How Does Episodic Migraine Impact Sensory Processing in Teens?

Challenges in sensory processing are common among adolescents with episodic migraine, while sensory avoidance may be related to individual pain experience, pain catastrophizing, and disability level, according to a study published in The Journal of Headache and Pain.

Children between the ages 6 and 12 with migraine exhibit different sensory patterns when compared with healthy controls, in that migraineurs tend to express a strong connection between their altered sensory profile and low quality of life, authors explain.

However, adolescence is a transition period and pain during adolescence is an important predictor of future pain. Current knowledge regarding pain perception and its relation to sensory processing patterns in adolescents is scarce, authors explain.

Forty participants with episodic migraine between ages 13 and 18 were prospectively recruited from outpatient pediatric neurology clinics. This cohort completed the pediatric Migraine Disability Assessment (pedMIDAS) questionnaire, the Pain Catastrophizing Scale for Children (PSC-C) and The Adolescent/Adult Sensory Profile (AASP). Fifty-two healthy controls in the same age group completed the PSC-C and AASO.

While pedMIDAS assesses migraine disability in pediatric and adolescent patients, PSC-C assesses catastrophizing about pain. Total PSC-C score, along with subcategories of rumination, magnification, and feelings of helplessness, were measured. AASP measures behavioral responses to sensory input in daily life. Participants indicate how often they respond to 60 sensory events. These events are divided into 4 quadrants: low registration, sensation seeking, sensory sensitivity, and sensation avoidance. Scores for each quadrant range from 5 to 75 and norms were established for each age group.

The study yielded the following results:

• Adolescents with migraine had significantly higher scores of rumination (P ≤ .001) and helplessness (P ≤ .05) than healthy controls
• Adolescents with migraine had significantly lower tendencies to seek sensory input than healthy controls: 31% of the study group were under the norm in the "sensation seeking" quadrant compared with 17% of healthy controls (Chi square  =  5.87, P = .05)
• Among healthy controls, greater sensory sensitivity and avoidance correlated with elevated rumination (r = .38, P  =  .006; r = .37, P = .006, respectively) and with elevated helplessness (r = .31, P = .03; r = .40, P = .004, respectively)
• Elevated rumination and helplessness correlated with higher migraine pain severity (r = .48, P = .03; r = .49, P = .02, respectively)

Researchers note adolescents with episodic migraine were shown to have significantly lower tendencies to seek sensory input compared with healthy controls. In addition, sensory avoidance was a predictor of migraine related disability, as reflected in PedMIDAS scores.

“In the present study, among adolescents with migraine, pain magnification correlated with sensory avoidance, probably because both factors represent the same hypersensitivity to non-aversive stimuli of daily scenarios as well as to painful stimuli,” researchers said.

Intervention programs targeted to adolescents should “focus on coping strategies to deal with pain perception and the extreme sensory processing patterns expressed in daily scenarios,” in order to optimize function and quality of life.

Future studies ought to further examine the relationship between sensory patterns and pain perception in larger samples.

“Enhanced pain catastrophizing level and extreme sensory processing patterns appear to characterize adolescents with episodic migraine,” researchers conclude. In addition, less frequent tendency to seek sensory input may predict migraine related disability.

Reference

Genizi J, Halevy A, Schertz M, et al. Sensory processing patterns affect headache severity among adolescents with migraine [published online May 6, 2020]. J Headache Pain. doi: 10.1186/s10194-020-01119-0.