Stress, Temporal Artery Activity, and Pain in Migraine Headache: a Prospective Analysis

SYNOPSIS
Temporal artery, frontal EMG, systemic blood pressure, peripheral temperature, heart rate, and anxiety levels were monitored daily four days preceding a typical migraine attack and during the headache in twelve female migraine cases. The specific relationship between temporal artery activity and anxiety and temporal artery activity and pain was also determined. The results indicated the presence of an increased variability in the right temporal artery three days preceding the migraine with the absence of changes in the general autonomic and skeletal muscle measures. Considerable individual differences in temporal artery amplitude were observed necessitating an analysis of individual patients which revealed a general pattern of dilation three days prior to the attack and constriction the day preceding the attack. Increased anxiety was noted only on the headache day. Elevations in anxiety four days prior to the migraine were associated with the increased temporal artery variability observed three days prior to the attack. Anxiety experienced on the headache day was not related to changes in temporal artery amplitude variability or pain. Temporal artery dilation was not consistently associated with the site of pain. The results provide support for a disregulation theory of migraine relating anxiety to temporal artery change across days preceding the attack but question major assumptions regarding anxiety, temporal artery activity and pain during the headache itself.