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Prevalence and Characteristics of Allodynia
in Headache Sufferers: A Population Study
Bigal ME, Ashina S, Burstein R, et al.
Posted: October 2008  
Neurology   2008;70:1525-1533

Objective:   The authors estimated the prevalence and severity of cutaneous allodynia (CA) in individuals with primary headaches from the general population.

Methods:   We mailed questionnaires to a random sample of 24,000 headache sufferers. The questionnaires included measures of headache features, disability, and comorbidities. We modeled allodynia as an outcome using headache diagnosis, frequency and severity of headaches, and disability as predictor variables in logistic regression. Covariates included demographic variables, comorbidities, use of preventive medication, and use of opioids.

Results:   Complete surveys were returned by 16,573 individuals. The prevalence of CA of any severity varied with headache type. Prevalence was significantly higher in transformed migraine than in episodic migraine and significantly elevated in both of these groups compared with probable migraine, other chronic daily headaches, and severe episodic tension-type headache. The prevalence of severe CA was also highest in transformed migraine followed by migraine, probable migraine, other chronic daily headaches, and severe episodic tension-type headache. In the migraine and transformed migraine groups, prevalence of CA was higher in women and increased with disability score. Among migraineurs, CA increased with headache frequency and body mass index.

Conclusions:   Cutaneous allodynia is more common and more severe in transformed migraine than in other primary headaches. Among migraineurs, CA is associated with female sex, headache frequency, increased body mass index, disability, and depression.