OBJECTIVE Pain catastrophizing and cutaneous allodynia represent two risk factors for greater headache-related disability. Yet, there is limited knowledge of the extent to which these risk factors are modifiable and whether nonpharmacological treatment-related changes are associated with migraine improvements. Using data from the Women's Health and Migraine (WHAM) study, a randomized controlled trial that compared effects of behavioral weight loss (BWL) and migraine education (ME) in women with migraine and overweight/obesity, we tested whether: (a) BWL versus ME produced greater changes in pain catastrophizing and allodynia from baseline across posttreatment and follow-up time points, and (b) whether these improvements were associated with improvements in headache disability. METHOD Women (N = 110) were randomly assigned to 16 weeks of either BWL or ME and assessed at baseline, posttreatment, and follow up (32 weeks). Multilevel mixed effects modeling tested: (a) for between-groups differences in pain catastrophizing and allodynia changes over time, and (b) associations of changes in pain catastrophizing and allodynia with changes in headache disability, adjusting for migraine severity and weight loss. RESULTS Both BWL and ME had significant reductions in pain catastrophizing and allodynia from baseline to posttreatment and follow up, and the improvements were comparable across conditions. Reductions in pain catastrophizing and cutaneous allodynia were associated with significant reductions in headache disability, even when controlling for intervention-related improvements in migraine and weight loss. CONCLUSION Pain catastrophizing and allodynia are not only reduced after nonpharmacologic treatments for migraine, but greater improvements are associated with greater reductions in headache-related disability, independent of migraine severity. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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治疗对偏头痛和超重/肥胖症妇女的灾难性痛苦和皮肤异常性疼痛症状的影响。

目的灾难性疼痛和皮肤异常性疼痛是与头痛相关的更大残疾的两个危险因素。然而，关于这些风险因素可改变的程度以及非药物治疗相关变化是否与偏头痛改善相关的知识尚有限。使用来自妇女健康和偏头痛（WHAM）研究的数据，该研究是比较行为偏重（BWL）和偏头痛教育（ME）对偏头痛和超重/肥胖女性的影响的随机对照试验，我们测试了：（a）BWL与ME相比，在整个治疗后和随访时间点，疼痛灾难性和异常性疼痛的基线发生了更大的变化，以及（b）这些改善是否与头痛残疾的改善相关。方法女性（N = 110）被随机分配到16周的BWL或ME中，并在基线，治疗后和随访（32周）中进行评估。测试了多级混合效应模型：（a）组间疼痛灾难性和异常性疼痛随时间变化的差异，以及（b）疼痛灾难性和异常性疼痛的变化与头痛残疾的变化之间的关联，调整偏头痛的严重程度和减轻体重。结果从基线到治疗后和随访，BWL和ME均显着减轻了疼痛的灾难性和异常性疼痛，并且在各种情况下这种改善都是可比的。即使控制了与偏头痛和体重减轻有关的干预相关的改善，疼痛灾难性的减轻和皮肤异常性疼痛的减少也与头痛残疾的显着减少有关。结论偏头痛的非药物治疗后，不仅减轻疼痛的灾难性和异常性疼痛，而且与偏头痛的严重程度无关，更大的改善与头痛相关的残疾的进一步减少相关。（PsycInfo数据库记录（c）2020 APA，保留所有权利）。