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Wilcox SL, Nelson S, Ludwick A, Youssef AM, Lebel A, Beccera L, Burstein R, Borsook D. Hippocampal volume changes across developmental periods in female migraineurs. NEUROBIOLOGY OF PAIN (CAMBRIDGE, MASS.) 2023; 14:100137. [PMID: 38099279 PMCID: PMC10719534 DOI: 10.1016/j.ynpai.2023.100137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 06/22/2023] [Accepted: 06/23/2023] [Indexed: 12/17/2023]
Abstract
Brain-related plasticity can occur at a significant rate varying on the developmental period. Adolescence in particular has been identified as a period of growth and change across the structure and function of the nervous system. Notably, research has identified migraines as common in both pediatric and adult populations, but evidence suggests that the phenotype for migraines may differ in these cohorts due to the unique needs of each developmental period. Accordingly, primary aims of this study were to define hippocampal structure in females (7-27 years of age) with and without migraine, and to determine whether this differs across developmental stages (i.e., childhood, adolescence, and young adulthood). Hippocampal volume was quantified based on high-resolution structural MRI using FMRIB's Integrated Registration and Segmentation Tool. Results indicated that migraine and age may have an interactional relationship with hippocampal volume, such that, while hippocampal volumes were lower in female migraineurs (compared to age-matched controls) during childhood and adolescence, this contrast differed during young adulthood whereby hippocampal volumes were higher in migraineurs (compared to age-matched controls). Subsequent vertex analysis localized this interaction effect in hippocampal volume to displacement of the anterior hippocampus. The transition of hippocampal volume during adolescent development in migraineurs suggests that hippocampal plasticity may dynamically reflect components of migraine that change over the lifespan, exerting possible altered responsivity to stress related to migraine attacks thus having physiological expression and psychosocial impact.
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Affiliation(s)
- Sophie L. Wilcox
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA
| | - Sarah Nelson
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, MA, USA
| | - Allison Ludwick
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA
| | - Andrew M. Youssef
- Department of Anatomy and Histology, The University of Sydney, Sydney, NSW, Australia
| | - Alyssa Lebel
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA
- Pediatric Headache Program, Boston Children's Hospital, Waltham, MA, USA
| | - Lino Beccera
- Center for Pain and the Brain, Harvard Medical School, Boston, MA, USA
- Invicro, Boston, MA, USA
| | - Rami Burstein
- Anesthesia and Critical Care, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - David Borsook
- Department of Psychiatry and Department of Radiology, Massachusetts General Hospital, Boston, MA, USA
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Rossi R, Benetti S, Lauria B, Grasso G, Castagno E, Ricceri F, Bondone C, Versace A. Cardiovascular Risk Factors and Family History of Major Thrombotic Events in Children with Migraine: A 12-Year Retrospective Single-Centre Study. J Clin Med 2023; 12:jcm12072582. [PMID: 37048668 PMCID: PMC10095463 DOI: 10.3390/jcm12072582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/14/2023] Open
Abstract
BACKGROUND Migraine is one of the most frequent primary headaches in childhood. The role of thrombotic predisposition in its pathogenesis is debated. Our aim was to analyse the cardiovascular risk factors and family history of major thrombotic events in children with migraine. METHODS A retrospective, single-centre study was performed over 12 years. Our headache centre record database was screened for migraine with aura (MA) and migraine without aura (MO) on the basis of the ICHD-II (until 2013) and III criteria. A control group of otherwise healthy children was recruited. Descriptive and multivariate analyses are provided; significance was set at p < 0.05. RESULTS Migraine was diagnosed in 930 children (24.7% MA); 73.3% were 9-14 years old. Children with MA were older (p < 0.001). A family history of cerebral ischemic events at ≤50 years old was more commonly reported by children with MA than those with MO (p < 0.001) and those in the control group (p = 0.001). Children with MA showed a higher risk of a family history of cerebral ischemic events at ≤50 years old than children with MO (OR: 2.6) and those in the control group (OR: 3.1). When comparing the family history of DVT, we observed a significantly increased risk for MA vs. MO (OR: 2.9). CONCLUSION A family history of cerebral ischemic events at ≤50 years old leads to an increased risk of MA. Further studies are needed to explore such an association.
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Affiliation(s)
- Roberta Rossi
- Department of Pediatric Emergency, Pediatric Headache Centre, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Piazza Polonia 94, 10126 Turin, Italy
| | - Stefania Benetti
- Department of Pediatrics, Ospedale degli Infermi, ASL TO3, Via Rivalta 29, 10098 Rivoli, Italy
| | - Barbara Lauria
- Department of Pediatric Emergency, Pediatric Headache Centre, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Piazza Polonia 94, 10126 Turin, Italy
| | - Giulia Grasso
- Department of Pediatric Emergency, Pediatric Headache Centre, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Piazza Polonia 94, 10126 Turin, Italy
| | - Emanuele Castagno
- Department of Pediatric Emergency, Pediatric Headache Centre, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Piazza Polonia 94, 10126 Turin, Italy
| | - Fulvio Ricceri
- Department of Clinical and Biological Sciences, University of Turin, Regione Gonzole 10, 10043 Orbassano, Italy
| | - Claudia Bondone
- Department of Pediatric Emergency, Pediatric Headache Centre, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Piazza Polonia 94, 10126 Turin, Italy
| | - Antonia Versace
- Department of Pediatric Emergency, Pediatric Headache Centre, Regina Margherita Children's Hospital, A.O.U. Città della Salute e della Scienza di Torino, Piazza Polonia 94, 10126 Turin, Italy
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Checchi MP, Tarantino S, Ursitti F, Monte G, Moavero R, Sforza G, Ferilli MAN, Grimaldi Capitello T, Vigevano F, Valeriani M, Papetti L. Long-Term Effects of COVID-19 Pandemic on Migraine in Adolescents. A Retrospective Analysis of the Population Attending the Headache Center in Different Phases of the Pandemic. Brain Sci 2023; 13:brainsci13020273. [PMID: 36831817 PMCID: PMC9953965 DOI: 10.3390/brainsci13020273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Literature data report that the first COVID-19 pandemic had an impact on the progression of migraine both in adults and children. The present study aimed to verify how the migraine course and psychological aspects varied in adolescent patients in relation to some of the different phases of the COVID-19 pandemic and compared with the months before COVID-19. In addition, the relationship between the characteristics of headache episodes and psychological and school-related aspects were analyzed. METHODS The study included 418 adolescents. Based on the timing of the evaluation, they were categorized into patients observed before the COVID-19 pandemic (pre COVID) or during the first (COVID 1) or second (COVID 2) wave of the pandemic. Subjects were also categorized into three further groups: those who had high or low frequency of migraine attacks during the month, those who had mild or severe pain during the attack, and those who were taking prophylactic drugs. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scales were utilized to assess depression and anxiety. RESULTS We observed a significant increase in the frequency of attacks and the use of prophylactic drugs during the COVID 2 period compared to the COVID 1 and pre-COVID periods (p < 0.05). Patients showed higher levels of anxiety and depression during each of the two COVID periods compared with the pre-COVID months (p < 0.05), especially during the COVID 2 period (p < 0.05). CONCLUSION Our results show long-term negative impacts of the COVID-19 pandemic on clinical parameters and psychological symptoms in adolescents with migraine.
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Affiliation(s)
| | - Samuela Tarantino
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Fabiana Ursitti
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Gabriele Monte
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Romina Moavero
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, 9220 Rome, Italy
| | - Giorgia Sforza
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | | | | | - Federico Vigevano
- Neurological Sciences and Rehabilitation Medicine, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Massimiliano Valeriani
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
| | - Laura Papetti
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
- Correspondence: ; Tel.: +39-0668592865
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Connelly M, Dilts J, Boorigie M, Gerson T. A Prospective Evaluation of the Effects of the COVID-19 Pandemic on Youth with Primary Headache Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020184. [PMID: 36832313 PMCID: PMC9954271 DOI: 10.3390/children10020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = -2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = -2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic.
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Affiliation(s)
- Mark Connelly
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
- Correspondence:
| | - Jennifer Dilts
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | | | - Trevor Gerson
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
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Lund J, Berring-Uldum A, Colak M, Debes NMM. Headache in Children and Adolescents: The Association between Screen Time and Headache within a Clinical Headache Population. Neuropediatrics 2022; 53:221-226. [PMID: 34905787 DOI: 10.1055/s-0041-1740550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND More than half of children and adolescents have experienced headache within the last 3 months. Several risk factors for headache have been identified, including obesity and lack of sleep. The association between screen time and headache in children and adolescents is sparsely investigated. The aim of this study was to assess this association and evaluate if it varied according to headache diagnosis. METHOD This cross-sectional study was performed at the tertiary pediatric outpatient clinic for headache at Herlev University Hospital. A total of 139 participants who answered a questionnaire on lifestyle factors and their daily living were included. Diagnoses of migraine and tension-type headache (TTH) were made according to the International Classification of Headache Disorders-3. Children with both migraine and TTH were allocated to a mixed headache group. We differentiated between total, leisure, and school-related screen time. RESULTS The mean age was 13.20 ± 3.38 years and 53.2% were girls. Note that 25.2% were diagnosed with migraine without aura, 23.0% migraine with aura, 28.1% TTH, 15.8% mixed headache, and 7.9% had an unclassified headache diagnosis at the time of inclusion. There was no statistically significant difference in screen time across the five headache groups. An association between screen time and headache frequency was found in children with migraine with aura. CONCLUSION In this study, we investigated the association between screen time and headache in children and adolescents. More screen time was associated with more frequent headaches in children with migraine with aura. Future prospective studies are needed to determine the causality of this association.
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Affiliation(s)
- Josefine Lund
- Department of Pediatrics, Herlev University Hospital, Copenhagen, Denmark
| | | | - Merve Colak
- Department of Pediatrics, Herlev University Hospital, Copenhagen, Denmark
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Çirakli S. Can flunarizine be used routinely as the first option for childhood headache treatment?: Flunarizine and childhood headache. Medicine (Baltimore) 2022; 101:e29265. [PMID: 35839040 PMCID: PMC11132379 DOI: 10.1097/md.0000000000029265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 03/16/2022] [Indexed: 11/26/2022] Open
Abstract
The prevalence of headache in childhood increases due to environmental factors. Various risk factors in children whose playgrounds are restricted outside and therefore remain inactive. So diagnosis and treatment can be challenging. The aim of this study was to evaluate the experience of flunarizine in childhood headache with a focus on efficacy and success. We conducted a retrospective observational study of 185 pediatric patients at the tertiary pediatric emergency and pediatric neurology unit between May 2018 and May 2020. Patients with headache for >15 days of a month for at least 3 months were included in the study, whether or not receiving treatment. Also, all patients who had an adequate follow-up period were included in the study. All patients were evaluated by history, physical-neurological examination, blood tests, blood pressure, eye examination, and cranial magnetic resonance imaging. All data were evaluated statistically. Ninety-eight (53%) of 185 cases were female and 87 (47%) were male. Average age was 11.4 years (min-max, 4-17). There was family history in 51.3% of the cases. The most frequent applicants were in the autumn season (43%), when schools were opened. Organic causes were hypertension in 1 case, brain tumor in 1 case, and papilledema due to idiopathic intracranial hypertension in 2 cases. The other cases were asked to make a 1-month pain chart and grading according to the visual analog scale. In this process, it was stated that painkillers could be used if needed. At the end of the first month, these patients were reevaluated. Flunarizine treatment was initiated in 95 patients who had to use painkillers for >4 times and who described ≥6 pain score according to the visual analog scale. The treatment was discontinued due to sleepiness and weakness in 2 patients. At the end of the third month, a 50% reduction in headache was observed in 82 cases (86.3%). We used flunarizine as the first choice in all patients and we achieved a high rate of treatment success. Flunarizine can be considered as an alternative option for headache management in terms of low side effects, easy accessibility, and compliance with treatment.
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Affiliation(s)
- Sevgi Çirakli
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ordu University, Ordu, Turkey
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Mingels S, Granitzer M. Cross-Sectional Study of Headache in Flemish Children and Adolescents. Child Neurol Open 2022; 9:2329048X221140783. [DOI: 10.1177/2329048x221140783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/11/2022] [Accepted: 11/03/2022] [Indexed: 12/03/2022] Open
Abstract
Background: Although headache is common in pediatrics, data for the Flemish population are missing. We explored headache-prevalence, and its association with communication-technology (CT) and physical activity (PA) in Flemish children and adolescents. Methods: A cross-sectional exploratory school-based questionnaire study was designed. Flemish boys and girls (5–18 years) completed a symptom-questionnaire. Primary outcomes: sociodemographic background, headache-prevalence, headache-characteristics, CT-use and PA characteristics (self-report). Secondary outcomes: associations between headache-characteristics, age, gender, and CT-use and PA-characteristics. Results: Four hundred twenty-four questionnaires were analysed: 5–7-years: n = 58; 8–11-years: n = 84; 12–15-years: n = 137; 16–18-years: n = 145. Fifty-five percent suffered from headache. Prevalence increased with age. More 16–18-year girls versus boys had headache. CT-use was the main headache-provocateur. Headache prevalence was significantly higher in a frequently physical active population. Conclusion: Our results suggest presence of headache in Flemish children and adolescents. PA-level associates with headache prevalence. However, children and adolescents with headache did not report more CT-use compared to controls.
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Affiliation(s)
- Sarah Mingels
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Musculoskeletal Research Unit, Department of Rehabilitation Sciences, Faculty of Kinesiology and Rehabilitation Sciences, Leuven University, Leuven, Belgium
| | - Marita Granitzer
- REVAL Rehabilitation Research Centre, Biomedical Research Institute, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
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LenglarT L, Caula C, Moulding T, Lyles A, Wohrer D, Titomanlio L. Brain to Belly: Abdominal Variants of Migraine and Functional Abdominal Pain Disorders Associated With Migraine. J Neurogastroenterol Motil 2021; 27:482-494. [PMID: 34642268 PMCID: PMC8521460 DOI: 10.5056/jnm20290] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 03/22/2021] [Accepted: 04/08/2021] [Indexed: 12/13/2022] Open
Abstract
Migraine is one of the most frequent causes of primary headache and 9% of children suffer from migraines. Most children will continue to experience migraine attacks as adults, therefore it is imperative that we have a thorough understanding of this major health issue. This article considers the so-called abdominal variants of migraine, which are more commonly seen in children rather than adults: abdominal migraine, cyclic vomiting syndrome, and infantile colic. Other functional abdominal pain disorders such as irritable bowel syndrome and functional dyspepsia have also been linked to migraine in clinical studies. The common pathophysiological root of these diseases seems to be the gut-brain axis mechanism. Abdominal variants of migraine are considered pediatric precursors of migraine whereas the functional abdominal pain disorders related to migraine seem to share a pathophysiological root with no temporarily link as for today. In this review we aim to describe the epidemiological background, the current pathophysiological theories and the relationship of each disease to migraine. This review is the first to compile abdominal variants of migraine and functional abdominal pain disorders associated with migraine and we endeavor to elucidate the broad spectrum of migraine-related episodes in children.
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Affiliation(s)
- Léa LenglarT
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Caroline Caula
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Thomas Moulding
- Department of Specialty and Integrated Medicine, The Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Annabel Lyles
- Department of Oncology, The Leeds Teaching Hospitals, NHS Trust, Leeds, UK
| | - Delphine Wohrer
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France
| | - Luigi Titomanlio
- Department of Pediatric Emergency Care, APHP - Hopital Robert Debré, Paris, France.,Pediatric Migraine and Neurovascular Diseases Unit, APHP - Hopital Robert Debré, Paris, France.,Paris University, INSERM U1141, DHU Protect, Paris, France
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Papetti L, Moavero R, Ferilli MAN, Sforza G, Tarantino S, Ursitti F, Ruscitto C, Vigevano F, Valeriani M. Truths and Myths in Pediatric Migraine and Nutrition. Nutrients 2021; 13:2714. [PMID: 34444875 PMCID: PMC8399652 DOI: 10.3390/nu13082714] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 07/29/2021] [Accepted: 08/01/2021] [Indexed: 12/19/2022] Open
Abstract
The link between migraine and nutrition can be explored from several points of view. Lifestyle and, in particular, aspects of nutrition can have a significant impact on the course of pediatric migraine. In addition, some dietary treatments, such as the ketogenic diet, and some active ingredients present in foods (nutraceuticals) may have a therapeutic effect on migraine. A diet that can control weight gain and obesity has beneficial effects on migraine severity. On the other hand, when we talk about the link between nutrition and headaches, it is also necessary to point out that some public information is actually fake news that has no scientific basis. The purpose of this review is to provide an update on the salient points linking pediatric migraine to nutritional principles, focusing on the relationship between weight and headaches, the therapeutic effect of food for medical purposes, the ketogenic diet as a migraine treatment, and the relationship between migraine and dietary habits.
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Affiliation(s)
- Laura Papetti
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Romina Moavero
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00165 Rome, Italy;
| | - Michela A. N. Ferilli
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Giorgia Sforza
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Samuela Tarantino
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Fabiana Ursitti
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Claudia Ruscitto
- Child Neurology Unit, Systems Medicine Department, Tor Vergata University Hospital of Rome, 00165 Rome, Italy;
| | - Federico Vigevano
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
| | - Massimiliano Valeriani
- Department of Neuroscience, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy; (R.M.); (M.A.N.F.); (G.S.); (S.T.); (F.U.); (F.V.); (M.V.)
- Center for Sensory-Motor Interaction, Denmark Neurology Unit, Aalborg University, 9100 Aalborg, Denmark
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Papetti L, Loro PAD, Tarantino S, Grazzi L, Guidetti V, Parisi P, Raieli V, Sciruicchio V, Termine C, Toldo I, Tozzi E, Verdecchia P, Carotenuto M, Battisti M, Celi A, D'Agnano D, Faedda N, Ferilli MA, Grillo G, Natalucci G, Onofri A, Pelizza MF, Ursitti F, Vasta M, Velardi M, Balestri M, Moavero R, Vigevano F, Valeriani M. I stay at home with headache. A survey to investigate how the lockdown for COVID-19 impacted on headache in Italian children. Cephalalgia 2020; 40:1459-1473. [PMID: 33146039 PMCID: PMC7684684 DOI: 10.1177/0333102420965139] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Objective The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy. Methods During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis. Results We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p < 0.001). The greater the severity of headache, the larger was the clinical improvement (p < 0.001). Disease duration was negatively associated with the improvement (p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis (p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05). Conclusions Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population.
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Affiliation(s)
- Laura Papetti
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Samuela Tarantino
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Licia Grazzi
- Headache Center, Neuroalgology Department, IRCCS Foundation "Carlo Besta" Neurological Institute, Milan, Italy
| | - Vincenzo Guidetti
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Pasquale Parisi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Vincenzo Raieli
- Child Neuropsychiatry Unit - Ismep - ARNAS Civico, Palermo, Italy
| | - Vittorio Sciruicchio
- Children Epilepsy and EEG Center, PO, San Paolo ASL (Azienda Sanitaria Locale), Bari, Italy
| | - Cristiano Termine
- Department of Medicine and Surgery, University of Insubria and ASST dei Sette Laghi, Varese, Italy
| | - Irene Toldo
- Centro Cefalee per l'età Evolutiva, Dipartimento di Salute della Donna e del Bambino, Università degli Studi, Azienda Ospedaliera di Padova, Padova, Italy
| | - Elisabetta Tozzi
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'ambiente, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Paola Verdecchia
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Marco Carotenuto
- Neuropsichiatria Infantile, Dipartimento di Salute Mentale e Fisica e Medicina Preventiva, Università della Campania "Luigi Vanvitelli", Napoli, Italy
| | - Matteo Battisti
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Angela Celi
- Department of Medicine and Surgery, University of Insubria and ASST dei Sette Laghi, Varese, Italy
| | - Daniela D'Agnano
- Children Epilepsy and EEG Center, PO, San Paolo ASL (Azienda Sanitaria Locale), Bari, Italy
| | - Noemi Faedda
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Michela An Ferilli
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Giovanni Grillo
- Child Neuropsychiatry Unit - Ismep - ARNAS Civico, Palermo, Italy
| | - Giulia Natalucci
- Department of Human Neuroscience, Section of Child and Adolescent Neuropsychiatry, "Sapienza" University, Rome, Italy
| | - Agnese Onofri
- Dipartimento di Medicina Clinica, Sanità Pubblica, Scienze della Vita e dell'ambiente, Università degli Studi dell'Aquila, L'Aquila, Italy
| | - Maria Federica Pelizza
- Centro Cefalee per l'età Evolutiva, Dipartimento di Salute della Donna e del Bambino, Università degli Studi, Azienda Ospedaliera di Padova, Padova, Italy
| | - Fabiana Ursitti
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Michelangelo Vasta
- Unità di Neuropsichiatroia Infantile, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Margherita Velardi
- Child Neurology, Department of Neuroscience, Mental Health and Sense Organs, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy
| | - Martina Balestri
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Romina Moavero
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Unità di Neuropsichiatroia Infantile, Dipartimento di Medicina dei Sistemi, Università Tor Vergata, Rome, Italy
| | - Federico Vigevano
- Neurology Unit, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Massimiliano Valeriani
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy.,Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
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Hancı F, Kabakuş N, Türay S, Bala KA, Dilek M. The role of obesity and vitamin D deficiency in primary headaches in childhood. Acta Neurol Belg 2020; 120:1123-1131. [PMID: 30963478 DOI: 10.1007/s13760-019-01134-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 04/02/2019] [Indexed: 02/01/2023]
Abstract
This study evaluates the role of obesity, overweight and vitamin D deficiency in primary headaches in childhood. This retrospective observational study included pediatric patients aged 5-17 years admitted to the pediatric neurology clinic with headaches between January 2015 and August 2018 and diagnosed with primary headache based on ICHD III-beta criteria. The control group consisted of healthy children without headache admitted to the pediatric outpatient clinic for check-ups before engaging in athletic or school activities. The control and patient groups were at the same risk of low 25(OH)D3 levels. The study population was divided into three groups-patients with migraine (group A), patients with tension-type headache (TTH) (group B) and the control group (group C). Participants' demographic data, medical histories, physical examination findings and laboratory results were retrieved retrospectively from the patient charts. BMI was significantly higher in patients with primary headache, the risk of primary headache increasing in patients with a BMI in excess of 25. Comparison of the patients with primary headache and the control group revealed lower 25(OH)D levels in the primary headache group, although the difference was not statistically significant. Girls with primary headache had significantly lower 25(OH)D levels than boys. A relationship may be present between overweight, obesity and primary headache, while female gender may be suggested as a negative factor for primary headache. Patients should be advised to lose weight if BMI indicates overweight or obesity.
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Ahmadiafshar A, Vafaee-Shahi M, Ghasemi S, Khosroshahi F, Riahi A. The Frequency of Food Allergy Among Children With Migraine Headache; A Descriptive Cross-Sectional Study. Open Neurol J 2020. [DOI: 10.2174/1874205x02014010046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Headache and particularly migraine headaches are considered as a debilitating disease worldwide that can adversely affect the quality of life of children and adults. Various factors can play a critical role in the development of migraine headache attacks. The food allergens are considered as important factors. This study aimed to determine the frequency of food allergy in children with migraine headaches.
Methods:
Forty patients aged <16 years with a migraine headache were entered into the study. A questionnaire was provided in which data on demographic information and skin test results for various allergens were recorded. Dietary allergies were defined based on a positive skin test plus a patient's history of food allergies. The severity of migraine was evaluated using the Migraine disability assessment score (MIDAS) questionnaire.
Results:
The present study showed 32.5% of our participants had a food allergy. No significant association was detected between sex (p=58) and age (p=0.14) with food allergy. However, the frequency of food allergy was significantly higher in patients aged ≥12 years old (44.4%) than those aged <12 (22.7%). A significant relationship was found between the number of attacks after prophylaxis and the frequency of food allergies (p=0.032). Individuals with lower attacks had a lower food allergy.
Conclusion:
Our findings revealed that about one-third of children with a migraine headache had a food allergy. This frequency was significantly higher in children with migraines than that of the general population based on the results of previous studies. It is recommended that these patients receive a skin allergy test while preparing a strong history of food allergies or when the frequency of migraine attacks does not decrease significantly despite proper prophylaxis.
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Natalucci G, Faedda N, Baglioni V, Guidetti V. The Relationship Between Parental Care and Pain in Children With Headache: A Narrative Review. Headache 2020; 60:1217-1224. [PMID: 32474926 DOI: 10.1111/head.13822] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/06/2020] [Indexed: 12/22/2022]
Abstract
PURPOSE In migraine or primary headache in children, parents play a fundamental role in pain management. For this narrative review, PubMed, Google Scholar, and Psych Info were searched using the terms "parent headache", "mother/father headache", "parental impact headache", "alexithymia parents headache", "catastrophizing parent headache", "family headache", "children parent headache", and "quality of life family headache". Articles were chosen for inclusion based on their relevance in to the topic. OVERVIEW Several parental and psychological characteristics can influence in children and adolescent headache, such as parental attitudes as oppressive or overprotective; punitive parenting styles; familial psychological symptoms, especially anxiety and depression; catastrophizing about their child's pain or excessive worry about their child's headache; inability to express emotions; and feelings that may lead to somatization problems. DISCUSSION Parents' attitudes and behaviors toward their child's headache have a strong relation with the severity of headache attacks. Mothers seem to have more influence than fathers on children's pain and emotional regulation. We suggest that the presence of caregiver-child transmission of maladaptive coping strategies, arising from difficulties expressing emotion, may lead to incorrect management of headache pain, further facilitating headache chronification.
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Affiliation(s)
- Giulia Natalucci
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Noemi Faedda
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Valentina Baglioni
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
| | - Vincenzo Guidetti
- Department of Human Neuroscience, Sapienza University of Rome, Rome, Italy
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15
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Ouyang CS, Chiang CT, Yang RC, Wu RC, Lin LC. Quantitative electroencephalogram analysis of frontal cortex functional changes in patients with migraine. Kaohsiung J Med Sci 2020; 36:543-551. [PMID: 32259398 DOI: 10.1002/kjm2.12213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Revised: 03/03/2020] [Accepted: 03/08/2020] [Indexed: 01/03/2023] Open
Abstract
The functional abnormality of brain areas accounting for the migraine remains to be elucidated. Most related studies have used functional magnetic resonance imaging to investigate brain areas involved in migraine. However, the results are heterogeneous. In this study, we used a convenient tool to explore the brain regions involved in migraine. In this study, 40 children with migraine and 40 sex- and age-matched health controls were enrolled, and electroencephalogram was used to explore the functional abnormal areas of migraine through electroencephalogram bands and low-resolution electromagnetic tomography analysis. The results revealed that spectrum edge frequency 50 in all electroencephalogram channels in patients with migraine were lower than those in controls. Significant differences were discovered over frontal areas. In addition, significantly higher current density over the frontopolar prefrontal cortex and orbitofrontal cortex and higher connectivity over the left prefrontal cortex were observed in patients with migraine. We suggest that functional disturbance of the prefrontal cortex may play a potential role in children with migraine, and that low-resolution electromagnetic tomography is a reliable and convenient tool for studying the functional disturbance of migraine.
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Affiliation(s)
- Chen-Sen Ouyang
- Department of Information Engineering, I-Shou University, Kaohsiung, Taiwan, ROC
| | - Ching-Tai Chiang
- Department of Computer and Communication, National Pingtung University, Pingtung, Taiwan, ROC
| | - Rei-Cheng Yang
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC
| | - Rong-Ching Wu
- Department of Electrical Engineering, I-Shou University, Kaohsiung, Taiwan, ROC
| | - Lung-Chang Lin
- Department of Pediatrics, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.,Department of Pediatrics, School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan, ROC
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Koller LS, Diesner SC, Voitl P. Quality of life in children and adolescents with migraine: an Austrian monocentric, cross-sectional questionnaire study. BMC Pediatr 2019; 19:164. [PMID: 31126268 PMCID: PMC6533686 DOI: 10.1186/s12887-019-1537-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 05/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine is a disabling primary headache disorder that occurs in about 10 % of children and might lead to a lower quality of life. There are several possible migraine triggers in a patient's environment, which should be avoided where possible. The objective of this Austrian monocentric study was to identify migraine triggers and the areas, in which children and adolescents with migraine have a lower quality of life than healthy, headache-free children. METHODS In this cross-sectional, questionnaire study, 76 children from ages 8 to 17 years were included. Thirty-seven were classified as migraineurs, 39 as non-migraineurs. Participants filled in a questionnaire surveying the areas of physical, socio-economic and school functioning. Migraineurs further answered migraine-specific questions. RESULTS The study included 33 (43.4%) males and 43 (56.6%) females. Median age was 13.00 (10.00-16.00) years. Average age of onset for migraine was 9.22 ± 3.34 years. Non-migraineurs skipped trendwise fewer meals (p.adjust = 0.108) and exercised more often (p.adjust = 0.108). In socio-economic functioning, the father's nationality being Austrian might be related to migraine (p.adjust = 0.108). Children with migraine had a significantly lower quality of life in school functioning (PedsQL 4.0 questionnaire, p.adjust = 0.04) and had significantly less often "good" grades than children without migraine (p.adjust = 0.048). CONCLUSION Children with migraine show a reduced quality of life in the areas of physical, socio-economic and school functioning.
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Affiliation(s)
- Lydia Stella Koller
- First Vienna Pediatric Medical Center, Donau-City Straße 1, 1220, Vienna, Austria
| | - Susanne C Diesner
- First Vienna Pediatric Medical Center, Donau-City Straße 1, 1220, Vienna, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Donau-City Straße 1, 1220, Vienna, Austria. .,Sigmund Freud University Vienna, Freudplatz 1, 1020, Vienna, Austria.
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Livingston RD, Shockey D, Morton L, Rao S. Pediatric Headache Management and Use of the PedMIDAS. J Dr Nurs Pract 2019; 12:24-30. [PMID: 32745052 DOI: 10.1891/2380-9418.12.1.24] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Headache is a worldwide problem affecting people of all ages, races, and incomes. Childhood headache is a common condition affecting quality of life and prompting frequent medical visits. The Pediatric Migraine Disability Assessment tool (PedMIDAS) is a validated questionnaire recognized in the assessment of pediatric headache. Use of the PedMIDAS is supported in the 2014 American Academy of Neurology headache quality measurement set, which provides practice parameters for headache management. OBJECTIVE The purpose of this quality improvement project is to introduce the PedMIDAS into the assessment of pediatric headache patients in a pediatric neurology practice in an attempt to standardize care and discern provider satisfaction. METHODS Chart review (11-21-16 to 11-30-17) following provider/staff education regarding the PedMIDAS. RESULTS The PedMIDAS was completed 23% of the time (404/1741). CONCLUSIONS Although the PedMIDAS was only completed 23% of the time, providers surveyed regarding usefulness indicated the PedMIDAS is helpful with quantifying the disability experienced by pediatric headache patients. IMPLICATIONS FOR NURSING Assessing disability through the use of the PedMIDAS is a beneficial practice change helping with evaluating headache interventions, differentiating headache frequency from disability, and clarifying the severity of pain related to headache that affects daily life.
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Affiliation(s)
| | - Debra Shockey
- Virginia Commonwealth University, Richmond, Virginia
| | | | - Sanjai Rao
- Virginia Commonwealth University, Richmond, Virginia
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19
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Hypnotherapy or transcendental meditation versus progressive muscle relaxation exercises in the treatment of children with primary headaches: a multi-centre, pragmatic, randomised clinical study. Eur J Pediatr 2019; 178:147-154. [PMID: 30357468 PMCID: PMC6339662 DOI: 10.1007/s00431-018-3270-3] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 10/05/2018] [Accepted: 10/11/2018] [Indexed: 12/02/2022]
Abstract
Many children suffer from headaches. Since stress may trigger headaches, effective techniques to cope with stress are needed. We investigated the effectiveness of two mind-body techniques, transcendental meditation (TM) or hypnotherapy (HT), and compared them with progressive muscle relaxation (PMR) exercises (active control group). Children (9-18 years) suffering from primary headaches more than two times per month received either TM (N = 42), HT (N = 45) or PMR (N = 44) for 3 months. Primary outcomes were frequency of headaches and ≥ 50% reduction in headaches at 3 and 9 months. Secondary outcomes were adequate relief, pain coping, anxiety and depressive symptoms, somatisation and safety of treatment. Groups were comparable at baseline. Headache frequency was significantly reduced in all groups from 18.9 days per month to 12.5 and 10.5 at respectively 3 and 9 months (p < 0.001), with no significant differences between the groups. Clinically relevant headache reduction (≥ 50%) was observed in 41% and 47% of children at 3 and 9 months respectively, with no significant differences between the groups. No differences were observed in secondary outcome measures between the intervention groups. No adverse events were reported.Conclusion: All three techniques reduced primary headache in children and appeared to be safe.Trial registration: NTR 2955, 28 June 2011 ( www.trialregister.nl ) What is Known: • Stress may be an important trigger for both tension type headache and migraine in children. • Good data are lacking on the effect of transcendental meditation, hypnotherapy or progressive muscle relaxation as possible stress-reducing therapies in children with primary headaches. What is New: • Three non-pharmacological techniques, i.e., transcendental meditation, hypnotherapy and progressive muscle relaxation exercises, all result in a clinically significant reduction of headaches and use of pain medication. • No large differences between the three techniques were found, suggesting that children can choose either one of the three techniques based on personal preferences.
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Foiadelli T, Piccorossi A, Sacchi L, De Amici M, Tucci M, Brambilla I, Marseglia GL, Savasta S, Verrotti A. Clinical characteristics of headache in Italian adolescents aged 11-16 years: a cross-sectional questionnaire school-based study. Ital J Pediatr 2018; 44:44. [PMID: 29618369 PMCID: PMC5885291 DOI: 10.1186/s13052-018-0486-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/26/2018] [Indexed: 12/16/2022] Open
Abstract
Background The purpose of this study was to determine headache characteristics, impact on daily activities and medication attitudes among a large sample of adolescents in Italy. Methods Secondary school classes were randomly selected from a national stratified multistage sampling. Data regarding socio-familial factors, headache characteristics, impact on daily activities and medication use were recorded with an anonymous multiple-choice questionnaire. Results The survey involved 2064 adolescents. 1950 questionnaires were considered for analysis. Study population included 944 males (48.4%) and 1006 females (51.6%), aged between 11 and 16 years (mean 13.5 ± 1.87). Headache prevalence was 65.9%. Mean age at headache onset was 8.33 years. 9.8% suffered from headache > 1/week, 14.3% > 1/month, 24.2% monthly and 17.7% less than monthly. The mean duration of a headache episode was less than 30 min in 32.9%, 1 hour in 28.1%, 2 hours in 19.3% and several hours in 19.5%. Pain intensity was moderate in 52.2% and severe in 9.5%. School represented the main trigger factor (67%). Impact on daily activities was noted in 57.5%. 69.2% of adolescents reported the use of pain relievers. Up to 5.7% declared self-medication, while only 20.6% followed a physician’s prescription. Female adolescents experienced headache more frequently (70.2% vs 60%) and more intensely than male peers. Girls had a higher family history of headache, could more frequently identify a trigger factor, and were more affected into their daily activities than boys. Conclusions Population-based studies of headache disorders are important, as they inform needs assessment and underpin service policy for a disease that is a public-health priority. Headache has a high prevalence among adolescents and carries a significant burden in terms of impact on daily activities and use of medication. Furthermore, underdiagnose is common, while trigger factors are often detectable. Special consideration should be given to female adolescents and self-medication attitudes.
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Affiliation(s)
- Thomas Foiadelli
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pediatric Clinic, I.R.C.C.S. Policlinico "S. Matteo" Foundation, 27100, Pavia, Italy.
| | - Alessandra Piccorossi
- Department of Pediatrics, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy
| | - Lucia Sacchi
- Department of Electrical, Computer and Biomedical Engineering, University of Pavia, Pavia, Italy
| | - Mara De Amici
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pediatric Clinic, I.R.C.C.S. Policlinico "S. Matteo" Foundation, 27100, Pavia, Italy
| | | | - Ilaria Brambilla
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pediatric Clinic, I.R.C.C.S. Policlinico "S. Matteo" Foundation, 27100, Pavia, Italy
| | - Gian Luigi Marseglia
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pediatric Clinic, I.R.C.C.S. Policlinico "S. Matteo" Foundation, 27100, Pavia, Italy
| | - Salvatore Savasta
- Department of Clinical-Surgical, Diagnostic and Pediatric Sciences, University of Pavia, Pediatric Clinic, I.R.C.C.S. Policlinico "S. Matteo" Foundation, 27100, Pavia, Italy
| | - Alberto Verrotti
- Department of Pediatrics, University of L'Aquila, San Salvatore Hospital, L'Aquila, Italy
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Abstract
There is little qualitative literature that addresses the adolescent experience of living with headache. The purpose of this study was to determine the dimensions of the health challenge of adolescent headache; the high points, low points, and turning points of living with headache; and the approaches used to resolve the challenge of living with headache. Story theory was used as the qualitative framework to guide data collection, and story inquiry provided the structure for analyzing the data. The Pediatric Migraine Disability Scale (PedMIDAS) quantitatively measured the impact of headaches on daily functioning. Of the 8 participants, 6 reported moderate to severe disability. From the stories, a theme for the complicating health challenge of living with adolescent headache was "an enduring distress manifested by pain, uncertainty, distancing self from family and friends, challenges with school, and not knowing how to resolve." Themes descriptive of the high points, low points, and turning points included "Contentment with school achievement, supportive relationships, and comforting engagement"; "Interruption in pursuing sports/exercise, time with others, and family relationships"; and "A developing realization, through hope and insight, of the possibilities for moving toward resolution." Stories revealed approaches used to resolve the challenge of living with headache, which included self-management through medication, sleep, and transcendence. The findings offer insight into the challenges faced by adolescents with headache and provide evidence of the importance for developing holistic plans of care that address the individual needs of the patient rather than relying on medication management alone.
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Ramírez-Vélez R, Silva-Moreno C, Correa-Bautista JE, González-Ruíz K, Prieto-Benavides DH, Villa-González E, García-Hermoso A. Self-Rated Health Status and Cardiorespiratory Fitness in a Sample of Schoolchildren from Bogotá, Colombia. The FUPRECOL Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:E952. [PMID: 28832546 PMCID: PMC5615489 DOI: 10.3390/ijerph14090952] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 08/08/2017] [Accepted: 08/17/2017] [Indexed: 02/08/2023]
Abstract
To evaluate the relationship between Self-Rated Health (SRH) and cardiorespiratory fitness (CRF) in a sample of children and adolescents enrolled in official schools in Bogotá, Colombia. A cross-sectional study was performed with 7402 children and adolescents between 9 and 17 years of age. Participants were asked to rate their health based on eight validated questions, addressing the participants propensity for headache, stomach-ache, backache, feeling-low, irritability/bad mood, nervousness, sleeping-difficulties, and dizziness. The choices were "rarely or never", "almost every month", "almost every week", and "more than once a week/about every day". Participants performed the international course-navette shuttle run test to estimate CRF, and cut-off points for age and gender were used to categorize the healthy/unhealthy fitness zone according to the FITNESSGRAM® criteria. Overall, 16.4% of those surveyed reported a perception of irritability/bad mood "more than once a week/about every day", followed by feeling-low and nervousness (both with 9.9%). Dizziness had the lowest prevalence with a percentage of 6.9%. Unhealthy CRF in boys increased the likelihood of headaches by 1.20 times, stomach aches by 1.31 times, feeling-low by 1.29 times, nervousness by 1.24 times, and dizziness by 1.29 times. In girls, unhealthy CRF increased the likelihood of headaches by 1.19 times, backache by 1.26 times, feeling-low by 1.28 times, irritability/bad mood by 1.17 times, sleeping-difficulties by 1.20 times, and dizziness by 1.27 times. SRH was associated with CRF in both genders. Early identification of children and adolescents with low CRF levels will permit interventions to promote healthy behaviors and prevent future diseases during adulthood.
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Affiliation(s)
- Robinson Ramírez-Vélez
- Centro de Estudios para la Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - Carolina Silva-Moreno
- Centro de Estudios para la Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - Jorge Enrique Correa-Bautista
- Centro de Estudios para la Medición de la Actividad Física (CEMA), Escuela de Medicina y Ciencias de la Salud, Universidad del Rosario, Bogotá DC 111221, Colombia.
| | - Katherine González-Ruíz
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC 110231, Colombia.
| | - Daniel Humberto Prieto-Benavides
- Grupo de Ejercicio Físico y Deportes, Vicerrectoría de Investigaciones, Universidad Manuela Beltrán, Bogotá DC 110231, Colombia.
| | - Emilio Villa-González
- Department of Education Sciences, University of Almería, 04120 Almería, Spain.
- PROFITH "PROmoting FITness and Health through Physical Activity" Research Group, Department of Physical Education and Sport, School of Sport Sciences, University of Granada, 18010 Granada, Spain.
| | - Antonio García-Hermoso
- Laboratorio de Ciencias de la Actividad Física, el Deporte y la Salud, Universidad de Santiago de Chile, Facultad de Ciencias Médicas, USACH, Santiago 9160030, Chile.
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