Muscle Tenderness and Hardness in Migraine Patients

Study Overview
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Brief Summary
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The aim of the study is to examine symptomatology, quantitative sensory test (QST) parameters, muscle tenderness and muscle hardness in migraine patients interictally and compare with healthy controls

Detailed Description
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Migraine patients exhibit different symptomatology and responses to treatment. For example do many migraine patients have neck symptoms, despite they apparently do not have any neck disorders.Furthermore the response to treatment differs between patients. Differences in symptomatology, QST parameters and muscle stiffness can be used to subdivide and phenotype migraine patients. The investigators are examining migraine patients with: A semistructured interview, Quantitative sensory testing (cold pain threshold, heat pain threshold and Pin Prick), Muscle tenderness (total tenderness score, local tenderness score and stimulus response curve), and muscle hardness with ultrasound elastography. All tests are performed the same day

Official Title
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Muscle Tenderness and Hardness in Migraine Patients

Conditions
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Migraine Disorders, Muscle Tenderness, Headache Disorders, Primary, Nervous System Diseases, Headache, Migraine

Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Migraine Patients from the Danish Headache Centre. Migraine classified using the International Classification of Headache Disorders (ICHD3) criteria. Exclusion Criteria: Pregnant or lactating women Musculoskeletal injuries in the neck or shoulder Other primary headache disorders than migraine or Tension Type Headache On the time of examination: Migraine free for at least 48 hours On the time of examination: haven't trained the upper body for at least 48 hours On the time of examination: haven't used painkillers for at least 48 hours Healthy controls: Exclusion Criteria: Pregnant or lactating women Musculoskeletal injuries in the neck or shoulder Migraine disorders 1. degree relatives with migraine disorders Over 1 day of tension type headache a month. On the time of examination: haven't trained the upper body for at least 48 hours On the time of examination: haven't used painkillers for at least 48 hours

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Migraine patients<br>Migraine patients attending the Danish Headache Centre | |
| Healthy Controls<br>Age and sex matched | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Logistic regression model, Neck Stiffness | We would like to examine the relationship between the variable variable: Neck stiffness during migraine attack (Yes/No) and the Independent variables: Total Tenderness Score (summed score from 8 points bilateral, each point can score 0-3), Migraine localisation (occipital: Yes/No), Tension Type Headache, Allodynia (yes/No), Stimulus response curve (Pressure and Pain). The result shows how much of the variability in neck stiffness that can be explained by the independent variables. | 3 hours | 
| Pericranial Muscle Tenderness | We will examine whether patients with neck stiffness during migraine attack (yes/no) have higher tenderness scores compared to patients without neck stiffness during migraine attacks, when correcting for headache frequency. | 3 hours | 
| Muscle Hardness measured by ultrasound elastography | Muscle hardness (m/s) in migraine patients compared to healthy controls.corrected for age, BMI and sex | 3 hours | 
| Muscle hardness measured by ultrasound elastography in migaine patients | Muscle hardness (m/s) in migraine patients with neck stiffness during migraine attacks compared to migraine patients without neck stiffness during migraine attacks. Corrected for age, BMI and sex. | 3 hours | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Multiple Regression model, Total Tenderness Score | We would like to examine the relationship between the dependent variable: Total Tenderness Score(summed score from 8 points bilateral, each point can score 0-3), and the Independent variables: Neck Pain in general(Yes/No), Migraine localisation (occipital: Yes/No), Headache Frequency(days/month), Allodynia (Yes/No), Years with Migraine(Number of years) | 3 hours | 
| Logistic regression model, Neck pain in general | We would like to examine the relationship between the variable variable: Neck pain in general (Yes/No) and the independent variables: Tension Type Headache(yes/no), Migraine localisation, Headache Frequency(Headache days/month), Allodynia(yes/No), Years with Migraine(number of years) | 3 hours | 
| Next migraine attack, Cox proportional hazards model | Using the prospective diary, we will examine the relationship between pericranial muscle tenderness and the next migraine attack, when correcting for headache frequency | 3 hours |