## 4 Discussion  
The hypothesis tested in this study was that migraineurs with worse clinical presentations of headache and higher levels of fear of movement and depression would demonstrate less cervical ROM. Our results did not confirm this hypothesis. Among all the correlations analyzed, only depressive symptoms presented as significant; however, weak correlations with the cervical ROM were noted in our sample of migraineurs--the higher the severity of depressive symptoms, the lower the cervical ROM. No other significant correlation was observed between cervical ROM and the remaining clinical variables. The lack of significant correlation between cervical ROM and frequency of migraine have already been reported previously [9; 18]. It contrasts with the lower cervical ROM observed in patients with chronic migraine or transformed migraine (15 or more headache-days per month) compared to controls [9; 42]. Therefore, we suggest that the relationship between cervical ROM and more frequent migraine attacks is not linear. Furthermore, it seems that there is no linear correlation between cervical ROM and the migraine character \begin{table}
\begin{tabular}{c c c c} \hline \hline  & **Sagittal Plane—Degrees** & **Frontal Plane—Degrees** & **Transverse Plane—Degrees** \\ \hline Migraine onset (years) & rho = \(-\)0.07 (\(-\)0.31 to 0.18) & rho = 0.04 (\(-\)0.23 to 0.29) & rho = 0.05 (\(-\)0.20 to 0.29) \\ Migraine frequency & rho = 0.14 (\(-\)0.13 to 0.38) & rho = 0.00 (\(-\)0.25 to 0.23) & rho = 0.07 (\(-\)0.16 to 0.30) \\ (days/month) & r = 0.05 (\(-\)0.21 to 0.32) & r = 0.02 (\(-\)0.19 to 0.28) & r = \(-\)0.02 (\(-\)0.27 to 0.23) \\ Neck pain frequency & rho = 0.06 (\(-\)0.18 to 0.32) & rho = 0.07 (\(-\)0.16 to 0.31) & rho = \(-\)0.003 (\(-\)0.25 to 0.23) \\ Neck pain intensity (NPRS) & rho = 0.11 (\(-\)0.14 to 0.35) & rho = 0.05 (\(-\)0.18 to 0.30) & rho = \(-\)0.006 (\(-\)0.22 to 0.23) \\ Neck pain disability (NDI) & rho = \(-\)0.14 (\(-\)0.26 to 0.25) & rho = \(-\)0.05 (\(-\)0.29 to 0.18) & rho = \(-\)0.05 (\(-\)0.30 to 0.16) \\ Neck pain during cervical & r = \(-\)0.05 (\(-\)0.28 to 0.18) & r = 0.12 (\(-\)0.11 to 0.34) & r = \(-\)0.03 (\(-\)0.26 to 0.20) \\ movement (yes/no) & rho = \(-\)0.05 (\(-\)0.28 to 0.17) & rho = \(-\)0.02 (\(-\)0.22 to 0.26) & rho = \(-\)0.17 (\(-\)0.41 to 0.08) \\ Digressive symptoms (PHQ) & **rho = \(-\)0.30 (\(-\)0.53 to \(-\)0.05)*** & rho = \(-\)0.34 (\(-\)0.54 to \(-\)0.08) \dagger** & rho = \(-\)0.31 (\(-\)0.53 to \(-\)0.06) \dagger** \\ Kinesiophobia (TSK) & r = \(-\)0.14 (\(-\)0.33 to \(-\)0.05) & r = \(-\)0.06 (\(-\)0.28 to 0.16) & r = \(-\)0.21 (\(-\)0.39 to \(-\)0.02) \\ \hline \hline \end{tabular}  
* * \(p\) \(<\) 0.05, \(\dagger\) \(p\) \(<\) 0.01. NPRS: numerical rating pain scale; NDI: Neck Disability Index; MIDAS: Migraine Disability Assessment; PHQ: Patient Health Questionnaire; TSK: Tampa Scale for Kinesiophobia.  
\end{table} 
Table 2: Correlation (95% CI) between cervical range of motion and migraine clinical presentation, depressive symptoms, and kinesiophobia levels in patients with migraine (\(n\) = 70). Figure 3: Association between PHQ scores and cervical range of motion (ROM). PHQ: Patient Health Questionnaire. istics such as years with migraine and migraine-related disability, or neck pain features, such as pain frequency, intensity, and related disability. The relationship between musculoskeletal disorders and depression has already been demonstrated [43]. They are not only comorbid conditions, but also mutually exacerbating and predictors of negative prognosis [26; 27; 44; 45; 46]. Depression is also a well-known comorbidity of migraine with negative repercussions on the patient's life and prognosis [22; 47]. Our results indicated a correlation between depressive symptoms, and cervical ROM, as a higher severity of depressive symptoms in female patients with migraine correlated with lower cervical ROM.