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Miscioscia M, Di Riso D, Spaggiari S, Poli M, Gaiga G, Randazzo G, Pelizza MF, Galdiolo L, Raffagnato A, Sartori S, Toldo I. Emotional Experience and Regulation in Juvenile Primary Headaches: A Cross-Sectional Pilot Study. CHILDREN (BASEL, SWITZERLAND) 2022; 9:1630. [PMID: 36360358 PMCID: PMC9688696 DOI: 10.3390/children9111630] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 07/27/2023]
Abstract
A headache is the most common neurological symptom in children. Its subtypes are migraine (MH) and tension-type headache (TTH). Internalizing rather than externalizing symptoms are more frequent in children with headaches, but little is known about the reasons why. We aim to: (a) examine the interplay between emotional experience, affective regulation, and internalizing symptoms in children suffering from primary headaches and their caregivers; (b) identify potential predictors of children with migraines' internalizing symptoms. Fifty children and adolescents with a diagnosis of primary headaches and their caregivers were compared to a sample of fifty-one healthy peers and caregivers. Self-reports and parent-reports were administered. Results indicate higher negative affect and internalizing symptoms and lower bodily awareness of emotions in the clinical sample (n = 50; Mage = 11.66, SD = 2.25) compared to controls (n = 51; Mage = 11.73, SD = 2.32); mothers of TTH children self-reported lower emotional awareness and higher difficulties in engaging in goal-directed behavior; a higher frequency of headaches was associated with greater emotional regulation difficulties. Internalizing symptoms were predicted by higher self-reported negative affect and parent-reported internalizing symptoms, and lower self-reported ability in the verbal sharing of emotions. These findings suggest the importance of assessing the psychological features linked to children with primary headaches' psychological well-being.
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Affiliation(s)
- Marina Miscioscia
- Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy
- Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy
| | - Daniela Di Riso
- Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy
| | - Silvia Spaggiari
- Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy
| | - Mikael Poli
- Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy
| | - Giacomo Gaiga
- Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy
| | - Giacomo Randazzo
- Department of Developmental Psychology and Socialization, University of Padova, 35121 Padova, Italy
| | - Maria Federica Pelizza
- Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy
- Juvenile Headache Center, Pediatric Neurology and Neurophysiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padova, Italy
| | - Laura Galdiolo
- Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy
- Juvenile Headache Center, Pediatric Neurology and Neurophysiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padova, Italy
| | - Alessia Raffagnato
- Neuropsychiatric Unit, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padova, Italy
| | - Stefano Sartori
- Juvenile Headache Center, Pediatric Neurology and Neurophysiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padova, Italy
| | - Irene Toldo
- Juvenile Headache Center, Pediatric Neurology and Neurophysiology Unit, Department of Woman’s and Child’s Health, University Hospital of Padua, 35128 Padova, Italy
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Polese D, Belli A, Esposito D, Evangelisti M, Luchetti A, Di Nardo G, Parisi P, Bruni O. Psychological Disorders, Adverse Childhood Experiences and Parental Psychiatric Disorders in Children Affected by Headache: A Systematic Review. Neurosci Biobehav Rev 2022; 140:104798. [PMID: 35907492 DOI: 10.1016/j.neubiorev.2022.104798] [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: 02/07/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Pediatric headaches have been linked to adverse life events or psychological factors in children and their families, with a complex and bidirectional association. Moreover, it is well-known that psychological stress can trigger headaches. METHODS We searched three databases for studies focusing on headaches and adverse events or psychological factors in children up to 12 years old or in their caregivers. RESULTS We included 28 studies. Child psychological factors, including internal and external symptoms, were commonly associated with all types of headaches. Sleep disturbances showed a positive association with headaches in 3 out of 5 studies. Family conflict and unhappiness were frequently found in children suffering with headaches, while single-parent families and divorce were not associated. Stressful environments and adverse life events, particularly bullying, were also found to be linked with headaches. CONCLUSIONS Childhood headaches represent an alarm bell for clinicians to investigate and treat psychological or psychiatric disorders in children and their family. Further studies are needed to elucidate the role of early-life adverse events in children and their families.
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Affiliation(s)
- Daniela Polese
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108 - 00185 Rome, Italy
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108 - 00185 Rome, Italy
| | - Melania Evangelisti
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Anna Luchetti
- "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giovanni Di Nardo
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Pasquale Parisi
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Oliviero Bruni
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy; Department of Social and Developmental Psychology, Sapienza University, Via dei Marsi 78 - 00185 Rome, Italy.
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Smith LE, Weinman J, Yiend J, Rubin J. Psychosocial Factors Affecting Parental Report of Symptoms in Children: A Systematic Review. Psychosom Med 2021; 82:187-196. [PMID: 31738317 PMCID: PMC7012335 DOI: 10.1097/psy.0000000000000767] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Revised: 08/20/2019] [Indexed: 11/26/2022]
Abstract
OBJECTIVE Parents make important treatment decisions for their children based on symptoms they perceive their child to be experiencing. Multiple psychological factors are associated with subjective symptom perception, but factors affecting perception of symptoms in others have been explored less. We systematically reviewed the literature to identify parent and child psychological factors associated with parental report of physical symptoms in their child. METHODS We searched Embase, Ovid, PsycINFO, and Scopus for studies that investigated associations between psychological factors and parental report of symptoms in their child. RESULTS Thirty-six citations reporting on 34 studies that assessed the association between parent or child psychological factors and parental report of physical symptoms in the child were included in the review. Three main factors were identified as being associated with parental symptom report. First, there was evidence for an association between parental symptom report and affect, in particular parent and child anxiety. Second, child behavioral and conduct problems, and temperament-related challenges (problems with feeding and sleeping) were associated with parental symptom report. Third, parental expectations and beliefs that symptoms would occur were associated with parental symptom report, although few studies investigated these associations. CONCLUSIONS Parent and child affect, and parental expectations and beliefs may influence parents' cognition, causing them to pay more attention to their child, interpret their child's behavior as symptomatic, and recall symptoms in the child. Given the importance of parental perception of symptoms in driving decisions around care, additional research in this field is needed.
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Affiliation(s)
- Louise E Smith
- From the Institute of Psychiatry, Psychology and Neuroscience (Smith, Yiend, Rubin); and School of Cancer and Pharmaceutical Sciences (Weinman), King's College London, London, United Kingdom
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Factors Associated with Parent-Child Discrepancies in Reports of Mental Health Disorders in Young Children. Child Psychiatry Hum Dev 2018; 49:1003-1010. [PMID: 29869765 DOI: 10.1007/s10578-018-0815-7] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
Abstract
The study compares parent and child reports of child mental health to determine the relationship between parent-child disagreement and parental psychological and attitudinal factors, and to determine how parent-child disagreement is associated with the use of specialized services. A cross-sectional study was conducted with 1268 children aged 6-11 years using the Dominic Interactive and the Strengths and Difficulties Questionnaire. Psychological distress and negative parental attitudes were associated with greater reporting of mental health problems, leading to greater parent-child agreement on symptom presence, and to parental over-reporting of symptoms. Parent/child agreement was associated with 43.83% of contact with a mental health provider for externalizing and 33.73% for internalizing problems. The contribution of key parental psychological and attitudinal factors in parent-child disagreement on child mental health status may prove helpful in improving the identification of children in need of specialized services.
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Smith LE, Weinman J, Amlôt R, Yiend J, Rubin GJ. Parental Expectation of Side Effects Following Vaccination Is Self-fulfilling: A Prospective Cohort Study. Ann Behav Med 2018; 53:267-282. [DOI: 10.1093/abm/kay040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Affiliation(s)
- Louise E Smith
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
- Public Health England, Emergency Response Department of Science and Technology, Porton Down, UK
| | - John Weinman
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Richard Amlôt
- Public Health England, Emergency Response Department of Science and Technology, Porton Down, UK
| | - Jenny Yiend
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - G James Rubin
- King’s College London, Institute of Psychiatry, Psychology and Neuroscience, London, UK
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Salem H, Vivas D, Cao F, Kazimi IF, Teixeira AL, Zeni CP. ADHD is associated with migraine: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 2018; 27:267-277. [PMID: 28905127 DOI: 10.1007/s00787-017-1045-4] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 08/29/2017] [Indexed: 12/13/2022]
Abstract
An association between primary headaches and attention-deficit/hyperactivity disorder (ADHD) has long been suggested. Moreover, headache is regarded as a common side effect of stimulants, the most effective treatment for ADHD. So far, no systematic review has evaluated the potential association between ADHD and headache. We performed a systematic review of the literature and a meta-analysis of all reported studies on ADHD and primary headaches. Our analysis showed a positive association between ADHD and migraine (OR 1.322, 95% CI 1.018-1717, p value 0.036), but not with tension-type headache. There is a significant association between migraine and ADHD. The mechanisms underlying this association remain to be elucidated, warranting further studies.
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Affiliation(s)
- Haitham Salem
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - David Vivas
- Pediatric Mood Disorders/ADHD Across Lifespan Programs, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Road, Suite 3128, Houston, TX, 77054, USA
| | - Fei Cao
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Iram F Kazimi
- Pediatric Mood Disorders/ADHD Across Lifespan Programs, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Road, Suite 3128, Houston, TX, 77054, USA
| | - Antonio L Teixeira
- Neuropsychiatry Program, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - Cristian P Zeni
- Pediatric Mood Disorders/ADHD Across Lifespan Programs, Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center, 1941 East Road, Suite 3128, Houston, TX, 77054, USA.
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Yang TC, Luber MJ, Coffey BJ. Impulsive Aggressive Behavior Triggered by Headaches in a Child with Severe Attention-Deficit/Hyperactivity Disorder. J Child Adolesc Psychopharmacol 2017; 27:555-558. [PMID: 28820639 DOI: 10.1089/cap.2017.29137.bjc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Thomas C Yang
- 1 Child and Adolescent Psychiatry Fellow PGY-5, Mount Sinai Health Systems, Mount Sinai St. Luke's Hospital , New York, New York
| | - Maxwell J Luber
- 2 Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, New York
| | - Barbara J Coffey
- 2 Department of Psychiatry, Icahn School of Medicine at Mount Sinai , New York, New York
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Thabrew H, McDowell H, Given K, Murrell K. Systematic Review of Screening Instruments for Psychosocial Problems in Children and Adolescents With Long-Term Physical Conditions. Glob Pediatr Health 2017; 4:2333794X17690314. [PMID: 28255576 PMCID: PMC5315369 DOI: 10.1177/2333794x17690314] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 12/27/2016] [Indexed: 01/03/2023] Open
Abstract
Children and adolescents with long-term physical conditions (LTPCs) are at greater risk of developing psychosocial problems. Screening for such problems may be undertaken using validated psychometric instruments to facilitate early intervention. A systematic review was undertaken to identify clinically utilized and psychometrically validated instruments for identifying depression, anxiety, behavior problems, substance use problems, family problems, and multiple problems in children and adolescents with LTPCs. Comprehensive searches of articles published in English between 1994 and 2014 were completed via Medline, Embase, PsycINFO, CINAHL, and Cochrane CENTRAL databases, and by examining reference lists of identified articles and previous related reviews. Forty-four potential screening instruments were identified, described, and evaluated against predetermined clinical and psychometric criteria. Despite limitations in the evidence regarding their clinical and psychometric validity in this population, a handful of instruments, available at varying cost, in multiple languages and formats, were identified to support targeted, but not universal, screening for psychosocial problems in children and adolescents with LTPCs.
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Straube A, Heinen F, Ebinger F, von Kries R. Headache in school children: prevalence and risk factors. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 110:811-8. [PMID: 24333367 DOI: 10.3238/arztebl.2013.0811] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Recurrent headache is a common problem in school children. Evaluation generally leads to the diagnosis of a primary headache syndrome (migraine or tension-type headache). This review is addressed to the question whether headaches in school children are becoming more common and, if so, what risk factors are associated with the rise in frequency. METHOD We selectively searched the PubMed database for pertinent publications that contained the terms "primary headache AND children/adolescent AND risk factors/prevalence." Articles published in either English or German up to April 2013 were considered. Articles on secondary types of headache were excluded. RESULTS Headaches are becoming more common among school children. At present, 66% to 71% of 12- to 15- year-olds have at least one headache every three months, and 33% to 40% have at least one per week. Headache is often accompanied by other physical and/or emotional manifestations. Studies from Scandinavia reveal increasing prevalence in age groups from 8 years of age and upward. Various studies have identified the following risk factors for headache or for its chronification (up to 5.8-fold elevation of risk): a dysfunctional family situation, the regular consumption of alcohol, caffeine ingestion, smoking, a low level of physical activity, physical or emotional abuse, bullying by peers, unfair treatment in school, and insufficient leisure time. CONCLUSION Headaches are becoming more common among children and adolescents. They are often associated with other physical and emotional complaints.
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Affiliation(s)
- Andreas Straube
- Department of Neurology, University of Munich, Campus Grosshadern, Department of Pediatric Neurology, University of Munich, Campus Innenstadt, Dr. von Haunersches Kinderspital, Clinic for Child and Adolescent Medicine, St. Vincent Hospital, Paderborn, and Center for Child and Adolescent Medicine, University of Heidelberg, Institute of Social Paediatrics and Adolescent Medicine, University of Munich
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Margari F, Lucarelli E, Craig F, Petruzzelli MG, Lecce PA, Margari L. Psychopathology in children and adolescents with primary headaches: categorical and dimensional approaches. Cephalalgia 2013; 33:1311-8. [PMID: 23827982 DOI: 10.1177/0333102413495966] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
BACKGROUND Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. OBJECTIVE The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. METHODS The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. RESULTS Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. CONCLUSION The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.
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Affiliation(s)
- Francesco Margari
- Psychiatry Unit, Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neurosciences and Sense Organs of the "Aldo Moro" University of Bari, Italy
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Fabbri CE, Barbieri MA, Silva AM, Gutierrez MR, Bettiol H, Speciali JG, Rona RJ. Maternal smoking during pregnancy and primary headache in school-aged children: a cohort study. Cephalalgia 2012; 32:317-27. [PMID: 22290555 DOI: 10.1177/0333102411436261] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND It is not known whether smoking by mothers during pregnancy is associated with headache in their offspring. METHODS Two prospective cohorts of 869 children aged 10-11 years from Ribeirão Preto (RP) and 805 children aged 7-9 years from São Luís (SL) were studied. Data on maternal smoking were collected at birth. Primary headache was defined as a reporting of ≥2 episodes of headache in the past 2 weeks, without any associated organic symptoms. RESULTS Prevalence of headache was 28.1% in RP and 13.1% in SL as reported by the mothers and 17.5% in RP and 29.4% in SL as reported by the children. Agreement between mothers' report and children's self-report of primary headache in the child was poor. After adjustment, children whose mothers smoked ≥10 cigarettes per day during pregnancy presented higher prevalence of primary headache than their counterparts in both cohorts, as reported by the mother and in RP as reported by the children. CONCLUSIONS Maternal smoking during pregnancy was associated with headache in 7- to 11-year-olds. With one exception, the consistency of the results, despite poor agreement between maternal and children reports of headache, indicates that maternal smoking during pregnancy may contribute to headaches in their children.
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Abstract
Primary headache are one of the most common health complaints in children and adolescents, yet there remain significant gaps in our understanding of the underlying pathophysiology of these conditions. Recently, there have been several areas of research that have assisted with filling this gap in our knowledge. These areas include a better understanding of the disease characteristics including additional associated symptoms and the refinement of the description of related conditions and comorbidities; continued examination of the epidemiology of primary headaches; the progression of migraine across these developmental ages; the molecular and physiological changes; and the potential role for vitamins and cofactor deficiencies in the pathophysiology. These studies continue to add to our fund of knowledge on the basis of migraine and tension-type headache as primary neurological conditions and their impact on the developing brain.
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Affiliation(s)
- Andrew D Hershey
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati, College of Medicine, Division of Neurology, Cincinnati, OH, USA
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