title: Characterization of Migraineurs Having Allodynia: Results of a Large Population-based Study.
abstract: OBJECTIVE
  Allodynia reflects the clinical correlate of central sensitization, but it is usually neglected in clinical headache management. We aimed to report the prevalence and previously unnoticed associations of allodynia in migraineurs by a nationwide face-to-face questionnaire-based study by physicians.
  
  
  METHODS
  A total of 5323 households were examined for headache according to the diagnostic criteria of International Classification of Headache Disorders-II. Detailed headache features, premonitory signs, demographics, socio-economic status, and hormonal status of female individuals were analyzed with regard to the presence of allodynia in patients with definite migraine.
  
  
  RESULTS
  Allodynia was present in 61.1% of migraineurs in the general population of Turkey. The duration and severity of attacks (P<0.0001), photophobia (P=0.001), phonophobia, and also osmophobia (P<0.0001), as well as premonitory signs (P=0.018), showed significant associations with allodynia. Migraineurs with aura or family history of migraine more often reported allodynia in comparison with those without (P=0.001 and 0.028, respectively). Allodynic migraineurs had a higher rate of physician consults and high levels on the Migraine Disability Assessment questionnaire, reflecting increased burden of headache. Furthermore, migraineurs with allodynia had high probability of attacks close to menses. Migraine improved during pregnancy, but it worsened after menopause or during oral contraceptive use in individuals experiencing allodynia when compared with those without allodynia.
  
  
  CONCLUSIONS
  The duration, severity, and disability of migraine attacks, photophobia, phonophobia, and osmophobia, as well as premonitory signs, showed significant associations with allodynia in the general population. Moreover, migraineurs with aura or family history of migraine more often reported allodynia, and allodynic migraneurs were more sensitive to hormonal changes. Allodynia, which seems to indicate higher tendency to central sensitization, should be implemented in daily headache practice to predict the prognosis and high levels of migraineous involvement.
authors.affiliation: *Department of Neurology, Istanbul Faculty of Medicine ‡Department of Neurology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul †Department of Neurology, Faculty of Medicine, Uludag University, Bursa, Turkey.
authors.forename: Betul
authors.initials: B
authors.lastname: Baykan
authors.forename: Esme
authors.initials: E
authors.lastname: Ekizoglu
authors.forename: Necdet
authors.initials: N
authors.lastname: Karli
authors.forename: Elif
authors.initials: E
authors.lastname: Kocasoy-Orhan
authors.forename: Mehmet
authors.initials: M
authors.lastname: Zarifoglu
authors.forename: Sabahattin
authors.initials: S
authors.lastname: Saip
authors.forename: Aksel
authors.initials: A
authors.lastname: Siva
authors.forename: Mustafa
authors.initials: M
authors.lastname: Ertas
mesh_terms: D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D006930:Hyperalgesia / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology*; D015995:Prevalence; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult