Impact of visceral pain on migraine symptoms in comorbid patients: a retrospective observational study
Abstract
BACKGROUND: Visceral pain and migraine, especially at a high frequency/chronic, are frequent comorbidities, but little is known about their mutual influences. This study investigated if visceral pain-migraine comorbidity involves higher migraine pain and somatic hyperalgesia than migraine-only and if effective visceral pain treatment also improves migraine and hyperalgesia parameters.
METHODS: Retrospective analysis of 2,903 charts of migraine patients presenting at a Hospital Headache Center for a first visit over 3 years, + 1 follow-up year. Selected charts of female patients meeting inclusion criteria were: 117 migraine-only and 139 migraine + visceral pain, including 50 dysmenorrhea, 48 irritable bowel syndrome (IBS), 41 painful bladder syndrome/recurrent infectious cystitis (PBS/C). They were reviewed for migraine parameters: monthly attacks, symptomatic consumption and pain intensity, for visceral pain: painful menstrual cycles, IBS and bladder pain days, and for sensory parameters: muscle, subcutis and skin electrical pain thresholds, pressure pain thresholds at three sites (trapezius, deltoid and quadriceps), all routinely part of the visit. Migraine-only (M) and migraine + visceral pain (M + VP) patients were compared. In comorbid subgroups, all under the same migraine prophylaxis, the effects of visceral treatment, i.e., 21 hormonal/laser for endometriosis in primary/secondary dysmenorrhea, 25 dietary in IBS, 23 bladder instillations in PBS or antibiotics in…
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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.
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