Aspectos somatossensoriais, clínicos, funcionais e psicoemocionais em pacientes com migrânea crônica : estudo caso controle

Abstract

Introduction: Chronic migraine is a type of primary headache that occurs on at least 15 days a month, and eight days a month these headaches have migratory characteristics (duration from 4 to 72 hours, unilateral location, pulsating quality, moderate or severe intensity, aggravated by routine physical activity, association with nausea and / or photophobia and phonophobia and presence of aura in some cases). Its pathophysiology is not yet fully elucidated, being underdiagnosed, undertreated and comorbidities that can affect various aspects in the lives of individuals. Objective: To investigate the somatosensory, clinical, functional and psychoemotional aspects of individuals with chronic migraine with healthy individuals. Methods: Epidemiological, observational, case-control study. Individuals of both sexes, aged 18 to 50 years, with a clinical diagnosis of chronic migraine, and control subjects, between January 2019 and February 2020 were included. Participants were evaluated in the following aspects: pain intensity cervical at rest, during movements of the cervical region and during mechanical pressure in the evaluated muscles (Numerical Scale of 11 points), temporal summation test, conditioned pain modulation test, pressure pain threshold (digital pressure algometer), symptoms central sensitization (Central Sensitization Inventory), allodynamic symptoms (12- item allodynia symptom checklist), cervical range of motion (fleximeter), levels of physical activity (International Physical Activity Questionnaire), cervical disability (Neck Disability Index), kinesiophobia (Tampa Scale Kinesiophobia), pain catastrophizing (Pain Catastrophising Scale), symptoms of anxiety and depression (Hospital Anxiety e Depression Scale), quality of life (Quality of Life Questionnaire), sleep quality (Pittsburgh Sleep Quality Index) and migraine deficiencies (Migraine Disability Assessment). This study considered and met the requirements of the STROBE statement, which provides subsidies for communicating observational studies. The software used to perform the statistical analysis was GraphPad Prism version 6.0 (San Diego, CA, USA). Result: Thirty-two patients with chronic migraine (GM), and 22 volunteers in the healthy control group (CG) were included. The GM presented greater pain intensity during mechanical pressure, greater pain amplification through the temporal summation test, deficits in the endogenous pain control system, lower pressure pain threshold in all evaluated muscles, lower cervical range of motion, greater presence of cervical disabilities and depressive symptoms, in addition to worse quality of life when compared to CG. Conclusion: Patients with chronic migraine showed somatosensory changes in the sensory dimensions of pain, exhibited functional deficits, a high prevalence of cervical disabilities with impairments in the general aspects of quality of life and the presence of depressive symptoms.