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. 2008 Feb;63(2):148-58.
doi: 10.1002/ana.21211.

Cutaneous allodynia in the migraine population

Richard B Lipton  1 , Marcelo E Bigal, Sait Ashina, Rami Burstein, Stephen Silberstein, Michael L Reed, Daniel Serrano, Walter F Stewart; American Migraine Prevalence Prevention Advisory Group
Affiliations

Cutaneous allodynia in the migraine population

Richard B Lipton et al. Ann Neurol. 2008 Feb.

Abstract

Objective: To develop and validate a questionnaire for assessing cutaneous allodynia (CA), and to estimate the prevalence and severity of CA in the migraine population.

Methods: Migraineurs (n = 11,388) completed the Allodynia Symptom Checklist, assessing the frequency of allodynia symptoms during headache. Response options were never (0), rarely (0), less than 50% of the time (1), > or = 50% of the time (2), and none (0). We used item response theory to explore how well each item discriminated CA. The relations of CA to headache features were examined.

Results: All 12 questions had excellent item properties. The greatest discrimination occurred with CA during "taking a shower" (discrimination = 2.54), wearing a necklace (2.39) or ring (2.31), and exposure to heat (2.1) or cold (2.0). The factor analysis demonstrated three factors: thermal, mechanical static, and mechanical dynamic. Based on the psychometrics, we developed a scale distinguishing no CA (scores 0-2), mild (3-5), moderate (6-8), and severe (> or = 9). The prevalence of allodynia among migraineurs was 63.2%. Severe CA occurred in 20.4% of migraineurs. CA was associated with migraine defining features (eg, unilateral pain: odds ratio, 2.3; 95% confidence interval, 2.0-2.4; throbbing pain: odds ratio, 2.3; 95% confidence interval, 2.1-2.6; nausea: odds ratio, 2.3; 95% confidence interval, 2.1-2.6), as well as illness duration, attack frequency, and disability.

Interpretation: The Allodynia Symptom Checklist measures overall allodynia and subtypes. CA affects 63% of migraineurs in the population and is associated with frequency, severity, disability, and associated symptoms of migraine. CA maps onto migraine biology.

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Fig. 1
Fig. 1
The 12-item Allodynia Symptom Checklist (ASC-12).
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