Localized and widespread pressure pain hypersensitivity in patients with episodic or chronic migraine: A systematic review and meta-analysis
Bibliographic record
Abstract
Abstract ObjectiveThis meta-analysis compared pressure pain sensitivity in trigeminal, cervical spine and remote pain-free areas between migraine patients and headache-free controls considering diagnosis (episodic versus chronic) and sex.<b>Databases and data treatment:</b> Electronic databases were searched for cross-sectional or prospective case-control studies comparing pressure pain thresholds between migraine and headache-free controls. Data were extracted by two reviewers. The risk of bias and methodological quality was assessed by Newcastle-Ottawa Quality Assessment Scale. Meta-analyses of trigeminal, extra-trigeminal (cervical spine) and remote pain-free areas were compared. Frequency of migraine and sex were taken into account. Mean differences (MD) and random effects were calculated.ResultsEighteen studies were included. Patients with migraine showed lower pressure pain thresholds than headache-free controls: trigeminal (MD −71.33 kPa, 95%CI −92.14 to −50.53), cervical spine (MD −68.50 kPa, 95%CI −84.67 to −52.33), and remote pain-free (MD −62.49 kPa, 95%CI −99.52 to −25.45) areas. Differences were consistently significant for episodic migraine in all locations, but only significant in the trigeminal area for chronic migraine (MD −67.36 kOPa, 95%CI −101.31 to −33.42). Overall, women had lower pressure pain thresholds than men. The methodological quality of most studies (66.7%) was good. The results showed a high heterogeneity.ConclusionThis meta-analysis found low to high quality evidence showing lower pressure pain thresholds in trigeminal, extra-trigeminal, and remote pain-free areas in migraine sufferers when compared with headache-free controls. Hypersensitivity to pressure pain locally and widespread was consistently observed in episodic migraine, but locally in chronic migraine as compared to headache-free controls. Women with migraine were more sensitive than men.Registration number: https://doi.org/10.17605/OSF.IO/YJTAK
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.012 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.008 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.032 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".