ArticleThe journal of headache and pain2024
Decoding pain through facial expressions: a study of patients with migraine.
Article in The journal of headache and pain, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed, 5 citations in OpenAlex.
- An exploratory study of headache pain intensity using facial expressions and APEX frames.NPJ digital medicine · 2026Article
- Facial Expressions as a Nexus for Health Assessment.Bioengineering (Basel, Switzerland) · 2026Review
- Injection-Based Therapies for Migraine in Older Adults: A Narrative Review of OnabotulinumtoxinA, Greater Occipital Nerve Block, and Anti-Calcitonin Gene-Related Peptide Monoclonal Antibodies.Journal of Korean medical science · 2025Review
- Resting-state frontal electroencephalography (EEG) biomarkers for detecting the severity of chronic neuropathic pain.Scientific reports · 2024Article
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
Abstract
backgroundThe present study used the Facial Action Coding System (FACS) to analyse changes in facial activities in individuals with migraine during resting conditions to determine the potential of facial expressions to convey information about pain during headache episodes.
methodsFacial activity was recorded in calm and resting conditions by using a camera for both healthy controls (HC) and patients with episodic migraine (EM) and chronic migraine (CM). The FACS was employed to analyse the collected facial images, and intensity scores for each of the 20 action units (AUs) representing expressions were generated. The groups and headache pain conditions were then examined for each AU.
resultsThe study involved 304 participants, that is, 46 HCs, 174 patients with EM, and 84 patients with CM. Elevated headache pain levels were associated with increased lid tightener activity and reduced mouth stretch. In the CM group, moderate to severe headache attacks exhibited decreased activation in the mouth stretch, alongside increased activation in the lid tightener, nose wrinkle, and cheek raiser, compared to mild headache attacks (all corrected p < 0.05). Notably, lid tightener activation was positively correlated with the Numeric Rating Scale (NRS) level of headache (p = 0.012). Moreover, the lip corner depressor was identified to be indicative of emotional depression severity (p < 0.001).
conclusionFacial expressions, particularly lid tightener actions, served as inherent indicators of headache intensity in individuals with migraine, even during resting conditions. This indicates that the proposed approach holds promise for providing a subjective evaluation of headaches, offering the benefits of real-time assessment and convenience for patients with migraine.
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