Clinical and personality features of allodynic migraine

Cutaneous allodynia (CA) is a frequent complaint during migraine attacks, recently associated with migraine transformation as well as psychiatric comorbidities. The aim of our study was to define the clinical features of allodynic migraineurs, in particular, the relationship between CA and personality profile. Between October 2008 and December 2009, 410 migraineurs admitted for the first time to our Headache Center underwent Allodynia Symptom Checklist, MIgraine DIsability Assessment Scale (MIDAS) and psychometric tests [Tridimensional Personality Questionnaire (TPQ), Toronto Alexithymia Scale, State and Trait Anxiety Inventory (STAI Y 1-2), and Beck Depression Inventory (BDI)]. Allodynia was present in 63% of cases, mostly in females. In CA patients, an association with female sex, chronic migraine, higher values of MIDAS, BDI, harm avoidance (HA, a TPQ dimension) and STAI Y-2 was found. Interestingly, CA appears to be associated with depression and a particular personality profile characterized by higher values of HA, suggesting an involvement of the serotonergic system in the development of CA in migraine. In conclusion, CA is associated with progression of migraine and it could be a marker of psychiatric comorbidities, in particular, depression and anxious trait.