## 5 Discussion
### Methodology  
With respect to the questionnaires used in this study, it cannot be excluded that the inclusion of further or other questionnaires could have had an impact of the interpretation of the results. alexithymia is primarily assessed using TAS-20 or TAS-26, which are, therefore, an adequate choice for assessing emotional blindness in this study. The same applies to the Central Sensitization Inventory (CSI), although it reflects psychological hypervigilance rather than increased responsiveness of nociceptive neurons [55]. In contrast, an assessment of psychological characteristics such as depression, anxiety, and stress is still possible with a variety of other questionnaires, such as the Beck Depression Inventory (BDI), the Beck Anxiety Inventory (BAI), or the Perceived Stress Questionnaire (PSQ) [56]. However, the abundance of questionnaires already to be answered prompted the study author to use the DASS to cover a wider range of psychological aspects with one questionnaire and to avoid possible non-compliance when completing the questionnaires. In addition, it must be repeated that within the DASS, the depression scale alone, with a sensitivity of 77% and a specificity of 83%, achieves an equally good and partly even better result than the described scores to validly detect depression utilizing a questionnaire. The NOT\({}^{\text{\textregistered}}\) Recognise programs represent the best available application for this purpose. Additionally, using these programs facilitates comparability with other studies that have also employed them [11; 20; 26]. In contrast, the CRAFTA\({}^{\text{\textregistered}}\) \"myfacetraining\" program remains insufficiently studied. Consequently, comparing the present results with other studies is challenging. The most common method for assessing emotion recognition is the FEEL test (Facially Expressed Emotion Labeling--Test), which has already been used \begin{table}
\begin{tabular}{c c c} \hline \hline
**Emotion** & **Migraine Group** & **Control Group** \\
**Spearman’s \(\boldsymbol{\rho}\) (rho)** & **Spearman’s \(\boldsymbol{\rho}\) (rho)** \\
**Significance \(\boldsymbol{p}\) Values** & **Significance \(\boldsymbol{p}\) Values** \\ \hline Fear & \(-0.24\) * (\(p=0.11\)) & \(-0.44\) * (\(p=0.03\)) \\ Disgust & \(0.03\) (\(p=0.16\)) & \(-0.21\) * (\(p=0.33\)) \\ Surprised & \(-0.22\) * (\(p=0.16\)) & \(-0.26\) * (\(p=0.21\)) \\ Happy & \(-0.21\) * (\(p=0.16\)) & \(0.03\) (\(p=0.88\)) \\ Sad & \(-0.27\) * (\(p=0.07\)) & \(0.04\) (\(p=0.87\)) \\ Angry & \(-0.24\) * (\(p=0.11\)) & \(-0.06\) (\(p=0.77\)) \\ Total number of wrong answers & \(0.21\) * (\(p=0.16\)) & \(0.48\) * (\(p=0.02\)) \\ Total number unanswered & \(0.19\) (\(p=0.21\)) & \(0.06\) (\(p=0.77\)) \\ Average response time & \(0.08\) (\(p=0.59\)) & \(-0.05\) (\(p=0.81\)) \\ \hline \hline \end{tabular}  
* Weak to moderate correlation.  
\end{table} 
Table 4: Correlations between TAS-20 and facial emotion recognition. in several psychiatric-psychological studies, as well as comparable physiotherapeutic studies [57; 58; 59; 60; 61; 62]. To date, there is a lack of meaningful correlation studies that support the validity of CRAFTA(r) \"myfacetraining\" and can, thus, clarify the results of this study. This program was chosen for its ease of accessibility, user-friendliness, and evaluation parameters of speed and accuracy. However, further research is needed. The good standardization of the test battery enhances the results' significance. Notably, this study adds ideas and reflects possible challenges for further research on this topic by exploring facial emotion recognition in the context of chronic migraine--an area not previously researched. This study's cross-sectional design presents certain limitations, such as the inability to make clear causal determinations or consider risk factors fully. Additionally, recording rare pathologies and diseases requires a large number of subjects, which was challenging in this work.