Mental pain and pain-proneness in migraine subjects: Results from the PAINMIG cohort-study

Background. Pain has been qualified under four categories: nociception, perception of pain, suffering, and pain behaviors. Most of the literature on migraine has devoted attention to the first two. The aim of the present cohort study was to investigate patients with migraine enrolled at a tertiary care unit to study and mental pain and identify potential risk factors for migraine. Methods: An observational cross-sectional study was carried out on patients with chronic migraine (CM), episodic migraine (EM), and healthy subjects (HS). The three groups were matched for age and sex. A comprehensive assessment of migraine disability, pain, psychiatric disorders, psychosomatic syndromes, depressive and anxious symptoms, euthymia, psychosocial variables, mental pain, and pain proneness was performed. Results: Three hundred subjects were enrolled (100 CM, 100 EM, 100 HS). Based on the multiple regression analyses, those presenting pain-proneness (social impairment: OR=3.59, 95%CI 1.14.-11.29; depressive symptoms: OR=3.82, 95%CI 1.74-8.41) were more likely to be CM than HS. Those with higher levels of pain-proneness (social impairment: OR=4.04, 95%CI 1.60-10.22; depressive symptoms: OR=2.02, 95%CI 1.26-3.24) were more likely to be EM than HS. Those presenting higher levels of mental pain were more likely to be CM than EM (OR=1.45, 95%CI 1.02-2.07). Conclusion: Migraine is an unpleasant sensory and emotional experience associated with psychosocial manifestations which might contribute to the level of suffering of the individuals. Mental pain resulted to be the variable which most differentiated chronic from episodic migraine individuals.