Is phonophobia associated with cutaneous allodynia in migraine?

Abstract

Objective: To determine whether phonophobia and dynamic mechanical (brush) allodynia are associated in episodic migraine (EM).

Methods: Adult patients with EM were prospectively recruited. A structured questionnaire was used to obtain demographic and migraine related data. Phonophobia was tested quantitatively using a real time sound processor and psychoacoustic software. Sound stimuli were pure tones at frequencies of 1000 Hz, 4000 Hz and 8000 Hz, delivered to both ears at increasing intensities, until an aversive level was reached. Allodynia was assessed by brushing the patient's skin with a gauze pad at different areas. Patients were tested both between and during acute attacks. Sound aversion thresholds (SATs) in allodynic and non-allodynic patients were compared.

Results: Between attacks, SATs were lower in allodynic compared with non-allodynic patients, with an average difference of -5.7 dB (p=0.04). During acute attacks, the corresponding average SAT difference (allodynic-non-allodynic) was -15.7 dB (p=0.0008). There was a significant negative correlation between allodynia scores and SATs, both within and between attacks.

Conclusions: The results support an association between phonophobia and cutaneous allodynia in migraine.

Figures

Figure 1

Sound aversion thresholds (mean (SEM)) between attacks in non-allodynic and allodynic patients.

Figure 2

Sound aversion thresholds (mean (SEM)) during an acute attack in non-allodynic and allodynic patients.

Figure 3

Allodynia scores versus sound aversion thresholds (SATs) during acute attacks.

Figure 4

Subjective rating of phonophobia during the acute attack, in relation to that between attacks, in non-allodynic and allodynic patients.