{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T08:40:09Z","timestamp":1750840809223,"version":"3.41.0"},"reference-count":36,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T00:00:00Z","timestamp":1750809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100004168","name":"Universit\u00e4t zu L\u00fcbeck","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100004168","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>The exact cause for no pain, local pain and referred pain groups according to the upper cervical palpation test (UPT) and whether neck pain in migraine patients is caused due to pain sensitization or influenced by perceived neck-related disability, is not fully understood. The aim was to determine whether upper cervical spine sensitivity tested by the UPT is associated with neck-related disability or increased pain sensitization in patients with migraine. Forty-two patients with episodic migraine were examined regarding mechanical and pressure pain thresholds, central sensitization (CSI), allodynia (ASC-12) and neck-related disability (NDI), and sub-grouped according to the UPT. An ANOVA analysis was performed for group differences. Exploratory regression and correlation analyses were performed with NDI and CSI as dependent variables to understand which factors are related and contribute to either subgroup allocation. No significant differences were found in UPT subgroups regarding CSI and NDI. The UPT subgroups could not be determined by any evaluated variable. The NDI was explained in 43.6% by the CSI and neck pain intensity. CSI results were explained to 49.4% by a model including ASC-12 and NDI. In conclusion, UPT subgroups were neither explained by differences in CSI, mechanical or pressure threshold testing or NDI.<\/jats:p>","DOI":"10.1038\/s41598-025-03344-6","type":"journal-article","created":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T08:10:05Z","timestamp":1750839005000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Results of upper cervical palpation test in migraine patients are not explained by pain sensitization"],"prefix":"10.1038","volume":"15","author":[{"given":"Juliana","family":"Pradela","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Melanie Maria","family":"Otto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Kaske","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Luise","family":"John","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicole","family":"Derner","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arne","family":"Vielitz","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kerstin","family":"Luedtke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,6,25]]},"reference":[{"issue":"1","key":"3344_CR1","doi-asserted-by":"publisher","first-page":"137","DOI":"10.1186\/s10194-020-01208-0","volume":"21","author":"TJ Steiner","year":"2020","unstructured":"Steiner, T. J., Stovner, L. J., Jensen, R., Uluduz, D. & Katsarava, Z. Migraine remains second among the world\u2019s causes of disability, and first among young women: Findings from GBD2019. J. Headache Pain 21(1), 137. https:\/\/doi.org\/10.1186\/s10194-020-01208-0 (2020).","journal-title":"J. Headache Pain"},{"issue":"1","key":"3344_CR2","doi-asserted-by":"publisher","first-page":"83","DOI":"10.1093\/bmb\/ldh052","volume":"73\u201374","author":"PJ Goadsby","year":"2005","unstructured":"Goadsby, P. J. Advances in the understanding of headache. Br. Med. Bull. 73\u201374(1), 83\u201392. https:\/\/doi.org\/10.1093\/bmb\/ldh052 (2005).","journal-title":"Br. Med. Bull."},{"issue":"4","key":"3344_CR3","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1016\/j.molmed.2010.02.004","volume":"16","author":"JE Meents","year":"2010","unstructured":"Meents, J. E., Neeb, L. & Reuter, U. TRPV1 in migraine pathophysiology. Trends Mol. Med. 16(4), 153\u2013159. https:\/\/doi.org\/10.1016\/j.molmed.2010.02.004 (2010).","journal-title":"Trends Mol. Med."},{"issue":"5","key":"3344_CR4","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1007\/s11916-003-0036-y","volume":"7","author":"T Bartsch","year":"2003","unstructured":"Bartsch, T. & Goadsby, P. J. The trigeminocervical complex and migraine: Current concepts and synthesis. Curr. Pain Headache Rep. 7(5), 371\u2013376. https:\/\/doi.org\/10.1007\/s11916-003-0036-y (2003).","journal-title":"Curr. Pain Headache Rep."},{"key":"3344_CR5","doi-asserted-by":"publisher","unstructured":"Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia. 38(1):1\u2013211. https:\/\/doi.org\/10.1177\/0333102417738202 (2018).","DOI":"10.1177\/0333102417738202"},{"issue":"1","key":"3344_CR6","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1186\/s10194-017-0808-0","volume":"18","author":"K Luedtke","year":"2017","unstructured":"Luedtke, K. & May, A. Stratifying migraine patients based on dynamic pain provocation over the upper cervical spine. J. Headache Pain 18(1), 97. https:\/\/doi.org\/10.1186\/s10194-017-0808-0 (2017).","journal-title":"J. Headache Pain"},{"issue":"5","key":"3344_CR7","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1177\/0333102417716934","volume":"38","author":"K Luedtke","year":"2018","unstructured":"Luedtke, K., Starke, W. & May, A. Musculoskeletal dysfunction in migraine patients. Cephalalgia Int. J. Headache 38(5), 865\u2013875. https:\/\/doi.org\/10.1177\/0333102417716934 (2018).","journal-title":"Cephalalgia Int. J. Headache"},{"issue":"7","key":"3344_CR8","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1177\/03331024211068073","volume":"42","author":"HM Al-Khazali","year":"2022","unstructured":"Al-Khazali, H. M. et al. Prevalence of neck pain in migraine: A systematic review and meta-analysis. Cephalalgia 42(7), 663\u2013673. https:\/\/doi.org\/10.1177\/03331024211068073 (2022).","journal-title":"Cephalalgia"},{"issue":"12","key":"3344_CR9","doi-asserted-by":"publisher","first-page":"1500","DOI":"10.1177\/0333102419854061","volume":"39","author":"MM Bragatto","year":"2019","unstructured":"Bragatto, M. M. et al. Is the presence of neck pain associated with more severe clinical presentation in patients with migraine? A cross-sectional study. Cephalalgia Int. J. Headache 39(12), 1500\u20131508. https:\/\/doi.org\/10.1177\/0333102419854061 (2019).","journal-title":"Cephalalgia Int. J. Headache"},{"issue":"7","key":"3344_CR10","doi-asserted-by":"publisher","first-page":"1203","DOI":"10.1111\/head.12393","volume":"54","author":"LL Florencio","year":"2014","unstructured":"Florencio, L. L. et al. Neck pain disability is related to the frequency of migraine attacks: A cross-sectional study. Headache 54(7), 1203\u20131210. https:\/\/doi.org\/10.1111\/head.12393 (2014).","journal-title":"Headache"},{"issue":"2","key":"3344_CR11","doi-asserted-by":"publisher","first-page":"109","DOI":"10.1097\/AJP.0000000000000387","volume":"33","author":"GN Ferracini","year":"2017","unstructured":"Ferracini, G. N. et al. Myofascial trigger points and migraine-related disability in women with episodic and chronic migraine. Clin. J. Pain 33(2), 109. https:\/\/doi.org\/10.1097\/AJP.0000000000000387 (2017).","journal-title":"Clin. J. Pain"},{"issue":"4","key":"3344_CR12","doi-asserted-by":"publisher","first-page":"324","DOI":"10.1007\/s11916-011-0195-1","volume":"15","author":"MB Vincent","year":"2011","unstructured":"Vincent, M. B. Headache and Neck. Curr. Pain Headache Rep. 15(4), 324\u2013331. https:\/\/doi.org\/10.1007\/s11916-011-0195-1 (2011).","journal-title":"Curr. Pain Headache Rep."},{"key":"3344_CR13","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1016\/j.math.2016.02.010","volume":"23","author":"K Luedtke","year":"2016","unstructured":"Luedtke, K. et al. International consensus on the most useful physical examination tests used by physiotherapists for patients with headache: A Delphi study. Man Ther. 23, 17\u201324. https:\/\/doi.org\/10.1016\/j.math.2016.02.010 (2016).","journal-title":"Man Ther."},{"issue":"7","key":"3344_CR14","doi-asserted-by":"publisher","first-page":"491","DOI":"10.1016\/j.jmpt.2008.08.006","volume":"31","author":"H Vernon","year":"2008","unstructured":"Vernon, H. The Neck Disability Index: State-of-the-art, 1991\u20132008. J. Manipulat. Physiol. Ther. 31(7), 491\u2013502. https:\/\/doi.org\/10.1016\/j.jmpt.2008.08.006 (2008).","journal-title":"J. Manipulat. Physiol. Ther."},{"issue":"8","key":"3344_CR15","doi-asserted-by":"publisher","first-page":"1801","DOI":"10.1093\/brain\/awg190","volume":"126","author":"T Bartsch","year":"2003","unstructured":"Bartsch, T. Increased responses in trigeminocervical nociceptive neurons to cervical input after stimulation of the dura mater. Brain 126(8), 1801\u20131813. https:\/\/doi.org\/10.1093\/brain\/awg190 (2003).","journal-title":"Brain"},{"issue":"7","key":"3344_CR16","first-page":"409","volume":"14","author":"H Vernon","year":"1991","unstructured":"Vernon, H. & Mior, S. The Neck Disability Index: A study of reliability and validity. J. Manipulat. Physiol. Ther. 14(7), 409\u2013415 (1991).","journal-title":"J. Manipulat. Physiol. Ther."},{"key":"3344_CR17","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1186\/1471-2474-15-91","volume":"15","author":"H Cramer","year":"2014","unstructured":"Cramer, H., Lauche, R., Langhorst, J., Dobos, G. J. & Michalsen, A. Validation of the German version of the Neck Disability Index (NDI). BMC Musculoskelet. Disord. 15, 91. https:\/\/doi.org\/10.1186\/1471-2474-15-91 (2014).","journal-title":"BMC Musculoskelet. Disord."},{"issue":"10","key":"3344_CR18","doi-asserted-by":"publisher","first-page":"802","DOI":"10.1016\/j.spinee.2009.06.002","volume":"9","author":"BA Young","year":"2009","unstructured":"Young, B. A. et al. Responsiveness of the neck disability index in patients with mechanical neck disorders. Spine J. 9(10), 802\u2013808. https:\/\/doi.org\/10.1016\/j.spinee.2009.06.002 (2009).","journal-title":"Spine J."},{"issue":"5","key":"3344_CR19","doi-asserted-by":"publisher","first-page":"515","DOI":"10.1097\/00007632-200203010-00012","volume":"27","author":"R Pietrobon","year":"2002","unstructured":"Pietrobon, R., Coeytaux, R. R., Carey, T. S., Richardson, W. J. & DeVellis, R. F. Standard scales for measurement of functional outcome for cervical pain or dysfunction: A systematic review. Spine 27(5), 515 (2002).","journal-title":"Spine"},{"issue":"4","key":"3344_CR20","doi-asserted-by":"publisher","first-page":"471","DOI":"10.1007\/s10006-021-00943-1","volume":"25","author":"INA Figueir\u00eado","year":"2021","unstructured":"Figueir\u00eado, I. N. A. et al. Occurrence and severity of neck disability in individuals with different types of temporomandibular disorder. Oral. Maxillofac. Surg. 25(4), 471\u2013476. https:\/\/doi.org\/10.1007\/s10006-021-00943-1 (2021).","journal-title":"Oral. Maxillofac. Surg."},{"issue":"7","key":"3344_CR21","doi-asserted-by":"publisher","first-page":"798","DOI":"10.1111\/j.1365-2702.2005.01121.x","volume":"14","author":"A Williamson","year":"2005","unstructured":"Williamson, A. & Hoggart, B. Pain: A review of three commonly used pain rating scales. J. Clin. Nurs. 14(7), 798\u2013804. https:\/\/doi.org\/10.1111\/j.1365-2702.2005.01121.x (2005).","journal-title":"J. Clin. Nurs."},{"issue":"2","key":"3344_CR22","doi-asserted-by":"publisher","first-page":"166","DOI":"10.1111\/papr.12440","volume":"17","author":"R Neblett","year":"2017","unstructured":"Neblett, R., Hartzell, M. M., Mayer, T. G., Cohen, H. & Gatchel, R. J. Establishing clinically relevant severity levels for the central sensitization inventory. Pain Pract. Off. J. World Inst. Pain 17(2), 166\u2013175. https:\/\/doi.org\/10.1111\/papr.12440 (2017).","journal-title":"Pain Pract. Off. J. World Inst. Pain"},{"issue":"5","key":"3344_CR23","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1016\/j.jpain.2012.11.012","volume":"14","author":"R Neblett","year":"2013","unstructured":"Neblett, R. et al. The central sensitization inventory (CSI): Establishing clinically significant values for identifying central sensitivity syndromes in an outpatient chronic pain sample. J. Pain 14(5), 438\u2013445. https:\/\/doi.org\/10.1016\/j.jpain.2012.11.012 (2013).","journal-title":"J. Pain"},{"issue":"2","key":"3344_CR24","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1002\/ana.21211","volume":"63","author":"RB Lipton","year":"2008","unstructured":"Lipton, R. B. et al. Cutaneous allodynia in the migraine population. Ann. Neurol. 63(2), 148\u2013158. https:\/\/doi.org\/10.1002\/ana.21211 (2008).","journal-title":"Ann. Neurol."},{"issue":"1","key":"3344_CR25","doi-asserted-by":"publisher","first-page":"77","DOI":"10.1016\/j.ejpain.2005.02.003","volume":"10","author":"R Rolke","year":"2006","unstructured":"Rolke, R. et al. Quantitative sensory testing: A comprehensive protocol for clinical trials. Eur. J. Pain 10(1), 77\u201388. https:\/\/doi.org\/10.1016\/j.ejpain.2005.02.003 (2006).","journal-title":"Eur. J. Pain"},{"issue":"8","key":"3344_CR26","doi-asserted-by":"publisher","first-page":"1226","DOI":"10.1111\/j.1526-4610.2012.02169.x","volume":"52","author":"DH Watson","year":"2012","unstructured":"Watson, D. H. & Drummond, P. D. Head pain referral during examination of the neck in migraine and tension-type headache. Headache 52(8), 1226\u20131235. https:\/\/doi.org\/10.1111\/j.1526-4610.2012.02169.x (2012).","journal-title":"Headache"},{"key":"3344_CR27","doi-asserted-by":"publisher","first-page":"67","DOI":"10.1016\/j.msksp.2019.04.007","volume":"42","author":"Z Liang","year":"2019","unstructured":"Liang, Z., Galea, O., Thomas, L., Jull, G. & Treleaven, J. Cervical musculoskeletal impairments in migraine and tension type headache: A systematic review and meta-analysis. Musculoskelet. Sci. Pract. 42, 67\u201383. https:\/\/doi.org\/10.1016\/j.msksp.2019.04.007 (2019).","journal-title":"Musculoskelet. Sci. Pract."},{"issue":"1","key":"3344_CR28","doi-asserted-by":"publisher","first-page":"379","DOI":"10.1186\/s12891-022-05329-2","volume":"23","author":"A Schwarz","year":"2022","unstructured":"Schwarz, A., Luedtke, K. & Sch\u00f6ttker-K\u00f6niger, T. Only cervical vertebrae C0\u2013C2, not C3 are relevant for subgrouping migraine patients according to manual palpation and pain provocation: Secondary analysis of a cohort study. BMC Musculoskelet. Disord. 23(1), 379. https:\/\/doi.org\/10.1186\/s12891-022-05329-2 (2022).","journal-title":"BMC Musculoskelet. Disord."},{"issue":"5","key":"3344_CR29","doi-asserted-by":"publisher","first-page":"1025","DOI":"10.4314\/ejhs.v31i5.15","volume":"31","author":"TE Balcha","year":"2021","unstructured":"Balcha, T. E., Getaneh, F. B. & Woldeyohannes, A. M. A Retrospective analysis on cervical spine magnetic resonance imaging findings in patients with neck pain in a tertiary hospital, Addis Ababa, Ethiopia. Ethiop. J. Health Sci. 31(5), 1025\u20131032. https:\/\/doi.org\/10.4314\/ejhs.v31i5.15 (2021).","journal-title":"Ethiop. J. Health Sci."},{"key":"3344_CR30","doi-asserted-by":"publisher","first-page":"1757","DOI":"10.2147\/JPR.S200723","volume":"12","author":"A Mibu","year":"2019","unstructured":"Mibu, A., Nishigami, T., Tanaka, K., Manfuku, M. & Yono, S. Difference in the impact of central sensitization on pain-related symptoms between patients with chronic low back pain and knee osteoarthritis. J. Pain Res. 12, 1757\u20131765. https:\/\/doi.org\/10.2147\/JPR.S200723 (2019).","journal-title":"J. Pain Res."},{"issue":"4","key":"3344_CR31","doi-asserted-by":"publisher","first-page":"786","DOI":"10.3390\/diagnostics13040786","volume":"13","author":"A Steinmetz","year":"2023","unstructured":"Steinmetz, A., Hacke, F. & Delank, K. S. Pressure pain thresholds and central sensitization in relation to psychosocial predictors of chronicity in low back pain. Diagn. Basel Switz. 13(4), 786. https:\/\/doi.org\/10.3390\/diagnostics13040786 (2023).","journal-title":"Diagn. Basel Switz."},{"issue":"6","key":"3344_CR32","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1111\/papr.13125","volume":"22","author":"A Mibu","year":"2022","unstructured":"Mibu, A. et al. Does a combination of self-reported signs related to central sensitization and pressure pain threshold allow for a more detailed classification of pain-related characteristics in patients with chronic musculoskeletal pain?: A cross-sectional study. Pain Pract. Off. J. World Inst. Pain 22(6), 556\u2013563. https:\/\/doi.org\/10.1111\/papr.13125 (2022).","journal-title":"Pain Pract. Off. J. World Inst. Pain"},{"issue":"9","key":"3344_CR33","doi-asserted-by":"publisher","first-page":"827","DOI":"10.1177\/03331024221082506","volume":"42","author":"S Di Antonio","year":"2022","unstructured":"Di Antonio, S. et al. Cervical musculoskeletal impairments in the 4 phases of the migraine cycle in episodic migraine patients. Cephalalgia 42(9), 827\u2013845. https:\/\/doi.org\/10.1177\/03331024221082506 (2022).","journal-title":"Cephalalgia"},{"issue":"3","key":"3344_CR34","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1007\/s10072-023-07118-8","volume":"45","author":"S Di Antonio","year":"2024","unstructured":"Di Antonio, S. et al. Profiling migraine patients according to clinical and psychophysical characteristics: Clinical validity of distinct migraine clusters. Neurol. Sci. 45(3), 1185\u20131200. https:\/\/doi.org\/10.1007\/s10072-023-07118-8 (2024).","journal-title":"Neurol. Sci."},{"key":"3344_CR35","doi-asserted-by":"publisher","first-page":"2673","DOI":"10.2147\/JPR.S329280","volume":"15","author":"K Suzuki","year":"2022","unstructured":"Suzuki, K., Suzuki, S., Shiina, T., Kobayashi, S. & Hirata, K. Central sensitization in migraine: A narrative review. J. Pain Res. 15, 2673\u20132682. https:\/\/doi.org\/10.2147\/JPR.S329280 (2022).","journal-title":"J. Pain Res."},{"issue":"1","key":"3344_CR36","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1177\/0333102420954518","volume":"41","author":"A Schwarz","year":"2021","unstructured":"Schwarz, A., Ziegeler, C., Daneshkhah, S., May, A. & Luedtke, K. Predicting the outcome of the greater occipital nerve block\u2014An observational study on migraine patients with and without musculoskeletal cervical impairment. Cephalalgia 41(1), 78\u201389. https:\/\/doi.org\/10.1177\/0333102420954518 (2021).","journal-title":"Cephalalgia"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03344-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03344-6","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03344-6.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,25]],"date-time":"2025-06-25T08:10:06Z","timestamp":1750839006000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-025-03344-6"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,6,25]]},"references-count":36,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["3344"],"URL":"https:\/\/doi.org\/10.1038\/s41598-025-03344-6","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,25]]},"assertion":[{"value":"26 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 May 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"25 June 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20276"}}