Surprisingly, migraine patients showed increased TPD thresholds in the upper cervical spine interictally. TPD did not correlate with headache days per month or the dominant headache side in migraine patients. There was a significant, moderate association with age for the right side ( r = 0.42 p = 0.002, n = 51), and less strong association for the left side ( r = 0.34, p = 0.14) in healthy individuals. Migraine patients had larger TPD thresholds (26.86 ± 7.21) than healthy controls (23.30 ± 6.17) but these became only statistically significant for the right side of the neck ( p = 0.02). The same protocol was applied by two further examiners to 28 migraine patients and 21 age-, and gender-matched healthy controls to investigate inter-rater reliability and between group differences. To introduce a standardized protocol for the measurement of TPD in the upper cervical spine, 51 healthy participants were investigated with a newly developed paradigm which was evaluated for intra-rater reliability. Limited evidence exists for tactile acuity in the neck and no data is available for migraine.

Previous reports proposed two-point discrimination (TPD) as a measurement for cortical alterations. Chronic pain including migraine is associated with structural and functional changes in the somatosensory cortex.

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