extra-trigeminal area) and tibialis anterior muscle (distant pain-free area). Clinical features of migraine, migraine related-disability (migraine disability assessment questionnaire, MIDAS), anxiety and depression (Hospital Anxiety-Depression Scale, HADS) were also assessed. Spearman rho correlation coefficients were computed to reveal correlations between pain extent and the remaining outcomes.

RESULTS: No significant associations were observed between pain extent and PPTs in trigeminal, extra-trigeminal or distant pain-free areas, migraine pain features, or psychological variables including anxiety or depression and migraine related-disability.

CONCLUSIONS: Pain extent within the trigemino-cervical area was not associated with any of the measured clinical outcomes and not related to the degree of pressure pain sensitization in women with episodic migraine. Further research is needed to determine if the presence of expanded pain areas outside of the trigeminal area can play a relevant role in the sensitization processes in migraine.


Original languageEnglish
JournalClinical Journal of Pain
Early online date20 Jul 2017
Publication statusE-pub ahead of print - 20 Jul 2017


  • Journal Article, migrane , pain area , pressure pain , anxiety , depression , sensitization