###### Abstract  
Background: In addition to being highly distressing, chronic migraine headaches are a major socioeconomic challenge. Like other pain syndromes, migraine headaches are associated with psychological and physiological impairments, including sensorimotor and somatosensory deficits. Aim: This study aims to explore whether patients with high-frequency or chronic migraine differ from a healthy population in the areas of laterality recognition (LAT) and facial emotion recognition (FER) and whether there are correlations between these areas and central sensitization of pain and psychological components like stress, depression, anxiety, and alexithymiaa. Methods: Using a cross-sectional design, individuals with high-frequency or chronic (ICHD classification) migraine (migraine group MG = 45) and healthy individuals (control group CG = 25) were studied using LAT testing (hand, neck, and face); FER testing; and questionnaires, including the Central Sensitization Inventory (CSI) and the Toronto Alexithymiaa Scale (TAS-20). Results: Data from 70 participants were collected for analysis. Statistically significant differences were found only in the assessment of central sensitization (\(p<0.001\)). Weak to moderate monotonic correlations were found for the MG, especially between alexithymiaa detection (TAS-20) and facial emotion recognition (FER test). Discussion: The methodological procedure and its accompanying challenges can be seen as limitations of this study. The lack of significant effects must be mentioned, but the selection of the collected questionnaires, the uniform diagnostics, and the statistical processing of a large amount of data represent methodological strengths. Conclusion: The CSI and the TAS-20 could be used in combination with FER to assess chronic migraine. Implementing the described sensorimotor parameters as a therapeutic intervention requires further investigation. headaches, including CM, are among the most challenging pain syndromes [7; 8]. Besides pain, sufferers report significant limitations in daily activities and social interactions, leading to mood disorders and depression [9; 10]. Like other chronic pain syndromes, sufferers withdraw from society and avoid occupational, recreational, and sporting activities. These components are accompanied by mood disorders that can lead to severe depression [10]. In addition to exhibiting fear-avoidance behavior towards movement, individuals with chronic headaches often display compromised movement planning abilities [11; 12]. This encompasses a disrupted capacity for laterality recognition (or left-right recognition (LAT)), which may be a quality of (facial) body distortion. So-called (facial) somatosensory distortions can be defined as a pattern observed during prolonged trigeminal sensitivity, affecting classical headaches and chronic orofacial pain (COFP) [13]. This distortion is characterized by dysfunctional pain processing within the central nervous system, leading to hyperexcitation and neuroplastic changes [13; 14]. These changes are part of the central sensitization phenomenon, which includes generalized mechanical hyperalgesia across the head, face, neck, and other body areas. Additionally, there are alterations in pain modulation, increased pain area expansion, and the presence of psychological factors [15; 16]. Central sensitization itself is a complex physiological process associated with sustained nociception and may result in prolonged pain perception [17]. It is crucial not to assume a causal phenomenon and to pathologize this physiological phenomenon but to understand it as a contribution in the course of a possible chronification of pain [18]. Thus, in chronic migraine, central sensitization may also play a role in sustaining pain perception, in addition to the previously mentioned mechanisms [19].