Tietjen, Gretchen E, Brandes, Jan L, Peterlin, B Lee et al. · Headache · 2009 · DOI
This study looked at how often migraine patients experience allodynia—pain or discomfort from things that normally wouldn't hurt, like light touch on the skin. The researchers found that 60% of migraine patients had at least one allodynic symptom, and those with allodynia were much more likely to also have other chronic pain conditions like fibromyalgia, irritable bowel syndrome, and chronic fatigue syndrome, as well as depression and anxiety.
This study is important for ME/CFS patients because it demonstrates a significant association between migraine-related allodynia and chronic fatigue syndrome alongside fibromyalgia and IBS—conditions frequently comorbid with ME/CFS. The findings suggest that central nervous system sensitization may be a shared pathophysiological mechanism linking these conditions, potentially informing treatment approaches for overlapping symptom management.
This study cannot establish causation—it does not prove that allodynia causes comorbid pain conditions or vice versa, only that they are associated. The cross-sectional design means we cannot determine whether allodynia develops before, after, or simultaneously with other conditions. Additionally, reliance on self-reported physician diagnoses of CFS and other conditions may not reflect confirmed clinical diagnoses by specialists, limiting the precision of comorbidity estimates.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Tietjen, Gretchen E, Brandes, Jan L, Peterlin, B Lee, Eloff, Arnolda, Dafer, Rima M, Stein, Michael R, et al. (2009). Allodynia in migraine: association with comorbid pain conditions.. Headache. https://doi.org/10.1111/j.1526-4610.2009.01521.x
BibTeX
@article{mecfsatlas-tietjen-2009-allodynia-migraine,
author = {Tietjen, Gretchen E and Brandes, Jan L and Peterlin, B Lee and Eloff, Arnolda and Dafer, Rima M and Stein, Michael R and Drexler, Ellen and Martin, Vincent T and Hutchinson, Susan and Aurora, Sheena K and Recober, Ana and Herial, Nabeel A and Utley, Christine and White, Leah and Khuder, Sadik A},
title = {Allodynia in migraine: association with comorbid pain conditions.},
journal = {Headache},
year = {2009},
doi = {10.1111/j.1526-4610.2009.01521.x},
note = {PubMed: 19788473},
url = {https://www.mecfsatlas.com/evidence/tietjen-2009-allodynia-migraine},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-05-30. https://www.mecfsatlas.com/evidence/tietjen-2009-allodynia-migraine
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