The influence of ictal cutaneous allodynia on the response to occipital transcutaneous electrical stimulation in chronic migraine and chronic tension-type headache: a randomized, sham-controlled study

Cephalalgia. 2015 Apr;35(5):389-98. doi: 10.1177/0333102414544909. Epub 2014 Jul 30.


Objective: The objective of this article is to determine whether cutaneous allodynia (CA) influences the response to treatment with occipital transcutaneous electrical stimulation (OTES) in chronic migraine (CM) and chronic tension-type headache (CTTH).

Methods: One hundred and sixty consecutive patients with CM or CTTH were randomized to be treated with real or sham OTES stimulation three times a day for two consecutive weeks. All patients completed the validated 12-item allodynia symptom checklist for assessing the presence and the severity of CA during headache attack. Primary end-point was change (≥50%) in number of monthly headache-free days.

Results: There was a significant difference in the percentage of responders in the real OTES compared with sham OTES group (p <0.001). Importantly, there was not a significant change of monthly headache-free days in the allodynic patients with CM and CTTH treated both with real and sham OTES, while the number of headache-free days per month was significantly reduced in the real (86%) but not in the sham group (7%) of non-allodynic patients with CTTH and CM.

Conclusions: Severe CA is associated with decreased response to treatment with OTES in patients with CM and CTTH.

Keywords: Occipital transcutaneous electrical stimulation; chronic migraine; chronic tension-type headache; cutaneous allodynia.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Double-Blind Method
  • Female
  • Headache Disorders / complications
  • Headache Disorders / prevention & control*
  • Humans
  • Hyperalgesia / epidemiology*
  • Hyperalgesia / etiology
  • Male
  • Middle Aged
  • Migraine Disorders / complications
  • Migraine Disorders / prevention & control*
  • Tension-Type Headache / complications
  • Tension-Type Headache / prevention & control*
  • Touch
  • Transcutaneous Electric Nerve Stimulation / methods*
  • Young Adult