Compared with nonmenstrual migraine attacks, menstrual migraine attacks have been linked with increased allodynia scores at the onset of migraine attacks, according to a study recently published in Headache.
This prospective cohort study included 32 participants (all women, mean age 27±6.7; mean years with migraine 11.5±7.4) assessed for migraine between March 2013 and July 2014 using the 12-item Allodynia Symptom Checklist (ASC-12). Assessments were completed for both menstrual migraine and nonmenstrual migraine attacks at 1, 2, 4, and 24 hours following migraine onset. The primary outcome was the association between menstrual migraine and allodynia and allodynia severity. Two-tailed testing was performed to test the hypothesis, while 2-way repeated-measure analysis of covariance was used to analyze ASC-12 scores.
Through pairwise comparisons, the menstrual migraine group showed significantly higher ASC-12 scores than the nonmenstrual migraine attacks group at 2 hours (mean difference 2.3; 95% CI, 0.31-4.7; P =.049), though changes at 1 hour (1.8; 95% CI, -0.1 to 3.8; P =.060), 4 hours (1.4; 95% CI, -0.7 to 3.5; P =.199), and 24 hours (-0.03; 95% CI, -1.26 to 1.2; P =.961) did not achieve significance. The Friedman test presented significant differences in average ASC-12 categorical score ranks by condition and time period (P <.001). Menstrual migraine showed significantly higher scores than nonmenstrual migraine attacks at both 1 hour (z Score [z]=-3.08; P =.021) and 4 hours (z=-2.97; P =.030).
Limitations to the generalizability of these findings include a small sample size and the inclusion of participants who were mostly white and from a Brazilian tertiary clinic.
The study researchers concluded that “[menstrual] headache attacks have an influence on allodynia with higher allodynia scores when compared [with] nonmenstrual-related attacks at 1, 2, and 4 hours after the onset of attack.” Furthermore, they identified a “significant effect of the covariates age of menarche and migraine history on allodynia,” though BMI and contraceptive use showed no effect.
Melhado EM, Thiers Rister HL, Galego DR, et al. Allodynia in menstrually related migraine: score assessment by Allodynia Symptom Checklist (ASC-12) [published online October 21, 2019]. Headache. doi: 10.1111/head.13677