title: Thermal pain thresholds are decreased in the migraine preattack phase.
abstract: OBJECTIVE
  Migraine patients may have cutaneous allodynia during attacks. In order to investigate if pain physiology changes in the preattack phase we estimated heat pain and cold pain detection threshold (HPT and CPT) on three different days in 41 migraine patients and 28 controls.
  
  
  METHODS
  A thermode was applied at four sites bilaterally: forehead, face, neck, and hand. A subgroup of 11 migraine patients had been tested within 24 h before their next attack and in the interictal phase.
  
  
  RESULTS
  In the preattack phase, HPT was lower compared with the paired interictal recording for the hand (44.8 degrees C vs. 45.9 degrees C, P = 0.009), neck (46.8 degrees C vs. 48.2 degrees C, P = 0.02), and forehead (45.1 degrees C vs. 46.3 degrees C, P = 0.02). Neck and hand CPT were higher in the preattack phase than interictally (10 degrees C vs. 7.3 degrees C, P = 0.01 and 11.6 degrees C vs. 9.4 degrees C, P = 0.06, respectively). Preattack forehead changes were most apparent on the headache side of the subsequent attack.
  
  
  CONCLUSIONS
  Subclinical preattack thermal pain hypersensitivity seems to be a feature of the process that leads to a migraine attack.
authors.affiliation: Department of Neuroscience, Norwegian University of Science and Technology, St Olavs University Hospital, Trondheim, Norway. trond.sand@ntnu.no
authors.forename: T
authors.initials: T
authors.lastname: Sand
authors.forename: N
authors.initials: N
authors.lastname: Zhitniy
authors.forename: K B
authors.initials: KB
authors.lastname: Nilsen
authors.forename: G
authors.initials: G
authors.lastname: Helde
authors.forename: K
authors.initials: K
authors.lastname: Hagen
authors.forename: L J
authors.initials: LJ
authors.lastname: Stovner
mesh_terms: D000368:Aged; D001921:Brain / Q000503:physiopathology; D003080:Cold Temperature / Q000009:adverse effects; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects; D006801:Humans; D006930:Hyperalgesia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications* / Q000503:physiopathology*; D009434:Neural Pathways / Q000503:physiopathology; D009460:Neurologic Examination; D009619:Nociceptors / Q000502:physiology; D010147:Pain Measurement / Q000379:methods; D017288:Pain Threshold / Q000502:physiology*; D010812:Physical Stimulation; D011237:Predictive Value of Tests; D012867:Skin / Q000294:innervation / Q000503:physiopathology; D013697:Thermosensing / Q000502:physiology; D014276:Trigeminal Nerve / Q000503:physiopathology