1
|
Orr SL. Headache in Children and Adolescents. Continuum (Minneap Minn) 2024; 30:438-472. [PMID: 38568493 DOI: 10.1212/con.0000000000001414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This article reviews the assessment of children and adolescents presenting with headache, provides an overview of primary headache disorders, and reviews evidence-based management of headache in this age group. LATEST DEVELOPMENTS In the last few years, new epidemiological data have shed light on less common pediatric headache disorders (eg, pediatric trigeminal autonomic cephalalgias) and psychosocial risk factors associated with primary headache disorders in children and adolescents. There has also recently been a substantial increase in interventions that target the calcitonin gene-related peptide pathway and that treat primary headache disorders using noninvasive neuromodulation. Although these interventions have primarily been studied in adults, there is emerging evidence of their use in the pediatric population. ESSENTIAL POINTS Primary headache disorders are very common in youth, and the most commonly encountered headache diagnosis in neurology practice is migraine, which affects approximately 10% of children and adolescents. Diagnosing and effectively treating primary headache disorders before adulthood may have a sustained impact on the patient by improving long-term headache and mental health outcomes, thereby significantly reducing the burden of disability over time. There are several available and emerging acute and preventive interventions for youth with primary headache disorders, and treatment decisions should be made in the context of available evidence using a shared decision-making approach.
Collapse
|
2
|
Bouman EJ, Mackenbach JD, Twisk JWR, Raimondo L, Beulens JWJ, Elders PJM, Rutters F. Is the association between social jetlag and BMI mediated by lifestyle? A cross-sectional survey study in the Dutch general population. Prev Med 2024; 181:107908. [PMID: 38382765 DOI: 10.1016/j.ypmed.2024.107908] [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: 11/27/2023] [Revised: 02/16/2024] [Accepted: 02/17/2024] [Indexed: 02/23/2024]
Abstract
OBJECTIVE Social jetlag is a discordance between the social and biological rhythm and is associated with higher HbA1c, higher BMI, and higher odds of obesity. The pathways that could explain these associations are still debated. This study aims to assess the mediating role of several lifestyle factors in the cross-sectional association between social jetlag and BMI. METHODS We used cross-sectional data from 1784 adults from urban areas in the Netherlands, collected in 2019. Social jetlag (difference in midpoint of sleep between week and weekend nights) was categorized as low(<1 h), moderate(1-2h), and high(>2 h). BMI(kg/m2) was calculated from self-reported height and weight. The association between social jetlag and BMI was assessed using linear regression, adjusted for sex, age, education, and sleep duration and stratified for the effect modifier stress (high vs. low). Mediation analysis was performed for self-reported smoking, physical activity, alcohol consumption, and adherence to a healthy diet. RESULTS High social jetlag was associated with higher BMI (0.69 kg/m2,95%CI 0.05;1.33). This association was stronger in people with high stress (0.93 kg/m2,95%CI 0.09;1.76). Social jetlag was also associated with higher odds of smoking, lower physical activity, higher alcohol consumption, and lower healthy diet adherence. In people with high stress, these factors mediated 10-15% of the association between social jetlag and BMI. CONCLUSIONS Social jetlag is associated with higher BMI and this association is stronger in people with high stress. In people with high stress, healthy diet adherence mediated 12% of this association. Other pathways involved in this association should be further investigated.
Collapse
Affiliation(s)
- Emma J Bouman
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands.
| | - Joreintje D Mackenbach
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
| | - Jos W R Twisk
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands
| | - Laura Raimondo
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands
| | - Joline W J Beulens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands; Julius Centre for Health Sciences and Primary Care, University Medical Centre Utrecht, the Netherlands
| | - Petra J M Elders
- Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands; Amsterdam UMC location Vrije Universiteit Amsterdam, General Practice, Meibergdreef 9, Amsterdam, Netherlands
| | - Femke Rutters
- Amsterdam UMC location Vrije Universiteit Amsterdam, Epidemiology and Data Science, Meibergdreef 9, Amsterdam, Netherlands; Amsterdam Public Health, Health Behaviors & Chronic Diseases, Amsterdam, the Netherlands
| |
Collapse
|
3
|
Nilles C, Williams JV, Patten SB, Pringsheim TM, Orr SL. Lifestyle Factors Associated With Frequent Recurrent Headaches in Children and Adolescents: A Canadian Population-Based Study. Neurology 2024; 102:e209160. [PMID: 38417103 DOI: 10.1212/wnl.0000000000209160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/07/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Lifestyle behaviors have been postulated to affect headache frequency in youth and are often the primary target of self-management recommendations. Our study aimed to assess the association between various lifestyle factors and frequent recurrent headaches in children and youth. METHODS Children and adolescents aged 5-17 years were enrolled in a large cross-sectional Canadian population-based health survey, completed on January 31, 2019. Headache frequency was dichotomized into "approximately once/week or less" or ">once/week" (defined as frequent recurrent headaches). The association between frequent headaches and meal schedules, screen exposure, physical activity, chronotype, and frequent substance use/exposure (alcohol, cigarettes, electronic cigarettes, and cannabis) was assessed using both unadjusted logistic regression models and models adjusted for age/sex. Fully adjusted models examined the odds of frequent headaches according to all exposures. Survey design effects were accounted for using bootstrap replicate weighting. RESULTS There were an estimated nweighted = 4,978,370 eligible participants in the population. The mean age was 10.9 years (95% CI 10.9-11.0); 48.8% were female; 6.1% had frequent headaches. Frequent headaches were associated with older age (odds ratio [OR] = 1.31, 95% CI 1.28-1.34, p < 0.001) and female sex (OR = 2.39, 95% CI 2.08-2.75, p < 0.001). In models adjusted for age/sex, the odds of frequent headaches decreased with meal regularity (adjusted OR [aOR] = 0.90, 95% CI 0.89-0.92, p < 0.001) and increased with later chronotype (aOR = 1.10, 95% CI 1.05-1.15, p < 0.001) and excess screen exposure (≥21 hours vs none in past week: aOR = 2.97, 95% CI 1.53-5.77, p = 0.001); there was no significant association with reported physical activity (aOR = 0.95, 95% CI 0.67-1.34, p = 0.77). In 12- to 17-year-olds, frequent headaches were associated with frequent alcohol use (≥1/wk vs never: aOR = 3.50, 95% CI 2.18-5.62, p < 0.001), binge drinking (≥5 times in past month vs never: aOR = 5.52, 95% CI 2.95-10.32, p < 0.001), smoking cigarettes (daily vs never: aOR = 3.81, 95% CI 1.91-7.62, p < 0.001), using e-cigarettes (daily vs never: aOR = 3.10, 95% CI 2.29-4.20, p < 0.001), and cannabis use (daily vs never: aOR = 3.59, 95% CI 2.0-6.45, p < 0.001). In the entire sample, daily exposure to smoking inside the house was associated with frequent headaches (aOR = 2.00, 95% CI 1.23-3.27, p = 0.005). DISCUSSION Several lifestyle behaviors were associated with frequent headaches in children and youth, such as meal irregularity, late chronotype, prolonged screen exposure, and frequent substance use/exposure, suggesting that these are potential modifiable risk factors to target in this population.
Collapse
Affiliation(s)
- Christelle Nilles
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeanne V Williams
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Scott B Patten
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tamara M Pringsheim
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Serena L Orr
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| |
Collapse
|
4
|
Cohen F, Bobker S. From diet to disasters, lifestyle factors can affect headaches and migraine. Headache 2023; 63:712-713. [PMID: 37317563 DOI: 10.1111/head.14500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 03/15/2023] [Indexed: 06/16/2023]
Affiliation(s)
- Fred Cohen
- Department of Neurology, Mount Sinai Center for Headache and Facial Pain, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sarah Bobker
- Department of Neurology, University of California at San Francisco, UCSF Headache Center, San Francisco, California, USA
| |
Collapse
|
5
|
Kuzik N, da Costa BGG, Hwang Y, Verswijveren SJJM, Rollo S, Tremblay MS, Bélanger S, Carson V, Davis M, Hornby S, Huang WY, Law B, Salmon J, Tomasone JR, Wachira LJ, Wijndaele K, Saunders TJ. School-related sedentary behaviours and indicators of health and well-being among children and youth: a systematic review. Int J Behav Nutr Phys Act 2022; 19:40. [PMID: 35382825 PMCID: PMC8979786 DOI: 10.1186/s12966-022-01258-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 02/08/2022] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND The purpose of this systematic review was to examine the associations between school-related sedentary behaviours and indicators of health and well-being in children and youth (~ 5-18 years) attending school. METHODS This review was conducted to inform the development of School-Related Sedentary Behaviour Recommendations. Peer-reviewed, published, or in-press articles in English were included. Reviews, meta-analyses, and case studies were excluded; all other study designs were eligible. Further, articles had to meet the a priori study criteria for population, intervention, comparator (PROSPERO ID: CRD42021227600). Embase, MEDLINE® ALL, and PsycINFO were searched. Risk of bias was assessed for individual experimental studies using the Cochrane risk of bias assessment tool, and in observational studies based on the GRADE framework and in line with previous systematic reviews examining sedentary behaviours in children. Overall quality of evidence was assessed using the GRADE framework for each outcome category and study design. Results were synthesized narratively, grouped by study design and outcome category. Further, several high-level summaries were conducted to help interpret results. RESULTS Evidence was synthesized from 116 reports, including 1,385,038 participants and 1173 extracted associations. More school-related sedentary behaviour was favourably associated with nearly one-third of extracted associations for cognitive (33%) and social-emotional (32%) indicators (e.g., less anxiety), but unfavourably associated with other movement behaviours (e.g., less physical activity) (35%). Active lessons were favourable (72%), compared to more school-related sedentary behaviours, when examining associations for all health and well-being indicators. More homework was favourable across all health and well-being indicators in 4% of extracted associations for primary school children, and 25% of extracted associations for secondary school children. However, ≥2 h/day of homework appeared to be unfavourable for health and well-being. Limitations for synthesized studies included generally low quality of evidence and a lack of studies in South American, African, or low-middle income countries. CONCLUSIONS Findings can help inform policy makers, schools, and teachers, regarding the amount of homework assigned and the introduction of active lessons into the classroom to enhance health and well-being of children. More research is needed examining school-related sedentary behaviours and indicators of health and well-being in low- and middle-income countries.
Collapse
Affiliation(s)
- Nicholas Kuzik
- Healthy Active Living and Obesity Research Group, Children's Hospital of Eastern Ontario Research Institute, Ottawa, Canada. .,Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | - Bruno G. G. da Costa
- grid.260989.c0000 0000 8588 8547School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Yeongho Hwang
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Simone J. J. M. Verswijveren
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Scott Rollo
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | - Mark S. Tremblay
- grid.414148.c0000 0000 9402 6172Healthy Active Living and Obesity Research Group, Children’s Hospital of Eastern Ontario Research Institute, Ottawa, Canada ,grid.28046.380000 0001 2182 2255Department of Pediatrics, Faculty of Medicine, University of Ottawa, Ottawa, Canada ,grid.34428.390000 0004 1936 893XDepartment of Health Sciences, Carleton University, Ottawa, Canada
| | - Stacey Bélanger
- grid.14848.310000 0001 2292 3357Département de Pédiatrie, Faculté de Médicine, Université de Montréal and CHU Sainte Justine, CIRENE (Centre Intégré du Réseau en Neurodéveloppement de L’Enfant), Montréal, Quebec Canada
| | - Valerie Carson
- grid.17089.370000 0001 2190 316XFaculty of Kinesiology, Sport, and Recreation, University of Alberta, Edmonton, Canada
| | - Melanie Davis
- Physical and Health Education (PHE) Canada, Ottawa, Canada
| | - Susan Hornby
- Pan-Canadian Joint Consortium for School Health (JCSH), Summerside, Canada
| | - Wendy Yajun Huang
- grid.221309.b0000 0004 1764 5980Department of Sport, Physical Education and Health, Hong Kong Baptist University, Hong Kong, China
| | - Barbi Law
- grid.260989.c0000 0000 8588 8547School of Physical & Health Education, Nipissing University, North Bay, Canada
| | - Jo Salmon
- grid.1021.20000 0001 0526 7079Institute for Physical Activity and Nutrition, Deakin University, Geelong, Australia
| | - Jennifer R. Tomasone
- grid.410356.50000 0004 1936 8331School of Kinesiology and Health Studies, Queen’s University, Kingston, Canada
| | - Lucy-Joy Wachira
- grid.9762.a0000 0000 8732 4964Physical Education, Exercise and Sports Science, Kenyatta University, Nairobi, Kenya
| | - Katrien Wijndaele
- grid.5335.00000000121885934MRC Epidemiology Unit, University of Cambridge, Cambridge, UK
| | - Travis J. Saunders
- grid.139596.10000 0001 2167 8433Department of Applied Human Sciences, University of Prince Edward Island, Charlottetown, Canada
| |
Collapse
|
6
|
Abu-Arafeh I. Predicting quality of life outcomes in children with migraine. Expert Rev Neurother 2022; 22:291-299. [PMID: 35263201 DOI: 10.1080/14737175.2022.2051481] [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: 11/04/2022]
Abstract
INTRODUCTION Several studies have shown that the response of children with migraine to medications is suboptimum and inferior to the response reported in adults, despite the similar pathogenesis and biological mechanisms. The poor response may be related to the significant differences that make assessment and treatment of children with migraine more challenging than in adults. AREAS COVERED The purpose of this review is to discuss the whole process of assessment of children with migraine, the necessary skills for eliciting the clinical features, making the correct diagnosis and exploring lifestyle issues, co-morbid conditions (psychological and physical) and social influences on disease presentations. Also, to establish and address peculiarities of migraine in children that would enable clinicians to advise on lifestyle modifications, co-morbid conditions and the correct choice of treatment options including non-pharmacologic therapies and medications. EXPERT OPINION The choice of treatment should be based on an assessment of each individual child taking into account, age, gender, pubertal status, body weight, comorbid disorders and family history. Also considering the profile of migraine episodes, frequency, duration, associated symptoms and effects of nausea and vomiting. Using the appropriate medications in appropriate dosage, formulation and route and timing of administration may improve adherence to treatment and outcome.
Collapse
Affiliation(s)
- Ishaq Abu-Arafeh
- Paediatric Neurosciences Unit, Royal Hospital for Children, 1345 Govan Road, Glasgow, G51 4TF, UK
| |
Collapse
|
7
|
Neiva GR, Meira E Cruz M, Salles C. Would chronotype change the impact of the relationship between early school schedules and adolescent migraine frequency? Headache 2021; 61:402-403. [PMID: 33471933 DOI: 10.1111/head.14060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Affiliation(s)
| | - Miguel Meira E Cruz
- Bahiana School of Medicine and Public Health, Salvador, Brazil.,Sleep Unit, Centro Cardiovascular da Universidade de Lisboa, Lisbon School of Medicine, Lisbon, Portugal.,Neuroimune Interface Sleep Lab, Faculdade São Leopoldo Mandic, Campinas, Brazil.,European Sleep Center, Lisbon, Portugal
| | - Cristina Salles
- Bahiana School of Medicine and Public Health, Salvador, Brazil
| |
Collapse
|