Harnessing the conditioned pain modulation response in migraine diagnosis, outcome prediction, and treatment—A narrative review

Objective: To present the potential use and relevance of the conditioned pain modulation (CPM) response to migraine diagnosis, outcome prediction, and treatment. Background: The CPM response is a widely used laboratory test to examine inhibitory pain modulation capabilities. Methods: This narrative review summarizes and synthesizes the findings on the CPM response in patients with migraine. Results: For diagnosis, we summarized the studies comparing CPM responses between patients with migraine and individuals without migraine or with other headache syndromes, as well as between patients with subtypes of migraine. For prediction, we summarized the studies utilizing the CPM response to predict migraine outcome, such as response to interventions. For treatment, we described a device that utilizes the CPM response for acute and preventative migraine treatment. In addition, we suggest the requirements needed for the CPM response to be used for migraine diagnosis, outcome prediction, and treatment. Conclusions: Although more research is needed, the CPM response could be a useful tool for improving migraine management.