According to the results of a recent study published in Plastic and Reconstructive Surgery, administration of the Pain Self-Efficacy Questionnaire (PSEQ) before and after migraine surgery may provide contextual information regarding migraine pain relative to other conditions. No association was established between preoperative and postoperative PSEQ scores.

In this prospective study, 90 patients with migraine who were undergoing migraine surgery because of unresponsiveness to conventional treatments were enrolled in the study. Pain and symptoms were evaluated with the Migraine Headache Index (MHI) and PSEQ, preoperatively and 12 months post-surgery. PSEQ scores were compared with representative scores from other pain-related conditions.

Compared with baseline, migraine headache frequency, duration, pain severity, and MHI total score were reduced 12 months post-surgery (P <.001 for all). In a similar fashion, mean PSEQ scores were improved after surgery, compared with their preoperative levels (38.6 vs 18.2; P <.001).

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There was no significant association (P >.05) between preoperative PSEQ scores and postoperative MHI scores. Furthermore, patients who had >99% MHI score improvement as a result of surgery had PSEQ scores comparable with those of study participants who had <5% MHI score improvement postoperatively (15.5 vs 16.7; P =.83).

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Patients undergoing migraine surgery had low PSEQ scores prior to treatment (mean, 18.2±11.7) compared with pre-treatment scores for other pain conditions, including: carpal tunnel syndrome (45±12), chronic pain with neuropathic characteristics (32.99±17.3), severe chronic pain with neuropathic characteristics (26.4±16.0), shoulder pain (37.36±15.44), and chronic lower back pain (35.68±13.40).

The study investigators concluded that “overall, the PSEQ allows for evaluation of functional impairment in migraine surgery patients. It further significantly improves our understanding of pain in migraine surgery patients by comparison to other pain conditions. Because of these advantages, it should be considered as an outcome measure in migraine surgery patients.”

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Gfrerer L, Lans J, Faulkner HR, et al. Ability to cope with pain puts migraine surgery patients in perspective. Plast Reconstr Surg. 2018;141(1):169-174. doi:10.1097/PRS.0000000000003955