Alexithymia Increases Pericranial and Cervical Muscle Tenderness in Women with Migraine

Author:

Rota Eugenia1ORCID,Cavagnetto Elisa1,Immovilli Paolo2ORCID,Frola Enrico3,Salari Pavel1,Morelli Nicola4ORCID,Battaggia Alessandro5ORCID

Affiliation:

1. Neurology Unit, San Giacomo Hospital, 15067 Novi Ligure, Italy

2. Neurology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy

3. IUSTO—Istituto Universitario Salesiano Torino Rebaudengo, 10155 Torino, Italy

4. Neuroradiology Unit, Guglielmo da Saliceto Hospital, 29121 Piacenza, Italy

5. SVEMG—Scuola Veneta di Medicina Generale, 35129 Padova, Italy

Abstract

Background/Objectives: Alexithymia is characterized by a deficit in identifying and communicating feelings. Emerging evidence suggests that alexithymia is highly prevalent in migraine, in a complex interplay with psychiatric comorbidity. Pericranial/cervical muscle tenderness is a remarkable clinical feature in a large proportion of migraine patients. This pilot study aimed at investigating the relationship between alexithymia and pericranial/cervical muscle tenderness in female migraineurs. Methods: A total of 42 female patients fulfilling the diagnostic criteria for migraine were enrolled into this pilot, observational, cross-sectional study after informed consent was obtained. Each patient underwent a psychological assessment to identify any alexithymia by means of TAS-20, anxiety/mood comorbidity (by means of STAI-Y1 STAI-Y2, BDI-II), and migraine-related disability (by means of HIT-6), and a physical cranial/cervical musculoskeletal examination. Palpation of pericranial and cervical muscles was carried out in the standardized manner. A Cumulative Muscle Tenderness (CUM) score (0–6) was calculated for each patient. A multivariate analysis was performed to investigate any association amongst the TAS-20 score, the CUM score, and the following covariates: BDI-II, STAI-Y1, STAI-Y2, and HIT-6 scores, age, disease duration, monthly migraine days, and average head pain intensity in the previous three months. Results: Overall, 35.6% of the sample had alexithymia. The multivariate analysis detected a linear and independent relationship between the TAS-20 and CUM scores, with a statistically significant (p = 0.017) association. Conclusions: This pilot study suggests that alexithymia plays a role in increasing pericranial/cervical muscle tenderness in migraine, independently from psychiatric comorbidity. A novel therapeutical approach, targeting alexithymia, may well reduce muscular tenderness in female migraineurs.

Publisher

MDPI AG

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