截断值能够通过单一评估识别与偏头痛周期无关的压力-疼痛敏感性增加的偏头痛患者：一项多中心、横断面、观察性研究的二次分析。

IF 3.5 2区医学 Q1 ANESTHESIOLOGY

European Journal of Pain Pub Date : 2025-01-21 DOI:10.1002/ejp.4787

Matteo Castaldo, Lars Arendt-Nielsen, Marta Ponzano, Francesca Bovis, Paola Torelli, Cinzia Finocchi, Stefano Di Antonio

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引用次数: 0

摘要

目的：通过单一评估，确定可以预测独立于偏头痛周期的压力疼痛敏感性增加的值。方法：这是对先前研究的二次分析，其中198例发作性和慢性偏头痛患者在偏头痛周期的所有阶段进行评估。评估颞肌、颈椎、手和腿的压痛阈值（PPT）。偏头痛患者被分为两个亚组：压力疼痛敏感性增加（IPS）患者和无IPS （No-IPS）患者。采用卡方自动交互检测决策树分析来确定IPS组或NoIPS组的预测因子。为了评估模型的内部效度，采用了十倍交叉验证。结果：IPS组161例（81%），NoIPS组37例（19%）。偏头痛患者：(1)颞肌PPT≤130 kPa；(2)颞肌PPT > 130 kPa≤197.5 kPa，手部PPT≤347.33 kPa；(3)颞肌PPT > 197.5 kPa，手部PPT≤315 kPa；正确纳入IPS组的敏感性为96%，特异性为81%，阳性预测值为96%，阴性预测值为81%。模型和交叉验证分析的准确率分别为93%和92%。结论：该模型具有较高的内部效度，可以独立于评估发生的阶段准确预测IPS的存在。三叉神经和手部PPT截断值可用于识别IPS患者。

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Cut-Off Values Able to Identify Migraine Patients With Increased Pressure-Pain Sensitivity Independent of the Migraine Cycle Through a Single Assessment: A Secondary Analysis of a Multicentre, Cross-Sectional, Observational Study

Aim

Identify values that could predict the presence of increased pressure-pain sensitivity independent of the migraine cycle through a single assessment.

Methods

This was a secondary analysis of a previous study in which 198 episodic and chronic migraine patients were assessed during all phases of the migraine cycle. Pressure pain threshold (PPT) was assessed over the temporalis, cervical spine, hand, and leg. Migraine patients were divided into two sub-groups: patients with increased pressure-pain sensitivity (IPS) and with No IPS (No-IPS). A Chi-squared Automatic Interaction Detection decision tree analysis was used to identify predictors to be included in the IPS or NoIPS group. To assess the internal validity of the model, a tenfold cross-validation was applied.

Results

161 (81%) patients were included in the IPS group, while 37 (19%) in the NoIPS group. Migraine patients with: (1) Temporalis PPT ≤ 130 kPa; (2) Temporalis PPT > 130 kPa and ≤ 197.5 kPa and hand PPT ≤ 347.33 kPa; (3) Temporalis PPT > 197.5 kPa and hand PPT ≤ 315 kPa; were correctly included in the IPS group with a sensitivity of 96%, a specificity of 81%, a positive predictive value of 96%, and a negative predictive value of 81%. The accuracy of the model and the cross-validation analysis were respectively 93% and 92%.

Conclusion

The high internal validity suggests that our model could precisely predict the presence of IPS independently by the phase in which the assessment occurred. Trigeminal and hand PPT cut-off values could be used to identify patients with IPS.

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来源期刊

European Journal of Pain 医学-临床神经学

CiteScore

7.50

自引率

5.60%

发文量

163

审稿时长

4-8 weeks

期刊介绍： European Journal of Pain (EJP) publishes clinical and basic science research papers relevant to all aspects of pain and its management, including specialties such as anaesthesia, dentistry, neurology and neurosurgery, orthopaedics, palliative care, pharmacology, physiology, psychiatry, psychology and rehabilitation; socio-economic aspects of pain are also covered. Regular sections in the journal are as follows: • Editorials and Commentaries • Position Papers and Guidelines • Reviews • Original Articles • Letters • Bookshelf The journal particularly welcomes clinical trials, which are published on an occasional basis. Research articles are published under the following subject headings: • Neurobiology • Neurology • Experimental Pharmacology • Clinical Pharmacology • Psychology • Behavioural Therapy • Epidemiology • Cancer Pain • Acute Pain • Clinical Trials.