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Gibler RC, Marzouk MA, Peugh J, Reidy BL, Ernst MM, Daffin ML, Powers SW, Kabbouche Samaha M, Kacperski J, Hershey AD, O'Brien H, Slater SK. Clinic-Based Characterization of Adolescents and Young Adults With Migraine: Psychological Functioning, Headache Days, and Disability. Neurol Clin Pract 2024; 14:e200294. [PMID: 38682006 PMCID: PMC11052567 DOI: 10.1212/cpj.0000000000200294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/24/2024] [Indexed: 05/01/2024]
Abstract
Background and Objectives This cross-sectional observational study retrospectively examined clinical data collected from adolescents and young adults (AYAs) seeking care in a specialty headache clinic. We characterized participants' headache characteristics and psychological functioning and examined the association between self-reported anxiety and depressive symptoms and headache frequency, severity, and disability. Methods During their clinic visit, AYAs (M age = 18.36; range = 14-32, 79.5% female) completed an intake questionnaire and reported about their headache characteristics (i.e., frequency, severity, and duration of symptoms in months), mental health history (i.e., previous diagnosis of an anxiety or depressive disorder), and utilization of emergency department (ED) services for migraine. AYAs also completed psychometrically validated screening tools for anxiety and depressive symptoms (i.e., the GAD-7 and PHQ-9). We computed descriptive statistics and examined associations among scores on psychological measures and headache characteristics, including migraine-related disability. We also tested whether individuals with clinically elevated GAD-7 and PHQ-9 scores had higher levels of disability relative to those with fewer/subclinical levels of anxiety and depressive symptoms. Results Participants (N = 283) reported more than 19 headache days per month on average, with more than 90% describing their average headache intensity as moderate or severe. Nearly half of AYAs reported severe headache-related disability. Approximately one-quarter of AYAs reported a previous diagnosis anxiety or depressive disorder diagnosis, and more than one-third scored above clinical cutoffs on the PHQ-9 and GAD-7. Higher scores on both psychological screening instruments were associated with greater headache frequency. More than 10% of patients endorsed current suicidal ideation; this was not related to headache-related disability. Participants reported a high degree of ED utilization for headache; these rates were unrelated to endorsement of psychological comorbidities. Discussion In this sample of AYAs, headache characteristics were generally unrelated to scores on measures on psychological functioning. However, the observed rates of clinically elevated anxiety/depressive symptoms and suicidality in this sample of AYAs underscore the importance of screening for psychological comorbidities in neurology clinics that serve this age group, irrespective of self-reported disability. Results also emphasize the need to expand access to behavioral health services for AYAs with headache disorders and the importance of incorporating a biopsychosocial perspective to the transition of health care from pediatrics to adult neurology practice.
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Affiliation(s)
- Robert C Gibler
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Maya A Marzouk
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - James Peugh
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Brooke L Reidy
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Michelle M Ernst
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Morgan L Daffin
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Scott W Powers
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Marielle Kabbouche Samaha
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Joanne Kacperski
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Andrew D Hershey
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Hope O'Brien
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
| | - Shalonda K Slater
- Division of Behavioral Medicine and Clinical Psychology (RCG, MAM, JP, BLR, MME, SWP, SKS); Headache Center (RCG, MAM, BLR, SWP, MKS, JK, ADH, SKS), Cincinnati Children's Hospital Medical Center; now with the Department of Pediatrics (RCG), University of Kansas Medical Center, Kansas City, KS; Department of Pediatrics (JP, BLR, MME, SWP, MKS, JK, ADH, SKS), University of Cincinnati College of Medicine, OH; Clinical Child and Adolescent Psychology (MLD), Norton Children's Hospital; University of Louisville School of Medicine (MLD), KY; Division of Neurology (MKS, JK, ADH), Cincinnati Children's Hospital Medical Center; and Headache Center of Hope (HOB), Cincinnati, OH
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Togha M, Rafiee P, Haghdoost F, Rafie S, Paknejad SMH, Amouian S, Şaşmaz T, Kale D, Uluduz D, Steiner TJ. The burdens attributable to primary headache disorders in children and adolescents in Iran: estimates from a schools-based study. J Headache Pain 2024; 25:86. [PMID: 38797825 PMCID: PMC11129382 DOI: 10.1186/s10194-024-01789-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2024] [Accepted: 05/13/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND We recently found headache disorders to be highly prevalent among children (aged 6-11 years) and adolescents (aged 12-17) in Iran (gender- and age-adjusted 1-year prevalences: migraine 25.2%, tension-type headache 12.7%, undifferentiated headache [UdH] 22.1%, probable medication-overuse headache [pMOH] 1.1%, other headache on ≥ 15 days/month [H15+] 3.0%). Here we report on the headache-attributed burden, taking evidence from the same study. METHODS In a cross-sectional survey, following the generic protocol for the global schools-based study led by the Global Campaign against Headache, we administered the child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaire in 121 schools, purposively selected to reflect the country's diversities. Pupils self-completed these in class, under supervision. Headache diagnostic questions were based on ICHD-3 criteria but for the inclusion of UdH (defined as mild headache with usual duration < 1 h). Burden enquiry was across multiple domains. RESULTS The analysed sample (N = 3,244) included 1,308 (40.3%) children and 1,936 (59.7%) adolescents (1,531 [47.2%] male, 1,713 [52.8%] female). The non-participating proportion was 3.4%. Mean headache frequency was 3.9 days/4 weeks, and mean duration 1.8 h. Estimated mean proportion of time in ictal state was 1.1% (1.4% for migraine, 16.5% for pMOH). Symptomatic medication was consumed on a mean of 1.6 days/4 weeks. Lost school time averaged 0.4 days/4 weeks overall (2%, assuming a 5-day week), but was eleven-fold higher (4.3 days; 22%) for pMOH. For most headache types, days of reported limited activity were several-fold more than days lost from school (45% for pMOH, 25% for other H15+). Almost one in 12 parents (7.9%) missed work at least once in 4 weeks because of their son's or daughter's headache. Emotional impact and quality-of-life scores reflected these measures of burden. CONCLUSIONS Headache, common in children and adolescents in Iran, is associated with symptom burdens that may be onerous for some but not for most. However, there are substantial consequential burdens, particularly for the 1.1% with pMOH and the 3.0% with other H15+, who suffer educational disturbances and potentially major life impairments. These findings are of importance to educational and health policies in Iran.
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Affiliation(s)
- Mansoureh Togha
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
- Neurology Ward, School of Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Pegah Rafiee
- Department of Clinical Nutrition and Dietetics, Faculty of Nutrition Sciences and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Faraidoon Haghdoost
- The George Institute for Global Health, University of New South Wales (UNSW), Sydney, Australia
| | - Shahram Rafie
- Department of Neurology, School of Medicine, Ahvaz Jundishappur University of Medical Sciences, Ahvaz, Iran
| | - Seyed Mohammad Hasan Paknejad
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Sepideh Amouian
- Neonatal and Children's Health Research Center, Golestan University of Medical Sciences, Gorgan, Iran
- Pediatric Neurology Department, Faculty of Medicine, Golestan University of Medical Sciences, Gorgan, Iran
| | - Tayyar Şaşmaz
- Department of Public Health, Mersin University School of Medicine, Mersin, Turkey
| | - Derya Kale
- Department of Public Health, Mersin University School of Medicine, Mersin, Turkey
| | - Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway.
- Department of Neurology, University of Copenhagen, Copenhagen, Denmark.
- Division of Brain Sciences, Imperial College London, London, UK.
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Azouz H, Muhammed W, Abd Elmaksoud M. Clinical Characteristics and Appropriateness of Investigations in Children With Headaches at the Emergency Department. Pediatr Neurol 2024; 154:58-65. [PMID: 38531164 DOI: 10.1016/j.pediatrneurol.2024.02.009] [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: 07/28/2023] [Revised: 01/25/2024] [Accepted: 02/23/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Identifying the cause of headaches in pediatric emergency departments (PEDs) can be challenging due to the lack of comprehensive research. This study aims to identify the frequency, characteristics, and unnecessary diagnostic procedures of patients with headaches in the PED setting. METHODS A six-month cross-sectional study was conducted at the PED of Alexandria University Children's Hospital, including all children with headaches. Children were classified as having primary headache (PH), secondary benign headache (SBH), and secondary serious headache (SSH) according to predetermined criteria. Logistic regression was employed to analyze the risk factors associated with SSH. RESULTS A total of 164 visits to the PED were recorded, out of a total of 22,662 visits, accounting for approximately 0.72% of all visits and 1.17% of the total number of children admitted. PH was the most common cause, accounting for 61.0% of cases, followed by SSH with 24.4%, whereas SBH was the least common with 13.4%. Abnormal neurological examination (odds ratio, 53.752 [1.628 to 1774.442], P = 0.026∗) was found to have a strong and statistically significant association with SSH in the multivariate analysis. Regarding the appropriateness of the investigations conducted, it was found that over half (66.5%) of the cases had unnecessary neuroimaging, with 52% of these cases being children with PH. CONCLUSIONS Headaches in children are commonly reported during visits to the PED. PH was the most prevalent, followed by SSH, whereas SBH was the least common. Many of the children received inaccurate first diagnoses and performed unnecessary laboratory tests, neuroimaging, and other tests, mostly electroencephalography.
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Affiliation(s)
- Hanan Azouz
- Neurology Unit, Pediatrics Department, Alexandria University, Alexandria, Egypt
| | - Wafaa Muhammed
- Neurology Unit, Pediatrics Department, Alexandria University, Alexandria, Egypt
| | - Marwa Abd Elmaksoud
- Neurology Unit, Pediatrics Department, Alexandria University, Alexandria, Egypt.
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Zewde YZ, Zebenigus M, Demissie H, Tekle-Haimanot R, Uluduz D, Şaşmaz T, Bozdag F, Steiner TJ. The burden attributable to primary headache disorders in children and adolescents in Ethiopia: estimates from a national schools-based study. J Headache Pain 2024; 25:47. [PMID: 38561646 PMCID: PMC10986066 DOI: 10.1186/s10194-024-01743-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 03/04/2024] [Indexed: 04/04/2024] Open
Abstract
BACKGROUND We previously reported high prevalences of headache disorders among children (6-11 years) and adolescents (12-17 years) in Ethiopia. Here we provide data on headache-attributed burden collected contemporaneously from the same study participants. Part of the global schools-based programme within the Global Campaign against Headache, the study is the first to present such data from sub-Saharan Africa. METHODS A cross-sectional survey following the generic protocol for the global study was conducted in six schools (urban and rural), in Addis Ababa city and three regions of Ethiopia. The child or adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) structured questionnaires were self-completed under supervision by pupils in class. Headache diagnostic questions were based on ICHD-3 beta but for the inclusion of undifferentiated headache (UdH). RESULTS Of 2,349 eligible participants, 2,344 completed the questionnaires (1,011 children [43.1%], 1,333 adolescents [56.9%]; 1,157 males [49.4%], 1,187 females [50.6%]; participating proportion 99.8%). Gender- and age-adjusted 1-year prevalence of headache, reported previously, was 72.8% (migraine: 38.6%; tension-type headache [TTH]: 19.9%; UdH: 12.3%; headache on ≥ 15 days/month (H15+): 1.2%). Mean headache frequency was 2.6 days/4 weeks but, with mean duration of 2.7 h, mean proportion of time with headache was only 1.0% (migraine: 1.4%; TTH: 0.7%; H15+: 9.1%). Mean intensity was 1.8 on a scale of 1-3. Symptomatic medication was consumed on about one third of headache days across headache types. Lost school time reportedly averaged 0.7 days over the preceding 4 weeks, representing 3.5% of school time, but was 2.4 days/4 weeks (12.0%) in the important small minority with H15+. However, actual absences with headache the day before indicated averages overall of 9.7% of school time lost, and 13.3% among those with migraine. Emotional impact and quality-of-life scores reflected other measures of burden, with clear adverse impact gradients (H15 + > migraine > TTH > UdH). CONCLUSIONS The high prevalence of headache among children and adolescents in Ethiopia, who represent half its population, is associated with substantial burden. Lost school time is probably the most important consequence. Estimates suggest a quite deleterious effect, likely to be reflected in both individual prospects and the prosperity of society.
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Affiliation(s)
- Yared Zenebe Zewde
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia.
| | - Mehila Zebenigus
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Hanna Demissie
- Department of Neurology, School of Medicine, College of Health Sciences, Addis Ababa University, Addis Ababa, Ethiopia
| | - Redda Tekle-Haimanot
- Department of Internal Medicine, School of Medicine, College of Health Science, Addis Ababa University, Addis Ababa, Ethiopia
| | - Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Tayyar Şaşmaz
- Public Health Department, School of Medicine, Mersin University, Mersin, Turkey
| | - Fatma Bozdag
- Siirt Kurtalan District Health Directorate, Kurtulan, Turkey
| | - Timothy J Steiner
- NorHEAD, Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Neurology, University of Copenhagen, Copenhagen, Denmark
- Division of Brain Sciences, Imperial College London, London, UK
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Zaranek L, Sobe H, Richter M, Hübler A, Berner R, von der Hagen M, Koch T, Sabatowski R, Klimova A, Goßrau G. [Gender-specific results of the Dresden children and adolescents headache program DreKiP]. Schmerz 2024; 38:107-117. [PMID: 37737282 PMCID: PMC10959813 DOI: 10.1007/s00482-023-00756-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 08/17/2023] [Accepted: 08/18/2023] [Indexed: 09/23/2023]
Abstract
BACKGROUND Girls and women are more frequently affected by headache than boys and men. The influence of gender on the effectiveness of headache therapies has so far been hardly investigated. We examined gender differences in the outpatient multimodal Dresden Child and Adolescent Headache Program DreKiP. METHODS We treated 140 patients with primary headache in a 15-hour structured group program. At baseline (T0) and six (T1) and twelve months (T2) after the end of the program, data on headache-related limitation of daily activities (PedMIDAS) as well as headache frequency, intensity, and pain-related disability (P-PDI) were collected. Retrospectively, these data were analyzed separately for girls and boys. RESULTS For 91 patients (9-19 years, median = 15; 71.4 % female) data were available for at least two measurement time points. Girls showed significantly higher headache frequency than boys at all time points (median headache days/last three months at T0: ♀ 43, ♂ 20; T1: ♀ 32, ♂ 12; T2: ♀ 28, ♂ 9) as well as numerically higher headache-related limitation of daily life. There were significant effects over time with a decrease in headache frequency (F (2.88) = 5.862; p = 0.004) and improvement in daily functioning (F (2.92) = 5.340; p = 0.006). There was no gender-specific treatment response. DISCUSSION The DreKiP therapy shows effects in girls and boys with primary headache. Higher headache frequencies and everyday life restrictions in girls may have hormonal but also psychosocial causes and should be addressed in educational measures.
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Affiliation(s)
- Laura Zaranek
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Hanna Sobe
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Matthias Richter
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - Anke Hübler
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
- Klinik für Anästhesiologie und Intensivtherapie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Reinhard Berner
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Maja von der Hagen
- Klinik für Kinder- und Jugendmedizin, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
- Abteilung Neuropädiatrie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Thea Koch
- Klinik für Anästhesiologie und Intensivtherapie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Rainer Sabatowski
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
- Klinik für Anästhesiologie und Intensivtherapie, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Anna Klimova
- NCT Partner Site Dresden, Institut für Medizinische Informatik und Biometrie, Medizinische Fakultät "Carl Gustav Carus", TU Dresden, Dresden, Deutschland
| | - Gudrun Goßrau
- UniversitätsSchmerzCentrum, Medizinische Fakultät und Universitätsklinikum "Carl Gustav Carus", TU Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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Rau LM, Humberg C, Könning A, Claus BB, Stahlschmidt L, Wager J. Predictors and concomitants of the remission of frequent headache in pediatrics: A longitudinal community study. Headache 2024; 64:306-316. [PMID: 38440947 DOI: 10.1111/head.14690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/04/2024] [Accepted: 01/08/2024] [Indexed: 03/06/2024]
Abstract
OBJECTIVE We aimed to examine factors associated with frequent headache remission in schoolchildren aged 10-18 years. BACKGROUND Frequent headache is a common health problem in adolescence, and some individuals in this population experience remission. Factors preceding headache remission as opposed to ongoing headache, and their development over time, have not been examined extensively. METHODS Data were derived from a large school sample (N = 2280). Over the course of 1 year, n = 156 adolescents experienced remission from frequent headaches, while n = 125 adolescents continued to have frequent headaches throughout the year. In this longitudinal case-control study, we predicted headache remission using demographic, pain, psychosocial, sleep, and physiological characteristics. Additionally, we sought to explore the development of psychosocial, sleep, and physiological characteristics in relation to remitted versus ongoing headache over the 1-year period. RESULTS A model containing the variables sex (odds ratio [OR] = 0.43, 95% confidence interval [CI] = 0.248-0.76, p = 0.003), headache intensity (OR = 0.85, 95% CI = 0.73-0.99, p = 0.035), anxiety score (OR = 0.92, 95% CI = 0.85-1.01, p = 0.071), and depression score (OR = 0.94, 95% CI = 0.89-1.00, p = 0.041) predicted the outcome variable (remitted vs. non-remitted headache), explaining 17% of the variance in group membership. Schoolchildren reporting remitted headache at the end of the year exhibited lower depression (F[1, 557.01] = 45.77, p < 0.001) and anxiety scores (F[1, 557.01] = 21.72, p < 0.001), higher school satisfaction (F[1, 209.46] = 7.15, p = 0.008), and fewer difficulties falling asleep (F[1, 856.52] = 41.21, p < 0.001) or sleeping through the night (F[1, 731.12] = 26.42, p < 0.001) throughout the year compared to those with non-remitted headache. Depression scores declined significantly over the year in the group with remitted headache, whereas these scores remained constant in the group with non-remitted headache. CONCLUSION Our results suggest a correlation between headache remission and male sex, improved mental health, and reduced pain-related burden. Moreover, there was an observed decline in symptoms of depression during headache remission. Psychotherapy may be a promising treatment strategy for addressing frequent headaches reported by children and adolescents.
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Affiliation(s)
- Lisa-Marie Rau
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Clarissa Humberg
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Anna Könning
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Benedikt B Claus
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Lorin Stahlschmidt
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
| | - Julia Wager
- German Paediatric Pain Centre, Children's and Adolescents' Hospital, Datteln, Germany
- Department of Children's Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, Witten, Germany
- PedScience Research Institute, Datteln, Germany
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Katsuki M, Matsumori Y, Ichihara T, Yamada Y, Kawamura S, Kashiwagi K, Koh A, Goto T, Kaneko K, Wada N, Yamagishi F. Treatment Patterns for and Characteristics of Headache in Children and Adolescents Aged 6-17 Years in Japan: A Retrospective Cross-Sectional and Longitudinal Analysis of Health Insurance Claims Data. Life (Basel) 2024; 14:96. [PMID: 38255711 PMCID: PMC10820976 DOI: 10.3390/life14010096] [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: 11/13/2023] [Revised: 12/21/2023] [Accepted: 01/06/2024] [Indexed: 01/24/2024] Open
Abstract
OBJECTIVE To investigate the prescription patterns for patients aged 6-17 years with headaches in the REZULT database. METHODS We cross-sectionally investigated (Study 1) the pattern of prescription and the proportion of triptan overprescription (≥30 tablets/90 d of triptans) among patients diagnosed with headaches in 2020. Next, we longitudinally studied patients (Study 2) for more than two years from the initial headache diagnosis (July 2010 to April 2022). The number of prescribed tablets was counted every 90 days. RESULTS In Study 1, headache diagnoses were assigned to 62,568 of 543,628 (11.51%) patients, and 1524 of 62,568 (2.44%) patients received acute medication. Single nonsteroidal anti-inflammatory drugs and triptans were prescribed to 620/624 (99.36%) and 5/624 (0.80%) of patients aged 6-11 years, respectively, and 827/900 (91.89%) and 91/900 (10.11%) of patients aged 12-17 years, respectively. Triptan overprescription was observed in 11/96 (11.46%) patients, and 5/11 (45.45%) of those patients received prophylactic medication. In Study 2, 80,756/845,470 (9.55%) patients aged 6-17 years were diagnosed with headaches that persisted for at least two years. Over two years, 44/80,756 (0.05%) patients were overprescribed triptans, and 3408/80,756 (4.22%) patients were prescribed prophylaxis on at least one occasion. CONCLUSIONS Based on real-world data, the appropriate use of prophylactic treatment is still problematic. Overprescription of triptans was observed, although the number of patients was small.
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Affiliation(s)
- Masahito Katsuki
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-0027, Japan
- Headache Outpatient, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | | | - Taisuke Ichihara
- Japan System Techniques Co., Ltd. (JAST), Minato-ku 108-8288, Japan
| | - Yuya Yamada
- Japan System Techniques Co., Ltd. (JAST), Minato-ku 108-8288, Japan
| | - Shin Kawamura
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Japan
| | - Kenta Kashiwagi
- Department of Neurology, Itoigawa General Hospital, Itoigawa 941-0006, Japan
| | - Akihito Koh
- Department of Neurosurgery, Itoigawa General Hospital, Itoigawa 941-0006, Japan
| | - Tetsuya Goto
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | - Kazuma Kaneko
- Headache Outpatient, Suwa Red Cross Hospital, Suwa 392-0027, Japan
- Department of Neurology, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | - Naomichi Wada
- Department of Neurosurgery, Suwa Red Cross Hospital, Suwa 392-0027, Japan
- Headache Outpatient, Suwa Red Cross Hospital, Suwa 392-0027, Japan
| | - Fuminori Yamagishi
- Department of Surgery, Itoigawa General Hospital, Itoigawa 941-0006, Japan
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Bierhals IO, de Oliveira GSP, Santos IS, Halal CS, Tovo-Rodrigues L, Matijasevich A, Barros FC. Relationship between sleep problems and headaches among adolescents: Pelotas 2004 Birth cohort. Sleep Med X 2023; 6:100079. [PMID: 37484546 PMCID: PMC10359655 DOI: 10.1016/j.sleepx.2023.100079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 07/25/2023] Open
Abstract
Objective To investigate the cross-sectional association between sleep problems (the exposure) and headaches (the outcome) among 15-year-olds from the Pelotas 2004 Birth Cohort, a population-based study in the south of Brazil. Method The occurrence of headaches was obtained through the question: "Do you usually suffer headaches?" and the ICHD-3 criteria were used to classify as: tension-type headache, headache with characteristics of migraine with or without aura, or other. Regarding sleep, the weekly frequency in the last month of insomnia and bad dreams/nightmares, and self-reported sleep quality were investigated. Unadjusted and adjusted prevalence ratios (PR) with 95% confidence intervals were calculated using Poisson regression with robust variance. Results A total of 1916 adolescents were analyzed. The prevalence of headaches was 51.6% (69.0% in females and 34.8% in males): 31.8% (39.7% vs. 24.1%) reported tension-type headache; 14.7% (21.9% vs. 7.8%), headaches with characteristics of migraines without aura; 3.6%, headaches with characteristics of migraines with aura; and 1.5% (5.1% vs. 2.3%), other types. Adolescents with insomnia ≥3 times/week presented higher probability of headaches (PR = 1.54; 95%CI 1.23-1.93), compared with those with no problems falling asleep or maintaining sleep. Among those who classified their sleep as poor/very poor, the probability of headaches was 33% higher (PR = 1.33; 95%CI 1.13-1.57) than among those who classified their sleep as very good. Conclusions Headaches were highly prevalent among the adolescents and were related to sleep problems even after allowing for several confounders.
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Affiliation(s)
- Isabel Oliveira Bierhals
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | | | - Iná S. Santos
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Camila S. Halal
- Postgraduate Program in Pediatrics and Child Health, School of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, RS, Brazil
- Hospital Nossa Senhora Conceição, Porto Alegre, RS, Brazil
| | - Luciana Tovo-Rodrigues
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
| | - Alicia Matijasevich
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de São Paulo, SP, Brazil
| | - Fernando C. Barros
- Postgraduate Program in Epidemiology, Faculty of Medicine, Federal University of Pelotas, Pelotas, RS, Brazil
- Postgraduation in Health and Behavior Program, Catholic University of Pelotas, Pelotas, RS, Brazil
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Van RN, Tubiana S, De Broucker T, Cédric J, Roy C, Meyohas MC, Prazuck T, Chirouze C, Hoen B, Duval X, Revest M. Persistent headaches one year after bacterial meningitis: prevalence, determinants and impact on quality of life. Eur J Clin Microbiol Infect Dis 2023; 42:1459-1467. [PMID: 37867184 DOI: 10.1007/s10096-023-04673-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Accepted: 09/27/2023] [Indexed: 10/24/2023]
Abstract
BACKGROUND Little is known on headaches long-term persistence after bacterial meningitis and on their impact on patients' quality of life. METHODS In an ancillary study of the French national prospective cohort of community-acquired bacterial meningitis in adults (COMBAT) conducted between February 2013 and July 2015, we collected self-reported headaches before, at onset, and 12 months (M12) after meningitis. Determinants of persistent headache (PH) at M12, their association with M12 quality of life (SF 12), depression (Center for Epidemiologic Studies Depression Scale) and neuro-functional disability were analysed. RESULTS Among the 277 alive patients at M12 87/274 (31.8%), 213/271 (78.6%) and 86/277 (31.0%) reported headaches before, at the onset, and at M12, respectively. In multivariate analysis, female sex (OR: 2.75 [1.54-4.90]; p < 0.001), pre-existing headaches before meningitis (OR: 2.38 [1.32-4.30]; p < 0.01), higher neutrophilic polynuclei percentage in the CSF of the initial lumbar puncture (OR: 1.02 [1.00-1.04]; p < 0.05), and brain abscess during the initial hospitalisation (OR: 8.32 [1.97-35.16]; p < 0.01) were associated with M12 persistent headaches. Neither the responsible microorganism, nor the corticoids use were associated with M12 persistent headaches. M12 neuro-functional disability (altered Glasgow Outcome Scale; p < 0.01), M12 physical handicap (altered modified Rankin score; p < 0.001), M12 depressive symptoms (p < 0.0001), and M12 altered physical (p < 0.05) and mental (p < 0.0001) qualities of life were associated with M12 headaches. CONCLUSION Persistent headaches are frequent one year after meningitis and are associated with quality of life alteration. CLINICAL TRIAL NCT01730690.
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Affiliation(s)
- Rémi Nguyen Van
- Infectious Diseases and Intensive Care Unit, UMR_1230, BRM (Bacterial RNA and Medicine), Inserm, CHU Rennes, Université Rennes 1, CIC-Inserm 1414, Rennes, France
| | - Sarah Tubiana
- IAME, Inserm UMR 1137, University Paris Diderot, Sorbonne Paris Cité, France
| | | | | | - Carine Roy
- Epidemiology, Biostatistics and Clinical Research Unit, Bichat Claude Bernard Hospital, APHP, Paris, France
| | | | | | | | - Bruno Hoen
- Infectious Diseases Unit, CHU Nancy, France
| | - Xavier Duval
- IAME, Inserm UMR 1137, University Paris Diderot, Sorbonne Paris Cité, France
- Centre d'investigation Clinique, Hôpital Bichat, APHP, Inserm CIC 1425, Paris, France
| | - Matthieu Revest
- Infectious Diseases and Intensive Care Unit, UMR_1230, BRM (Bacterial RNA and Medicine), Inserm, CHU Rennes, Université Rennes 1, CIC-Inserm 1414, Rennes, France.
- UMR-1230 BRM (Bacterial RNA and Medicine), Inserm, Université Rennes, Rennes, France.
- Centre d'investigation Clinique, CHU Rennes, Inserm CIC 1414, Rennes, France.
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Karaaslan Z, Uygunoğlu U, Şaşmaz T, Uludüz D, Topaloğlu P, Siva A, Yapıcı Z. The Prevalence of Headache Disorders in Children and Adolescents in Istanbul: A School-Based Study. Pediatr Neurol 2023; 149:100-107. [PMID: 37837756 DOI: 10.1016/j.pediatrneurol.2023.09.007] [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: 08/18/2023] [Accepted: 09/14/2023] [Indexed: 10/16/2023]
Abstract
BACKGROUND Headache among children and adolescents is an important health problem. In this school-based epidemiological study conducted in Istanbul, we aimed to reveal the frequency of headaches in this population, define the risk factors associated with headaches, and establish the effect of headaches on the quality of life in this population. METHODS The child and adolescent versions of the Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation structured questionnaire were conducted in 30 schools in Istanbul. The diagnosis was made based on the International Classification of Headache Disorders III-(ICHD-3) beta version. Risk factors associated with headaches were analyzed in a binary logistic regression model. RESULTS Among the 5944 students (boys = 3011 [50.7%], girls 2933 [49.3%]) who completed the survey and were enrolled in this study, 3354 (56.4%) reported a headache ever. The prevalence of headaches was significantly higher in girls (62.6% vs. 50.4%, P < 0.001). Migraine prevalence was found to be 5.2%, whereas tension-type headache (TTH) prevalence was 26.1%. Being a female, age, living on the European side, and headache history in the family were found to be associated with an increased risk of having a headache. Pupils with headaches reported that they missed an average of 0.5 ± 1.5 school days due to headaches. CONCLUSION TTH was found to be the most common headache syndrome in Istanbul metropolitan area. Considering the effect of headaches on school success and quality of life in childhood, it is clear that the correct diagnosis of headaches and careful handling of risk factors are crucial for this population.
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Affiliation(s)
- Zerrin Karaaslan
- Istanbul Faculty of Medicine, Department of Neurology, Istanbul University, Istanbul, Turkey; Department of Neuroscience, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Uğur Uygunoğlu
- Cerrahpaş a Faculty of Medicine, Department of Neurology, Istanbul-Cerrahpaş a University, Istanbul, Turkey
| | - Tayyar Şaşmaz
- Faculty of Medicine, Department of Public Health, Mersin University, Mersin, Turkey
| | - Derya Uludüz
- Cerrahpaş a Faculty of Medicine, Department of Neurology, Istanbul-Cerrahpaş a University, Istanbul, Turkey
| | - Pınar Topaloğlu
- Istanbul Faculty of Medicine, Department of Neurology, Istanbul University, Istanbul, Turkey
| | - Aksel Siva
- Cerrahpaş a Faculty of Medicine, Department of Neurology, Istanbul-Cerrahpaş a University, Istanbul, Turkey
| | - Zuhal Yapıcı
- Istanbul Faculty of Medicine, Department of Neurology, Istanbul University, Istanbul, Turkey.
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11
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Nilles C, Williams JVA, Patten S, Pringsheim T, Orr SL. Association Between Peer Victimization, Gender Diversity, Mental Health, and Recurrent Headaches in Adolescents: A Canadian Population-Based Study. Neurology 2023; 101:e1654-e1664. [PMID: 37532511 PMCID: PMC10624480 DOI: 10.1212/wnl.0000000000207738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/20/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND AND OBJECTIVES It is unknown whether bullying and gender diversity are associated with increased headache frequency in adolescents. Our study aimed to assess the association between peer victimization, gender diversity, and frequent recurrent headaches in adolescents, while controlling for age, sex, socioeconomic status, and potential confounders (mood and anxiety disorders, suicidality). METHODS This was a cross-sectional observational study of adolescents aged 12-17 years using data from a Canadian population-based health survey. Headache frequency was dichotomized into "≤once/wk" or ">once/wk" (i.e., frequent recurrent headaches). Logistic regression was used to quantify the association between frequent peer victimization (overt or relational), gender diversity (female sex at birth + male gender, male sex at birth + female gender, or gender diverse), mood/anxiety disorder, suicidality, and the odds of frequent recurrent headaches. The fully adjusted multivariable logistic regression model included all exposures and was controlled for age, sex, and socioeconomic status. Bootstrap replicate weighting was used to account for survey design effects. RESULTS There were an estimated 2,268,840 eligible participants (weighted sample size) (mean age = 14.4 years, 48.8% female, 0.5% gender diverse), and 11.2% reported frequent recurrent headaches. Frequent recurrent headaches were associated with older age (odds ratio [OR] = 1.26 per year of age, 95% CI 1.20-1.31), female sex (OR = 2.89, 95% CI 2.47-3.37), and being gender diverse (OR = 3.30, 95% CI 1.64-6.63, adjusted for age/sex). Youth with frequent headaches had higher odds of experiencing both overt and relational bullying compared with peers (OR = 2.69, 95% CI 2.31-3.14, and OR = 3.03, 95% CI 2.58-3.54, adjusted for age/sex). In the fully adjusted model, frequent headaches were no longer associated with gender diversity (OR = 1.53, 95% CI 0.63-3.69) but were still associated with frequent overt and relational peer victimization (OR = 1.82, 95% CI 1.41-2.34, and OR = 1.54, 95% CI 1.17-2.03, respectively), suicidality (OR = 1.83, 95% CI 1.44-2.32), and having a mood or anxiety disorder (OR = 1.50, 95% CI 1.01-2.21, and OR = 1.74, 95% CI 1.24-2.45, respectively). In a model adjusted for age, sex, and mood/anxiety disorders, the risk of suicidality increased incrementally with headache frequency. DISCUSSION Peer victimization and suicidality may be associated with higher headache frequency in adolescents with headaches, independently of mood and anxiety symptoms. Gender-diverse adolescents may have a higher risk of experiencing frequent headaches when compared with cisgender peers, and this may be explained by associated psychosocial factors (anxiety, depression, suicidality, and peer victimization).
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Affiliation(s)
- Christelle Nilles
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeanne V A Williams
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Scott Patten
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tamara Pringsheim
- From the Department of Clinical Neurosciences (C.N., S.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; 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.P., T.P.), Psychiatry, Pediatrics and Community Health Sciences, University of Calgary; Departments of Community Health Sciences (J.V.A.W.) and Clinical Neurosciences (T.P., S.L.O.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.P., T.P., S.L.O.); Hotchkiss Brain Institute (T.P., S.L.O.), University of Calgary; and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada.
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Ombashi S, Tsangaris E, Heeres AG, van Roey V, Neuteboom RF, van Veelen-Vincent MLC, Jansson K, Mathijssen IMJ, Klassen AF, Versnel SL. Quality of life in children suffering from headaches: a systematic literature review. J Headache Pain 2023; 24:127. [PMID: 37718449 PMCID: PMC10506203 DOI: 10.1186/s10194-023-01595-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/12/2023] [Indexed: 09/19/2023] Open
Abstract
BACKGROUND Headaches are the most common complaints among pediatric populations. Determining the cause and appropriate treatment for headaches may be challenging and costly, and the impact of headaches on the lives of patients and their families is not well understood. OBJECTIVE A systematic literature review was conducted to examine what PROMs are currently used, and to identify quality of life (QoL) concepts important to children suffering from headaches and any known determinants of QoL. METHODS Embase, Medline, Web of Science, CINAHL, EBSCOhost, PsychINFO, Cochrane CENTRAL and Google Scholar were searched from their inception through to June 2021. Studies investigating QoL, using a validated outcome measure in pediatric patients with headaches, were included. Relevant studies were identified through title and abstract screening and full text review by two independent reviewers. A citation review of included studies was performed. QoL concepts were extracted from the outcome measures that were used in each study to develop a preliminary conceptual model of QoL in children suffering from headaches. Determinants of QoL were also identified and categorized. RESULTS A total of 5421 studies were identified in the search. Title and abstract screening resulted in the exclusion of 5006 studies. Among the 415 studies included for full text review, 56 were eligible for final analysis. A citation review resulted in the addition of five studies. Most studies were conducted in high-income countries and included a patient-sample accordingly (n = 45 studies). Sixteen different PROMs were identified in the included studies, of which the PedsQL was used the most often (n = 38 studies). The most common health concepts reported were physical functioning (n = 113 items), social and psychological wellbeing (N = 117, n = 91 resp.). Twenty-five unique determinants of QoL were extracted from the included studies. CONCLUSION There is a need for a condition-specific PROM to facilitate the measurement of QoL outcomes in the pediatric headache population. A conceptual model was developed based on the findings from the health concepts. Findings from this review could be used for future qualitative interviews with pediatric patients with headaches to elicit and refine important QoL concepts.
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Affiliation(s)
- S Ombashi
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands.
- European Reference Network for Craniofacial Anomalies and Ear- Nose- and Throat Disorders, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands.
| | - E Tsangaris
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - A G Heeres
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - V van Roey
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- European Reference Network for Craniofacial Anomalies and Ear- Nose- and Throat Disorders, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
| | - R F Neuteboom
- Children's Brain Lab, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M L C van Veelen-Vincent
- European Reference Network for Craniofacial Anomalies and Ear- Nose- and Throat Disorders, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Children's Brain Lab, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Pediatric Neurosurgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - K Jansson
- European Reference Network for Craniofacial Anomalies and Ear- Nose- and Throat Disorders, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Department of Reconstructive Surgery and Craniofacial Surgery, Stockholm, Karolinska University Hospital, Stockholm, Sweden
| | - I M J Mathijssen
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- European Reference Network for Craniofacial Anomalies and Ear- Nose- and Throat Disorders, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Children's Brain Lab, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - A F Klassen
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - S L Versnel
- Department of Plastic and Reconstructive Surgery, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- European Reference Network for Craniofacial Anomalies and Ear- Nose- and Throat Disorders, Erasmus University Medical Center, Dr. Molewaterplein 40, 3015 GD, Rotterdam, The Netherlands
- Children's Brain Lab, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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13
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Walter SM, Dai Z, Wang K. Comorbidities of Rural Children and Adolescents with Migraine and without Migraine. CHILDREN (BASEL, SWITZERLAND) 2023; 10:1133. [PMID: 37508629 PMCID: PMC10378174 DOI: 10.3390/children10071133] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Revised: 06/16/2023] [Accepted: 06/26/2023] [Indexed: 07/30/2023]
Abstract
(1) Background: Migraine is associated with comorbidities that are common in the general rural pediatric population. The purpose of this study is to evaluate the differences in the occurrence of comorbidities between rural children and adolescents with and without migraine. (2) Methods: A cross-sectional, secondary data analysis using electronic medical records of 1296 patients (53.8% females, aged 12.4 ± 3.2) was completed. Mann-Whitney U test was used to detect the difference in the number of comorbidities between the two groups. Chi-square test was used to identify the differences in the number of comorbidities, which were classified as low (0-1 comorbidities), medium (2-3 comorbidities), and high (4 or plus comorbidities) degree of comorbidities. (3) Results: Significant differences were found between those children and adolescents with migraine vs. those without for depression (p < 0.0001), anxiety (p < 0.0001), and Ehlers-Danlos Syndrome (EDS; p = 0.0309). A marginally significant difference was found between those children and adolescents with migraine (47.2%; n = 306) vs. those without (42.1%; n = 273) for unhealthy weight (p = 0.0652). Approximately 40% of the migraineurs had 2-3 comorbidities, whereas 32% of the non-migraineurs had 2-3 comorbidities (p = 0.0003). (4) Conclusions: Findings demonstrate the importance of identifying comorbidities associated with rural pediatric migraine in order to develop effective treatment strategies that optimize patient outcomes.
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Affiliation(s)
- Suzy Mascaro Walter
- Department of Family and Community Health, School of Nursing, West Virginia University, Morgantown, WV 26506, USA
| | - Zheng Dai
- Health Affairs Institute, West Virginia University, Morgantown, WV 26506, USA
| | - Kesheng Wang
- Department of Family and Community Health, School of Nursing, West Virginia University, Morgantown, WV 26506, USA
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14
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Rentsch M, Zumbrunn Wojczyńska A, Gallo LM, Colombo V. Prevalence of Temporomandibular Disorders Based on a Shortened Symptom Questionnaire of the Diagnostic Criteria for Temporomandibular Disorders and Its Screening Reliability for Children and Adolescents Aged 7-14 Years. J Clin Med 2023; 12:4109. [PMID: 37373802 DOI: 10.3390/jcm12124109] [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: 05/24/2023] [Revised: 06/08/2023] [Accepted: 06/16/2023] [Indexed: 06/29/2023] Open
Abstract
The prevalence and adequacy of diagnostic approaches for temporomandibular disorders (TMD) in children and adolescents are still matters of debate. This study aimed to determine the prevalence of TMD and oral habits in children and adolescents aged 7-14 years and evaluate the consistency between self-reported TMD symptoms and clinical findings using a shortened Axis I of Diagnostic Criteria for TMD (DC/TMD). Children (aged 7-10) and adolescents (aged 11-14) of both sexes were invited to participate in this study (n = 1468). Descriptive statistics for all observed variables and Mann-Whitney U-Tests for the clinical examination were performed. A total of 239 subjects participated in the study (response rate 16.3%). The self-reported prevalence of TMD was found to be 18.8%. The most frequently reported oral habit was nail biting (37.7%), followed by clenching (32.2%) and grinding (25.5%). Self-reported headache increased with age, while clenching and grinding decreased. Based on the answers to the DC/TMD Symptom Questionnaire, subgroups of asymptomatic and symptomatic participants (n = 59; 24.7%) were established and randomly selected for the clinical examination (f = 30). The shortened Symptom Questionnaire showed a sensitivity of 0.556 and a specificity of 0.719 for pain during the clinical examination. Although the Symptom Questionnaire exhibited high specificity (0.933), its sensitivity (0.286) for temporomandibular joint sounds was low. Disc displacement with reduction (10.2%) and myalgia (6.8%) were the most common diagnoses. In conclusion, the self-reported prevalence of TMD in children and adolescents in this study was comparable to that reported in the literature for adults. However, the accuracy of the shortened Symptom Questionnaire as a screening tool for TMD-related pain and jaw sounds in children and adolescents was found to be low.
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Affiliation(s)
- Mathias Rentsch
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
- Public-School Dental Services of the City of Zurich, 8002 Zurich, Switzerland
| | | | - Luigi M Gallo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
| | - Vera Colombo
- Clinic of Masticatory Disorders, Center of Dental Medicine, University of Zurich, 8032 Zurich, Switzerland
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15
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Steiner TJ, Husøy A, Thomas H, Stovner LJ. The HARDSHIP databases: a forthcoming free good from the Global Campaign against Headache. J Headache Pain 2023; 24:21. [PMID: 36879195 PMCID: PMC9986863 DOI: 10.1186/s10194-023-01554-9] [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: 02/08/2023] [Accepted: 02/21/2023] [Indexed: 03/08/2023] Open
Abstract
In order to pursue its purpose of reducing the global burden of headache, the Global Campaign against Headache has gathered data on headache-attributed burden from countries worldwide. These data, from the individual participants in adult population-based studies and child and adolescent schools-based studies, are being collated in two databases, which will be powerful resources for research and teaching and rich information sources for health policy.Here we briefly describe the structure and content of these databases, and announce the intention to make them available in due course as a free good.
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Affiliation(s)
- Timothy J Steiner
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway. .,Department of Neurology, University of Copenhagen, Copenhagen, Denmark. .,Division of Brain Sciences, Imperial College London, London, UK.
| | - Andreas Husøy
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, Norwegian Advisory Unit On Headaches, St Olavs Hospital, Trondheim, Norway
| | - Hallie Thomas
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, NorHEAD, Norwegian University of Science and Technology, Edvard Griegs Gate, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, Norwegian Advisory Unit On Headaches, St Olavs Hospital, Trondheim, Norway
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16
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Onofri A, Pensato U, Rosignoli C, Wells-Gatnik W, Stanyer E, Ornello R, Chen HZ, De Santis F, Torrente A, Mikulenka P, Monte G, Marschollek K, Waliszewska-Prosół M, Wiels W, Boucherie DM, Onan D, Farham F, Al-Hassany L, Sacco S. Primary headache epidemiology in children and adolescents: a systematic review and meta-analysis. J Headache Pain 2023; 24:8. [PMID: 36782182 PMCID: PMC9926688 DOI: 10.1186/s10194-023-01541-0] [Citation(s) in RCA: 35] [Impact Index Per Article: 35.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 01/24/2023] [Indexed: 02/15/2023] Open
Abstract
INTRODUCTION Headache is the most prevalent neurological manifestation in adults and one of the leading causes of disability worldwide. In children and adolescents, headaches are arguably responsible for a remarkable impact on physical and psychological issues, yet high-quality evidence is scarce. MATERIAL AND METHODS We searched cross-sectional and cohort studies in Embase, Medline, Web of Science, and Cochrane databases from January 1988 to June 2022 to identify the prevalence of headaches in 8-18 years old individuals. The risk of bias was examined with the Joanna Briggs Institute (JBI) scale. A random-effects model was used to estimate the pooled prevalence of pediatric headache. Subgroup analyses based on headache subtypes were also conducted. RESULTS Out of 5,486 papers retrieved electronically, we identified 48 studies that fulfilled our inclusion criteria. The pooled prevalence of primary headaches was 11% for migraine overall [95%CI: 9-14%], 8% for migraine without aura (MwoA) [95%CI: 5-12%], 3% for migraine with aura (MwA) [95%CI:2-4%] and 17% for tension-type headache (TTH) [95% CI: 12-23%]. The pooled prevalence of overall primary headache in children and adolescents was 62% [95% CI: 53-70%], with prevalence in females and males of 38% [95% CI: 16-66%] and 27% [95% CI: 11-53%] respectively. After the removal of studies ranked as low-quality according to the JBI scale, prevalence rates were not substantially different. Epidemiological data on less common primary headaches, such as trigeminal autonomic cephalalgias, were lacking. CONCLUSION We found an overall remarkably high prevalence of primary headaches in children and adolescents, even if flawed by a high degree of heterogeneity. Further up-to-date studies are warranted to complete the picture of pediatric headache-related burden to enhance specific public interventions.
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Affiliation(s)
- Agnese Onofri
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, L’Aquila, Italy
| | - Umberto Pensato
- grid.417728.f0000 0004 1756 8807Neurology and Stroke Unit, IRCCS Humanitas Research Hospital, Rozzano, Milan Italy ,grid.452490.eHumanitas University, Pieve Emanuele, Milan, Italy
| | - Chiara Rosignoli
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, L’Aquila, Italy
| | - William Wells-Gatnik
- grid.7841.aDepartment of Clinical and Molecular Medicine, Sapienza University of Rome, Rome, Italy
| | - Emily Stanyer
- grid.13097.3c0000 0001 2322 6764Wolfson Centre for Age Related Diseases, King’s College London, London, UK
| | - Raffaele Ornello
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, L’Aquila, Italy
| | - Hui Zhou Chen
- grid.13097.3c0000 0001 2322 6764Wolfson Centre for Age Related Diseases, King’s College London, London, UK
| | - Federico De Santis
- grid.158820.60000 0004 1757 2611Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L’Aquila, L’Aquila, Italy
| | - Angelo Torrente
- grid.10776.370000 0004 1762 5517Department of Biomedicine, Neurosciences and Advanced Diagnostics, University of Palermo, Palermo, Italy
| | - Petr Mikulenka
- grid.412819.70000 0004 0611 1895Department of Neurology, Third Faculty of Medicine, Charles University and University Hospital Kralovske Vinohrady, Prague, Czech Republic
| | - Gabriele Monte
- grid.414125.70000 0001 0727 6809Department of Neuroscience, Neurology Unit, Bambino Gesù Children’s Hospital, Istituto Di Ricovero E Cura a Carattere Scientifico (IRCCS), Rome, Italy
| | - Karol Marschollek
- grid.4495.c0000 0001 1090 049XDepartment of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Waliszewska-Prosół
- grid.4495.c0000 0001 1090 049XDepartment of Neurology, Wroclaw Medical University, Wroclaw, Poland
| | - Wietse Wiels
- grid.8767.e0000 0001 2290 8069Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Deirdre M. Boucherie
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Dilara Onan
- grid.14442.370000 0001 2342 7339Faculty of Physical Therapy and Rehabilitation, Hacettepe University, Ankara, Turkey
| | - Fatemeh Farham
- grid.411705.60000 0001 0166 0922Department of Headache, Iranian Center of Neurological Researchers, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Linda Al-Hassany
- grid.5645.2000000040459992XDepartment of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences (DISCAB), University of L'Aquila, L'Aquila, Italy.
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Ali M, Asghar N, Hannah T, Schupper AJ, Li A, Dreher N, Murtaza-Ali M, Vasan V, Nakadar Z, Alasadi H, Lin A, Hrabarchuk E, Quinones A, McCarthy L, Asfaw Z, Dullea J, Gometz A, Lovell M, Choudhri T. A multicenter, longitudinal survey of headaches and concussions among youth athletes in the United States from 2009 to 2019. J Headache Pain 2023; 24:6. [PMID: 36755244 PMCID: PMC9909942 DOI: 10.1186/s10194-022-01528-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 11/17/2022] [Indexed: 02/10/2023] Open
Abstract
OBJECTIVE/ BACKGROUND Chronic headaches and sports-related concussions are among the most common neurological morbidities in adolescents and young adults. Given that the two can overlap in presentation, studying the effects of one on another has proven difficult. In this longitudinal study, we sought to assess the relationship between chronic headaches and concussions, analyzing the role of historic concussions on chronic headaches, as well as that of premorbid headaches on future concussion incidence, severity, and recovery. METHODS This multi-center, longitudinal cohort study followed 7,453 youth athletes who were administered demographic and clinical surveys as well as a total of 25,815 Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) assessments between 2009 and 2019. ImPACT was administered at baseline. Throughout the season concussions were examined by physicians and athletic trainers, followed by re-administration of ImPACT post-injury (PI), and at follow-up (FU), a median of 7 days post-concussion. Concussion incidence was calculated as the total number of concussions per patient years. Concussion severity and recovery were calculated as standardized deviations from baseline to PI and then FU in Symptom Score and the four neurocognitive composite ImPACT scores: Verbal Memory, Visual Memory, Processing Speed, and Reaction Time. Data were collected prospectively in a well-organized electronic format supervised by a national research-oriented organization with rigorous quality assurance. Analysis was preformed retrospectively. RESULTS Of the eligible athletes, 1,147 reported chronic headaches (CH) at the start of the season and 6,306 reported no such history (NH). Median age of the cohort was 15.4 ± 1.6 years, and students were followed for an average of 1.3 ± 0.6 years. A history of concussions (OR 2.31, P < 0.0001) was associated with CH. Specifically, a greater number of past concussions (r2 = 0.95) as well as concussions characterized by a loss of consciousness (P < 0.0001) were associated with more severe headache burden. The CH cohort had a greater future incidence of concussion than the NH cohort (55.6 vs. 43.0 per 100 patient-years, P < 0.0001). However, multivariate analysis controlling for demographic, clinical, academic, and sports-related variables yielded no such effect (OR 0.99, P = 0.85). On multivariable analysis the CH cohort did have greater deviations from baseline to PI and FU in Symptom Score (PI OR per point 1.05, P = 0.01, FU OR per point 1.11, P = 0.04) and Processing Speed (OR per point 1.08, P = 0.04), suggesting greater concussion severity and impaired symptomatic recovery as compared to the NH cohort. CONCLUSION A history of concussions was a significant contributor to headache burden among American adolescents and young adults. However, those with chronic headaches were not more likely to be diagnosed with a concussion, despite presenting with more severe concussions that had protracted recovery. Our findings not only suggest the need for conservative management among youth athletes with chronic headaches, they also indicate a potential health care gap in this population, in that those with chronic headaches may be referred for concussion diagnosis and management at lower rates than those with no such comorbidity.
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Affiliation(s)
- Muhammad Ali
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA.
| | - Nek Asghar
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Theodore Hannah
- Department of Neurosurgery, Lewis Katz School of Medicine at Temple University, 19140, Philadelphia, PA, USA
| | - Alexander J Schupper
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Adam Li
- Department of Neurosurgery, University of Rochester School of Medicine and Dentistry, 14642, Rochester, NY, USA
| | - Nickolas Dreher
- Department of Medicine, Columbia University Vagelos College of Physicians and Surgeons, 10032, NY, USA
| | - Muhammad Murtaza-Ali
- Department of Anthropology, State University of New York at Binghamton, 13902, NY, USA
| | - Vikram Vasan
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Zaid Nakadar
- Department of Neurosurgery, State University of New York Downstate Health Sciences University, 11203, NY, USA
| | - Husni Alasadi
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Anthony Lin
- Department of Pathology, Joan & Sanford I. Weill Medical College of Cornell University, 10021, NY, USA
| | - Eugene Hrabarchuk
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Addison Quinones
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Lily McCarthy
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Zerubabbel Asfaw
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Jonathan Dullea
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
| | - Alex Gometz
- Concussion Management of New York, 10021, NY, USA
| | - Mark Lovell
- Department of Neurology, The University of Pittsburgh Medical Center, 15260, Pittsburgh, PA, USA
| | - Tanvir Choudhri
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, 10021, NY, USA
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18
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Global epidemiology of migraine and its implications for public health and health policy. Nat Rev Neurol 2023; 19:109-117. [PMID: 36693999 DOI: 10.1038/s41582-022-00763-1] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2022] [Indexed: 01/25/2023]
Abstract
Migraine is one of more than 200 headache disorders but stands out among these as a major cause of population ill health. In migraine epidemiology, the key variable is prevalence, but, from the perspective of public health, prevalence is uninformative without burden estimates. Here, we discuss how migraine epidemiology, from a quite recent start, has evolved into the respectable though imperfect science of today, but with the legacy that much of the large corpus of older literature is of questionable reliability. Newer studies have benefited from a universally accepted definition of migraine, while methodological developments have broadened the scope of migraine caseness, and published guidelines address important methodological issues. In the light of these developments, we question the apparent increase in migraine prevalence over time, offering explanations as to why this may be illusory. We suggest that the current best estimates are that global migraine prevalence is 14-15%, and that migraine accounts for 4.9% of global population ill health quantified in years lived with disability (YLDs). These evaluations are probably under-quantified rather than over-quantified, and YLDs are not a comprehensive measure of migraine-attributed burden. Despite these uncertainties, such high estimates of population ill health have clear implications for health policy.
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19
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Hassan R, Gudiwala V, Dawn P, Jeynes L. Greater Occipital Nerve Block as an Effective Intervention for Medically Refractory Pediatric Migraine: A Retrospective Study. Cureus 2023; 15:e34930. [PMID: 36938185 PMCID: PMC10016313 DOI: 10.7759/cureus.34930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2023] [Indexed: 02/15/2023] Open
Abstract
Background Migraine is a common complaint worldwide, spanning all ages, but is not so well investigated in children and adolescents. Pediatric migraines incur significant health and social consequences with the most incisive effects seen in school performance, physical health, and mental well-being, making early effective management of pediatric migraine desirable. However, unlike adult migraine, the treatment for pediatric migraine has not been well established, which is especially true for the treatment of medically refractory migraine in children. Methodology We conducted a retrospective study to assess the feasibility of greater occipital nerve (GON) blocks as a therapeutic option for medically refractory migraine in children. We recruited subjects under 18 years old with a severe medically refractory headache that was affecting day-to-day life and who consented to receive a GON block. GON block effectivity was assessed through follow-up consultations and a post-procedural questionnaire. Results Six subjects received a first-time GON block for medically refractory migraine (mean age = 12 years and three months old, age range = 10 to 15 years old, three out of six subjects were female). We found that GON block was effective in all six patients for treatment of medically refractory migraine as assessed through follow-up consultations and a questionnaire sent out six weeks post-intervention. GON block was generally tolerable with only one patient reporting side effects (migraine flare-up for three days) post-intervention. Repeat injection was performed in four out of six patients, all of whom reported a repeat benefit. Conclusions We conclude that GON block is a feasible therapeutic option for the management of medically refractory migraine in children.
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Affiliation(s)
- Refaat Hassan
- School of Clinical Medicine, University of Cambridge, Cambridge, GBR
| | - Viral Gudiwala
- School of Clinical Medicine, University of Cambridge, Cambridge, GBR
| | - Pretty Dawn
- Pain Medicine, West Suffolk Hospital, Bury St Edmunds, GBR
| | - Louise Jeynes
- Pain Medicine, West Suffolk Hospital, Bury St Edmunds, GBR
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20
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Assessment of Headache Characteristics, Impact, and Managing Techniques among Pharmacy and Nursing Undergraduates-An Observational Study. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:medicina59010130. [PMID: 36676754 PMCID: PMC9863829 DOI: 10.3390/medicina59010130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 12/23/2022] [Accepted: 01/05/2023] [Indexed: 01/12/2023]
Abstract
Background and Objectives: Many different forms of headaches can change or impact daily activity and quality of life, which increases the financial burden on society over time. Undergraduates who get headaches may be absent from attending lectures, perform less well on their daily tasks and academic achievement, as well as struggle to build and maintain relationships with peers and mentors. Therefore, this study aimed to assess the headache-related characteristics and managing approaches among Saudi pharmacy and nursing students at a Saudi university, in Riyadh, Saudi Arabia. Materials and Methods: A survey questionnaire was administered in this cross-sectional study to participants at a Saudi university, in Riyadh, Saudi Arabia. Participants included males. The sample size was calculated with Raosoft® software. Data analysis was executed using IBM Statistic SPSS, and the level of statistical significance was set at p < 0.05. Results: A total of 236 participants completed the questionnaires. The majority, i.e., 218 (92.4%) of them, were male; in addition, 124 (52.5%) were aged between 26 and 30, 124 (52.5%) were pharmacy students, 112 (47.5%) were nursing students, and 134 (56.8%) were smokers. When asked about ever having at least one episode of headache during the week, 66.1% (n = 156) agreed that they had one episode of headache, although 57 (24.2%) of the students had a headache for five days during a week. With regard to the impact of headaches on everyday activities, only 34.7% of the students said that headache disrupted their regular activities. Almost 41% of the students agreed that headache impacted their academic performance. Nearly 34% of students (n = 79) who had headaches considered napping, while 33% (n = 64) took painkillers and anti-inflammatory medicines, and 25% (n = 59) considered taking caffeine. In this study, the participants’ ages and headache severity were strongly associated (p = 0.0001). More pharmacy students (66.1%) reported having severe headaches than nursing students (14.3%) (p = 0.0001). Conclusions: The current findings revealed that most of the undergraduates suffered from headaches, and the intensity of the pain was moderate; furthermore, one in four undergraduates reported that headaches impacted their academic performance. Caffeine and simple analgesics and anti-inflammatories were used for headache relief.
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21
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Gungor M, Guler MA, Karagoz YS. Management and behavior-modifying recommendation effects in childhood headache. Pediatr Int 2023; 65:e15406. [PMID: 36326638 DOI: 10.1111/ped.15406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 10/05/2022] [Accepted: 10/14/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Headaches are common in childhood. Recently, there has been an increasing trend toward pharmacological treatment. METHODS Secondary causes were excluded first in patients who attended our clinic with headache. Those without a secondary cause were evaluated as primary headache and classified into subgroups. Behavior-modifying recommendations (adequate and regular sleep, adequate and regular nutrition, adequate fluid intake, and restriction of screen exposure) were given to all patients. Patients were re-evaluated at 1, 3, and 6 months. Pharmacologic treatment was started at the end of the first month with follow-up at the third and sixth months for those who did not benefit from the behavior-modifying recommendations. RESULTS A total of 875 patients presented with headache complaints, of which 30.6% were evaluated as primary headache. Behavior-modifying recommendations were beneficial for 23.1% with migraine with aura; 20.3% with migraine without aura, and 36.8% with tension-type headache. CONCLUSION Secondary causes should be excluded first in patients who present to the pediatric neurology clinic with headache. Behavioral modifications to change the lifestyle of patients diagnosed with primary headache should be tried before giving pharmacologic treatment.
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Affiliation(s)
- Mesut Gungor
- Department of Pediatric Neurology, Kocaeli University Medical Faculty, Kocaeli, Turkey
| | - Muhammet Akif Guler
- Department of Pediatrics, Ataturk University Medical Faculty, Erzurum, Turkey
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22
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da Silva Cardoso J, Curto C, Manuel-Vieira P, Ashworth J, Temudo T, Carrilho I. Primary headache with onset in childhood and adolescence: natural history and prognostic factors in a Portuguese population. Rev Neurol 2023; 76:9-14. [PMID: 36544371 PMCID: PMC10364019 DOI: 10.33588/rn.7601.2022356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Headaches are the most frequent neurological disorder in the pediatric population, with great impact on quality of life. This study aims to characterize a cohort of patients followed at a pediatric neurology unit between January 1st 2013 and December 31st, 2021. MATERIALS AND METHODS We reviewed medical records and selected patients with primary headaches and a minimum follow-up of 12 months. RESULTS A total of 226 patients were included, 54.4% female, with an average age at headache onset of 9 ± 3.5 (3.1-16.5) years; 63.5% were prepubertal. A positive family history of headache was identified in 76.6% of cases and triggers in 63.6%. At first clinical assessment, 45.1% were classified as migraine without aura, 10.6% as migraine with aura, 3.5% tension-type, 8% mixed (tension and migraine), 1.3% other type and 31.4% were unclassifiable. The patients had a median follow-up of 2.4 (1.8-3.3) years. The diagnosis of tension-type headaches remained stable in 75% of the patients and resolved in 25%; 13% of the patients with migraine without aura changed into another type of headache and 17.4% resolved; 44.4% of the patients with migraine with aura turned into another type of headache and 11.1% resolved. Of the variables studied, only duration of headache episode had a significant association with headache remission, with odds ratio 0.16 (p = 0.03; 95% confidence interval: 0.032-0.84). CONCLUSIONS Our study shows that headache type in pediatric population changes over time, especially in those with migraine with aura. The duration of each headache episode was presented as a predictor of headache remission over time.
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Affiliation(s)
- J da Silva Cardoso
- Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - C Curto
- Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - P Manuel-Vieira
- Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - J Ashworth
- Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - T Temudo
- Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - I Carrilho
- Centro Materno-Infantil do Norte Albino Aroso, Centro Hospitalar Universitário do Porto, Porto, Portugal
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23
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Esin OR. [Modern principles of primary headaches prevention in children and adolescents]. Zh Nevrol Psikhiatr Im S S Korsakova 2023; 123:31-37. [PMID: 37315239 DOI: 10.17116/jnevro202312305131] [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: 06/16/2023]
Abstract
Headaches in children and adolescents are an actual problem of modern medicine. In most cases, headaches are regarded as a manifestation of vertebrogenic or cerebrovascular pathology, or as a manifestation of autonomic dystonia syndrome which leads to an erroneous diagnosis and treatment. The review considers the factors of occurrence and chronicity of primary headaches (hypodynamia, postural disorders, magnesium and vitamin D deficiency, anxiety and depression, central sensitization, alexithymia), methods for their diagnosis and treatment.
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Affiliation(s)
- O R Esin
- Kazan (Volga region) Federal University, Kazan, Russia
- Clinic of Otorhinolaryngology, Kazan, Russia
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24
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Triggers and clinical changes of childhood primary headache characteristics during COVID-19 pandemic lockdown. Acta Neurol Belg 2023; 123:215-220. [PMID: 36478546 PMCID: PMC9734329 DOI: 10.1007/s13760-022-02150-5] [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: 11/28/2021] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Children with primary headache are particularly vulnerable to the negative impacts of the pandemic due to factors like increased social isolation, disruption of sleep and impairment of healthy diet. We aimed to investigate the clinical changes and triggering factors for childhood primary headaches to demonstrate the impact of the pandemic lockdown. METHOD Children aged between 60 months and 18 years with headache complaint attending the general outpatient clinic between December 2019 and December 2020 were included in the study. Patients were classified according to ICHD-3 regarding clinical and laboratory data. Primary headaches diagnosed before (December 2019-March 2020) and during the pandemic lockdown (April 2020-December 2020) were divided into two groups as migraine and tension-type headache (TTH). Clinical picture and triggering factors were compared between groups to illustrate the effect of the lockdown. RESULTS The study included 612 subjects, with 463 patients (76%) classified in the primary headache group and 149 (24%) in the secondary headache group. Among the first group, 267 patients (58%) had migraine and 196 patients (42%) had TTH. Comparisons between before and during the pandemic lockdown showed significant increased frequency of TTH, but no difference in the frequency and duration of migraine. Both screen exposure and sleep pattern changes were found to be significantly increased in the TTH group during the pandemic lockdown. DISCUSSION We found a significant increase in the attack frequency for TTH patients during the pandemic lockdown. Reduction in screen time is an important strategy in preventing primary headache attacks in children.
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25
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Arruda MA, Arruda R. Case report: Look at my eyes. HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2022.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
The comorbidity of migraine and Autism Spectrum Disorder (ASD) still remain unclear. In spite of plausible evidences of such comorbidity, there is a scarcity of populational studies focusing this hypothesis. The diagnosis of migraine in children with ASD is very challenge due to the large clinical heterogeneity and limited communication skills, particularly verbal abilities in young children and those with intellectual disability. ASD and migraine are chronic prevalent disorders sharing some pathophysiological changes (neurotransmission dysregulation, altered immune response, abnormal findings in the cortical minicolumn organization, and dysfunctions in the gut–brain axis), susceptibility genes (including calcium channel mutations and polymorphisms), and atypical sensory processing. Herein, we take advantage of a prototypical case of an adolescent with episodic migraine transformed to chronic, not responsive to preventive treatment, to explore the diagnostic workup and successful personalized clinical and therapeutical management.
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26
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Lou F, Lou Q, Li J, Zhang X, Wang W. Effectiveness and safety of ear acupuncture for tension-type headache: A protocol for a systematic review and meta-analysis. Medicine (Baltimore) 2022; 101:e31826. [PMID: 36482643 PMCID: PMC9726306 DOI: 10.1097/md.0000000000031826] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Tension-type headache (TTH) refers to a type of functionalism disease, which is commonly characterized by recurrent headaches of mild to moderate intensity, bilateral location, pressing or tightening quality, and no aggravation by routine physical activity. Has significantly impacts on people's work and life. Ear acupuncture as a traditional Chinese therapy, showing several advantages (e.g., safety, economy, and less side effects), has been extensively used to treat TTH. However, its curative effect is supported by limited evidence. Accordingly, the present study aims to comprehensively assess the reliability of ear acupuncture in TTH. METHODS AND ANALYSIS The study will conduct a systematic review and meta-analysis. Seven databases, including the Embase, Cochrane Library, Pubmed, SinoMed, CNKI, VIP, and Wanfang Data, will be searched using predefined search terms to identify relevant studies. The primary outcomes will be the pain intensity, the pain frequency and the impact of headache. The methodological quality of the included studies will be assessed with a previously established checklist. The Cochrane Collaboration's bias risk tool will be used for assessing the bias of included RCTs. Stata 17.0 software is used for meta-analysis.
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Affiliation(s)
- Fei Lou
- Fuyang District Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
- *Correspondence: Fei Lou, Fuyang District Hospital of Traditional Chinese Medicine, No. 2-4, Guihua Road, Fuchun Street, Hangzhou, 310053, China (e-mail: )
| | - Qihui Lou
- Fuyang District Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
| | - Jingjing Li
- Fuyang District Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
| | - Xiaoli Zhang
- Fuyang District Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
| | - Wei Wang
- Fuyang District Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang, China
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27
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Physical Activity and Recurrent Pain in Children and Adolescents in Germany—Results from the MoMo Study. CHILDREN 2022; 9:children9111645. [PMID: 36360373 PMCID: PMC9689024 DOI: 10.3390/children9111645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022]
Abstract
Recurrent pain can be a significant disruption in the activities of daily life, and is not only a health problem in adults but also in children and adolescents. This study analyzed the prevalence of recurrent pain in the current sample (n = 1516; 11–17 years (meanage = 14.4 ± 2.0 years); 50.8% female) of a nationwide study in Germany, evaluated the association of participants’ device-based physical activity (PA) with the prevalence of recurrent pain, and assessed whether children and adolescents who reported pain for the last three months accumulated less PA than those who did not. A higher prevalence was found in girls for recurrent headaches (42.2% vs. 28.7%), abdominal pain (28.2% vs. 20.1%), and back pain (26.9% vs. 19.5%). We found higher odds for recurrent headaches in girls (OR = 1.54) and in participants that did not reach at least 60 min of moderate to vigorous PA (MVPA) per day (OR = 2.06). Girls who reported recurrent headaches accumulated 4.7 min less MVPA per day than those without. The prevalence of pain remains at a high level in the German youth and underscores the need for interventions to improve the health situations of children and adolescents.
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28
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Kawatu N, Wa Somwe S, Ciccone O, Mukanzu M, Uluduz D, Şaşmaz T, Yalçın BNB, Wöber C, Steiner TJ. The prevalence of primary headache disorders in children and adolescents in Zambia: a schools-based study. J Headache Pain 2022; 23:118. [PMID: 36085007 PMCID: PMC9461122 DOI: 10.1186/s10194-022-01477-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/12/2022] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND The Global Campaign against Headache collects data from children (6-11 years) and adolescents (12-17) to inform health and education policies and contribute to the Global Burden of Disease (GBD) study. This survey in Zambia, part of this global enquiry, was the second from sub-Saharan Africa (SSA). METHODS Following the generic protocol, this was a schools-based cross-sectional survey. We used the child and adolescent versions of the structured Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire, self-completed by pupils within classes, in a total of nine schools in Lusaka (urban) and Copperbelt (semi-rural). These two of Zambia's ten provinces were selected to represent the country's urban/rural divide. Headache diagnostic questions were based on ICHD-3 except for undifferentiated headache (UdH). RESULTS Of 2,759 potential participants, 2,089 (615 children [29.4%], 1,474 adolescents [70.6%]) completed questionnaires (participating proportion 75.7%). Children were therefore under-represented (mean age 13.1 ± 2.8 years), while gender distribution (1,128 [54.0%] male, 961 [46.0%] female) was close to expectation. Observed lifetime prevalence of headache was 97.5%. Gender- and age-adjusted 1-year prevalence estimates were 85.8% for all headache, 53.2% for migraine (definite 17.5%, probable 35.7%), 12.1% for tension-type headache (TTH), 14.8% for UdH, 3.3% for all headache on ≥ 15 days/month and 0.9% for probable medication-overuse headache. Headache durations were short: only 28.6% of participants with any headache, and only 10.5% of those diagnosed as probable migraine, reported usual durations of > 2 h (the threshold for definite migraine). Of the latter, 36.6% reported < 1 h, the duration criterion for UdH. There were weak associations of migraine (definite + probable) with female gender, and of TTH and headache on ≥ 15 days/month with adolescence. Headache yesterday was reported by 22.2% of the sample, 25.5% of those with headache. CONCLUSIONS Headache disorders among young people are prevalent in Zambia. Among them, migraine is the most common, with UdH also highly prevalent. In this study there were diagnostic uncertainties, which rested to a large extent on the distinction between migraine and UdH among the many participants reporting headache of < 2 h' duration. Similar uncertainties occurred in the first study in SSA, in Ethiopia. Because of these, we conclude only that migraine affects at least 17.5% of these age groups in Zambia, which is still a large proportion, adult prevalence in an earlier study being 22.9%. Supplementary estimates of attributed burden are needed to inform public-health and educational policies in Zambia.
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Affiliation(s)
- Nfwama Kawatu
- grid.12984.360000 0000 8914 5257Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Somwe Wa Somwe
- grid.12984.360000 0000 8914 5257Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Ornella Ciccone
- grid.12984.360000 0000 8914 5257Department of Paediatrics and Child Health, School of Medicine, University of Zambia, Lusaka, Zambia
| | - Misheck Mukanzu
- grid.12984.360000 0000 8914 5257University of Zambia School of Medicine, Lusaka, Zambia
| | - Derya Uluduz
- grid.9601.e0000 0001 2166 6619Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Tayyar Şaşmaz
- grid.411691.a0000 0001 0694 8546Public Health Department, School of Medicine, Mersin University, Mersin, Turkey
| | - Bengü Nehir Buğdaycı Yalçın
- grid.411691.a0000 0001 0694 8546Public Health Department, School of Medicine, Mersin University, Mersin, Turkey
| | - Christian Wöber
- grid.22937.3d0000 0000 9259 8492Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Timothy J. Steiner
- grid.5947.f0000 0001 1516 2393Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway ,grid.5254.60000 0001 0674 042XDepartment of Neurology, University of Copenhagen, Copenhagen, Denmark ,grid.7445.20000 0001 2113 8111Division of Brain Sciences, Imperial College London, London, UK
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29
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Kaltseis K, Frank F, Bernar B, Kiechl S, Winder B, Kiechl-Kohlendorfer U, Knoflach M, Broessner G. Primary headache disorders in adolescents in North- and South-Tyrol: Findings of the EVA-Tyrol-Study. Cephalalgia 2022; 42:993-1004. [PMID: 35331020 PMCID: PMC9442274 DOI: 10.1177/03331024221088997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
OBJECTIVE Assessment of the prevalence of primary headache disorders, associated risk factors and use of acute/preventive medication in a representative large sample of adolescents. METHODS Within the EVA-Tyrol project, a community-based non-randomized controlled cross-sectional study, data was collected from adolescents aged 14-19 years from 45 sites across North-, East- and South Tyrol. Headaches were classified according to the latest ICHD-3 and assessed by headache specialists in face-to-face interviews. FINDINGS Of 1923 participants 930 (48.4%) reported having headaches. Female to male ratio was 2:1. Migraine, tension-type headache and other headache were diagnosed in 10%, 30.2% and 8.2% respectively. Medication overuse was diagnosed in 3.4%, increasing up to 21.7% in participants with chronic headache. The use of preventative medication was not reported by any adolescent. Sleep disturbances (p < 0.05), alcohol consumption (p < 0.05), low physical activity (p < 0.01) and high screen time exposure (p < 0.01) were associated with an increased risk of headaches. CONCLUSION We report high prevalence of primary headache disorders and medication overuse in a large community-based sample of teenagers. Acute and preventive non-drug and pharmacological treatments are not established due to lack of paediatric headache outpatient clinics. Promoting health education in teenagers and encouraging public awareness, including that of health care providers is pivotal.Trial registration: EVA-Tyrol has been retrospectively registered at clinicaltrials.gov under https://clinicaltrials.gov/ct2/show/NCT03929692 since April 29, 2019.
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Affiliation(s)
- Katharina Kaltseis
- Department of Neurology, Medical University of Innsbruck,
Innsbruck, Austria
| | - Florian Frank
- Department of Neurology, Medical University of Innsbruck,
Innsbruck, Austria
| | - Benoît Bernar
- Department of Paediatrics I, Medical University of Innsbruck,
Innsbruck, Austria
| | - Sophia Kiechl
- Department of Neurology, Medical University of Innsbruck,
Innsbruck, Austria,VASCage, Research Centre on Vascular Ageing and Stroke,
Innsbruck, Austria
| | - Bernhard Winder
- VASCage, Research Centre on Vascular Ageing and Stroke,
Innsbruck, Austria,Department of Paediatrics II, Medical University of Innsbruck,
Innsbruck, Austria
| | - Ursula Kiechl-Kohlendorfer
- VASCage, Research Centre on Vascular Ageing and Stroke,
Innsbruck, Austria,Department of Paediatrics II, Medical University of Innsbruck,
Innsbruck, Austria
| | - Michael Knoflach
- Department of Neurology, Medical University of Innsbruck,
Innsbruck, Austria,VASCage, Research Centre on Vascular Ageing and Stroke,
Innsbruck, Austria
| | - Gregor Broessner
- Department of Neurology, Medical University of Innsbruck,
Innsbruck, Austria,Gregor Broessner, Department of Neurology,
Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
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30
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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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31
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Thorud HMS, Mork R, Bjørset CO, Gilson SJ, Hagen LA, Langaas T, Pedersen HR, Svarverud E, Vikesdal GH, Baraas RC. Laboured reading and musculoskeletal pain in school children - the role of lifestyle behaviour and eye wear: a cross-sectional study. BMC Pediatr 2022; 22:416. [PMID: 35831809 PMCID: PMC9278319 DOI: 10.1186/s12887-022-03465-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/28/2022] [Indexed: 12/26/2022] Open
Abstract
Background Lifestyle behaviour in children and adolescents has become increasingly sedentary and occupied with digital work. Concurrently, there has been an increase in the prevalence of headache, neck- and low back pain, which are leading causes of disability globally. Extensive near work and use of digital devices are demanding for both the visual system and the upper body head-stabilizing musculature. Uncorrected vision problems are present in up to 40% of Nordic school children, and a lack of corrective eye wear may cause eyestrain, musculoskeletal pain and headache. The aim of this study was to investigate associations between laboured reading, musculoskeletal pain, uncorrected vision, and lifestyle behaviours in children and adolescents. Methods This was a cross-sectional study with a total of 192 Norwegian school children aged 10–11 and 15–16 years. As a part of a school vision testing program, the children completed an online questionnaire about general and ocular health, socioeconomic status, academic ambition, near work and related symptoms, upper body musculoskeletal pain, and physical and outdoor activities. Results The 15–16-year-olds had a more indoor, sedentary, digital-based lifestyle with higher academic demands, compared with the 10–11-year-olds. Concurrently, reading became more laboured and upper body musculoskeletal pain increased with age. Girls reported more symptoms, higher academic ambitions, and more time spent on schoolwork and reading, compared with boys. Non-compliance in wearing prescribed eye wear (glasses or contact lenses), increased use of near digital devices, and experiencing visual stress (glare) were positively associated with laboured reading and upper body musculoskeletal pain. Conclusions A screen-based lifestyle with high academic demands challenges the ability to sustain long hours of static, intensive near work. Extensive near work tires the visual system and upper body musculature and provokes laboured reading and musculoskeletal pain symptoms. This study emphasizes the importance of regular eye examinations in school children, and the need to raise awareness among children, parents, and school- and health personnel about the importance of optimal vision and visual environment for academic performance and health.
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Affiliation(s)
- Hanne-Mari Schiøtz Thorud
- National Centre for Optics, Vision and Eye Care, Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway.
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32
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de Oliveira-Souza AIS, da Silva Freitas D, Ximenes RCC, Raposo MCF, de Oliveira DA. The presence of migraine symptoms was associated with a higher likelihood to present eating disorders symptoms among teenage students. Eat Weight Disord 2022; 27:1661-1667. [PMID: 34562226 DOI: 10.1007/s40519-021-01302-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 09/08/2021] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVE To investigate the association between migraine and signs and symptoms of eating disorders among teenagers. And as secondary objectives: to investigate the prevalence of eating disorders signs and symptoms and to identify the prevalence of migraine among teenagers. METHODS Cross-sectional study was carried out in public schools which included adolescents aged 11-18 years, of both sexes. For eating disorders evaluation two self-reported questionnaires were used: Eating Attitudes Test-26 (EAT-26) and The Bulimic Investigatory Test of Edinburg (BITE). The presence and characterization of headache were verified following the International Classification of Headache Disorders (ICHD-II). RESULTS 607 adolescents (388 females) with mean age of 13.9 years (95% CI: 13.7; 14) were included. The eating disorders symptoms based on EAT-26 (p = 0.041) and the bulimia nervosa symptoms (p = 0.014) evaluation were more prevalent among teenagers with migraine compared with non-migraine. Also, in multivariate analysis, the adjusted odds ratio (OR) to present bulimia nervosa symptoms is 1.85 times higher among females than males. And, the adjusted OR to present bulimia nervosa symptoms among teenagers with migraine is 1.51 times (OR) higher than among non-migraine. CONCLUSIONS The presence of migraine symptoms were associated with a higher likelihood to present eating disorders symptoms among teenagers, especially in females, that was associated with a 1.85-fold increase in the risk to present bulimia nervosa symptoms. LEVEL OF EVIDENCE III, Evidence obtained from cross-sectional study.
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Affiliation(s)
- Ana Izabela Sobral de Oliveira-Souza
- Physiotherapy Department, Federal University of Pernambuco (UFPE), Av. Jorn. Aníbal Fernandes, w/n, Cidade Universitária, Recife, PE, 50740-560, Brazil.
| | - Dayzene da Silva Freitas
- Physiotherapy Department, Federal University of Pernambuco (UFPE), Av. Jorn. Aníbal Fernandes, w/n, Cidade Universitária, Recife, PE, 50740-560, Brazil
| | | | | | - Daniella Araújo de Oliveira
- Physiotherapy Department, Federal University of Pernambuco (UFPE), Av. Jorn. Aníbal Fernandes, w/n, Cidade Universitária, Recife, PE, 50740-560, Brazil
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33
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Bonfert MV, Sollmann N, Renner T, Börner C, Urban G, Schandelmaier P, Hannibal I, Huß K, Parisi C, Gerstl L, Vill K, Blaschek A, Koenig H, Klose B, Heinen F, Landgraf MN, Albers L. Burden of disease and lifestyle habits in adolescents and young adults prone
to frequent episodic migraine: A secondary comparative analysis. J Child Health Care 2022; 26:215-227. [PMID: 33955272 PMCID: PMC9194962 DOI: 10.1177/13674935211008712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to assess the burden of disease and prevalence of lifestyle factors for adolescents and young adults with frequent episodic migraine. We conducted a secondary comparative analysis of data collected during two previous studies. Inclusion criteria for this analysis were age 15-35 years, 15 to 44 migraine episodes within 12 weeks, and completeness of Migraine Disability Assessment and lifestyle questionnaire data. Datasets of 37 adults (median age [interquartile range]: 25 [6]) and 27 adolescents (median age [interquartile range]: 15 [1]) were analyzed. 81% (n = 30) of adults reported severe disability (16% [n = 3] of adolescents; p < 0.001). Headache frequency (24 vs. 17 days; p = 0.005) and prevalence of regular analgesic use (60% [n = 22] vs. 18% [n = 5]; p = 0.002) were significantly higher in adults. In adults, sleep duration on weekdays was significantly lower (8.5 vs. 10 h; p < 0.001). Any consumption of caffeine tended to be higher in adolescents and alcohol consumption tended to be higher in adults (p > 0.05). This study underlines the importance of educating adolescents and young adults with migraine about lifestyle habits that are likely to interfere with the condition.
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Affiliation(s)
- Michaela V Bonfert
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Michaela V Bonfert, Department of Pediatric
Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity,
Dr von Hauner Children’s Hospital, LMU Hospital, Lindwurmstraße 4, Munich, Bavaria 80337,
Germany.
| | - Nico Sollmann
- Department of Diagnostic and Interventional
Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Germany,TUM-Neuroimaging Center, Klinikum Rechts
der Isar, Technical University of Munich, Germany,Department of Diagnostic and Interventional
Radiology, University Hospital Ulm, Germany
| | - Tabea Renner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Corinna Börner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Giada Urban
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Paul Schandelmaier
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Iris Hannibal
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Kristina Huß
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Carmen Parisi
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Gerstl
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Katharina Vill
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Astrid Blaschek
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Helene Koenig
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Birgit Klose
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Albers
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Department of Neurosurgery, Klinikum Rechts
der Isar, Technical University of Munich, Germany
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Cultural Identity in Bicultural Young Adults in Ireland: A Social Representation Theory Approach. SOCIAL SCIENCES-BASEL 2022. [DOI: 10.3390/socsci11060230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
This research investigates the nature by which first- and second-generation Irish young adults of (1) African descent, (2) Asian descent, and (3) Eastern European descent explore their cultural identity(ies) through communicating and interpreting social representations relating to their ethnic and national cultures. Using Social Representation Theory (SRT) and, more widely, Proculturation Theory as the theoretical underpinning, we examine how grown children of migrants construct their cultural identity(ies) by exploring external social representations. We conducted three separate in-depth focus groups for each continental group in virtual rooms on Zoom, lasting between 60 and 90 mins. A thematic analysis was pursued to understand how the participants discussed the representation of their cultural groups both in social and media-driven situations. The results indicated the overarching themes of Anchoring Irishness and Latent Media Representation, whereby participants communicated and dialogically explored their subjective interpretations of the social representations of their cultural groups which, in turn, may have informed their cultural identity(ies). Highlighting the dynamic nature of the cultural reality of Ireland and how it impacts generations after the initial migration period, this research highlights and exemplifies the importance of external social representations that serve to construct the multiple cultural identities of first- and second-generation migrants.
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Rożniecka A, Minarowska A. Tools for Evaluating the Quality of Life of the Paediatric Population with Primary Headaches-A Review of Selected Questionnaires. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:6295. [PMID: 35627830 PMCID: PMC9141686 DOI: 10.3390/ijerph19106295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/19/2022] [Accepted: 05/20/2022] [Indexed: 11/16/2022]
Abstract
Primary headaches are a common health issue in the paediatric population. These conditions have a negative impact on the quality of life of patients at the development age in every area of their lives. The aim of this study is to list the tools used to evaluate the quality of life of the paediatric population with primary headaches and to discuss their advantages and limitations. Examining the quality of life of children and adolescents suffering from primary headaches is of particular importance. This is a consequence of a high disease incidence rate and a considerable negative impact of the ailment on the everyday life of this population. It is very important to conduct such examinations with specific and validated tools. It is significant because of the particular features of the areas of patients' lives at the developmental age. Each of the available questionnaires has specific characteristics, advantages and limitations. The data accumulated in this literature review can be of help in designing research on the quality of life of children and adolescents suffering from primary headaches.
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Affiliation(s)
- Adrianna Rożniecka
- Department of Nursing, Public Health School, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland
| | - Alina Minarowska
- Department of Pulmonology, Public Health School, University of Warmia and Mazury in Olsztyn, 10-719 Olsztyn, Poland;
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Steiner TJ, Birbeck GL, Jensen RH, Martelletti P, Stovner LJ, Uluduz D, Leonardi M, Olesen J, Katsarava Z. The Global Campaign turns 18: a brief review of its activities and achievements. J Headache Pain 2022; 23:49. [PMID: 35448941 PMCID: PMC9022610 DOI: 10.1186/s10194-022-01420-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/10/2022] [Indexed: 01/11/2023] Open
Abstract
The Global Campaign against Headache, as a collaborative activity with the World Health Organization (WHO), was formally launched in Copenhagen in March 2004. In the month it turns 18, we review its activities and achievements, from initial determination of its strategic objectives, through partnerships and project management, knowledge acquisition and awareness generation, to evidence-based proposals for change justified by cost-effectiveness analysis.
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Affiliation(s)
- Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway. .,Division of Brain Sciences, Imperial College London, London, UK.
| | - Gretchen L Birbeck
- UTH Neurology Research Office, University of Zambia, Lusaka, Zambia.,Department of Neurology, University of Rochester, Rochester, NY, USA
| | - Rigmor H Jensen
- Department of Neurology, Danish Headache Centre, University of Copenhagen, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Lars Jacob Stovner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway.,Department of Neurology and Clinical Neurophysiology, Norwegian Advisory Unit On Headaches,, St Olavs Hospital, Trondheim, Norway
| | - Derya Uluduz
- Neurology Department, Istanbul University Cerrahpaşa School of Medicine, Istanbul, Turkey
| | - Matilde Leonardi
- Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico C Besta, NeurologyMilan, Italy
| | - Jes Olesen
- Department of Neurology, Danish Headache Centre, University of Copenhagen, Rigshospitalet-Glostrup, Glostrup, Denmark
| | - Zaza Katsarava
- Centre of Neurology, Geriatric Medicine and Early Rehabilitation, Evangelical Hospital, Unna, Germany.,Medical Faculty, University of Essen, Essen, Germany
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Shimomura H. Emotional Problems in Pediatric Headache Patients. Curr Pain Headache Rep 2022; 26:469-474. [DOI: 10.1007/s11916-022-01045-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2022] [Indexed: 12/21/2022]
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Wehbe AT, Costa TE, Abbas SA, Costa JE, Costa GE, Wehbe TW. The Effects of the COVID-19 Confinement on Screen Time, Headaches, Stress and Sleep Disorders among Adolescents: A Cross Sectional Study. CHRONIC STRESS (THOUSAND OAKS, CALIF.) 2022; 6:24705470221099836. [PMID: 35574178 PMCID: PMC9096190 DOI: 10.1177/24705470221099836] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 04/25/2022] [Indexed: 04/20/2023]
Abstract
BACKGROUND Headache is a common symptom affecting children and adolescents. The medical literature over the last three decades reveals a variable prevalence and triggers in different countries, regions, circumstances and times. This study aims to assess the prevalence, frequency and quality of headaches in the Lebanese adolescent population under the COVID-19 confinement and study its triggers and relationship to screen time, self-reported anxiety, and sleep. METHODS A cross sectional design was used to collect two survey results by snowball distribution using social media targeting adolescents aged 15 to 17 years of age. The first survey included 13 questions with a single best answer about screen time, feeling anxious, sleep time, schedule and consistency, and headaches. The second survey included 3 questions about the quality of the headaches, anxiety and its triggers. RESULTS Among 433 responders to the first survey, the prevalence of headaches, especially pressure points and band-like pressure was higher than any previously reported among adolescents in the literature, reaching 93.4%. Screen time was also higher than any previous reports with 95.6% spending 9 hours or more on screen while 64% of adolescents spending at least 12 hours a day on screen. In addition, the majority (82%) don't have consistent sleep habits and 41.8% consider themselves anxious. School was considered the main source of stress by 82.8% of the responders. The frequency of headache correlated significantly with increased screen time, self-reported anxiety and inconsistent sleep habits. CONCLUSIONS Headaches among adolescents are associated with increased screen use, sleep disorders, and self-reported anxiety. It is one of the primary somatization symptoms in this group expressing their extreme stress under the current economic, political, and health crisis. The present trends are likely to have major long term implications on adolescents' health and academic achievements and should alarm educators and health officials to intervene in this situation.
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Affiliation(s)
| | - Tarek E. Costa
- Faculty of Medicine, Saint- Joseph University, Beirut, Lebanon
| | - Samar A. Abbas
- Department of Neurology, Hotel Dieu de France Hospital, Faculty of Medicine, Saint- Joseph University, Beirut, Lebanon
| | - Jad E. Costa
- Gilbert and Rose Mary Chagoury School of Medicine, Lebanese American University, Byblos , Lebanon
- Neurology Department, Lebanese American University Medical Center Rizk Hospital, Beirut, Lebanon
| | - George E. Costa
- Gilbert and Rose Mary Chagoury School of Medicine, Lebanese American University, Byblos , Lebanon
| | - Tarek W. Wehbe
- Department of Medicine, Notre Dame University Hospital, Jounieh, Lebanon
- Tarek Wehbe, Department of Medicine, Notre Dame University Hospital, Jounieh, Lebanon.
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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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Merison K, Victorio MCC. Approach to the Diagnosis of Pediatric Headache. Semin Pediatr Neurol 2021; 40:100920. [PMID: 34749917 DOI: 10.1016/j.spen.2021.100920] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 08/09/2021] [Accepted: 08/15/2021] [Indexed: 10/20/2022]
Abstract
Headache in children and adolescents is a common symptom that can be worrisome to patients, their parents and clinicians due to the myriad of underlying etiologies, both benign and life-threatening. The evaluation of headache must be directed primarily to exclude secondary causes. A detailed headache history, recognition of headache patterns and red flags and thorough physical and neurological examinations are essential in the diagnosis; and identifies patients requiring further workup. Considerations for neuroimaging and ancillary testing are also discussed.
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Affiliation(s)
- Kelsey Merison
- NeuroDevelopmental Science Center Akron Children's Hospital, Akron, OH.
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Grazzi L, Grignani E, Raggi A, Rizzoli P, Guastafierro E. Effect of a Mindfulness-Based Intervention for Chronic Migraine and High Frequency Episodic Migraine in Adolescents: A Pilot Single-Arm Open-Label Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211739. [PMID: 34831494 PMCID: PMC8619568 DOI: 10.3390/ijerph182211739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
In this single-arm pilot open-label study we examined the effect of a mindfulness-based intervention on reduction of headache frequency after 12 months in adolescents aged 12-18 with chronic or high-frequency migraine without aura. Adolescents were recruited at the headache center of the C. Besta Neurological Institute and followed-up for 12 months. The mindfulness-based intervention was delivered in small groups and consisted of six weekly group sessions of guided meditation, and one booster session 15 days after. Patients filled in questionnaires assessing headache frequency (primary endpoint), medication intake, disability, anxiety, depression, catastrophizing, and caregivers' burden. Within-person ANOVA was used to address variation of endpoints over time. Thirty-five out of 37 patients completed the study for primary endpoints, and 33 for secondary endpoints. Headache frequency dropped from 21.3 (95% CI 18.5; 24.1) to 9.6 (95% CI 6.1; 13.1) days per month at 12 months (F = 30.5, p < 0.001); 23 patients out of 35 (65.7%) achieved a headache frequency reduction greater than or equal to 50%. Significant improvements were also reported for medication intake (F = 18.7, p < 0.001), disability (F = 3.8, p = 0.027), trait anxiety (F = 5.1, p = 0.009), symptoms of depression (F = 9.5, p < 0.001), and catastrophizing (F = 23.6, p < 0.001). In conclusions, our study shows a reduction of headache attacks in adolescents who follow a mindfulness-based program, suggesting benefit of this nonpharmacological approach.
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Affiliation(s)
- Licia Grazzi
- Dipartimento Neuroalgologia Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy;
- Correspondence: ; Tel.: +39-02-2394-2366
| | - Eleonora Grignani
- Dipartimento Neuroalgologia Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy;
| | - Alberto Raggi
- UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy; (A.R.); (E.G.)
| | - Paul Rizzoli
- John Graham Headache Center, Brigham and Women’s Faulkner Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Erika Guastafierro
- UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy; (A.R.); (E.G.)
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Schwedt TJ, Buse DC, Argoff CE, Reed ML, Fanning KM, Hussar CR, Adams AM, Lipton RB. Medication Overuse and Headache Burden: Results From the CaMEO Study. Neurol Clin Pract 2021; 11:216-226. [PMID: 34476122 PMCID: PMC8382341 DOI: 10.1212/cpj.0000000000001037] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 01/04/2021] [Indexed: 12/25/2022]
Abstract
Objective To estimate the relative frequency of acute medication overuse (AMO) among people with episodic migraine and chronic migraine, to characterize the types of acute medications overused for migraine, and to identify factors associated with AMO. Methods We analyzed data from the Chronic Migraine Epidemiology and Outcomes (CaMEO) Study (ClinicalTrials.gov, NCT01648530), a cross-sectional and longitudinal internet study that included a systematic sampling of the US population. From September 2012 to November 2013, the CaMEO Study respondents participated in different modules to collect data on the clinical course of migraine, family burden, barriers to care, endophenotypes, and comorbidities. Among people who met the criteria for migraine consistent with the International Classification of Headache Disorders, third edition (ICHD-3), we evaluated types and frequency of medications used for headache/migraine, selected comorbidities, and emergency department (ED) and urgent care (UC) use. AMO was defined by days per month of medication use as specified by ICHD-3 criteria for medication overuse headache (MOH) without the requirement for ≥15 monthly headache days (MHDs). Nested, multivariable binary logistic regression modeling was used to identify factors associated with an increased risk of AMO. Results Of 16,789 CaMEO respondents with migraine, 2,975 (17.7%) met the AMO criteria. Approximately 67.9% (2,021/2,975) of AMO respondents reported <15 MHDs. Simple analgesics, combination analgesics, and opioids were the medication classes most commonly overused. Factors associated with AMO in the final multivariable logistic regression model included ≥15 MHDs, moderate to severe disability, severe migraine interictal burden, use of preventive medication, and an ED/UC visit for headache within 6 months. Conclusions Approximately two-thirds of respondents with AMO reported <15 MHDs and therefore did not meet the criteria for MOH. Those with AMO had greater disease burden and increased ED/UC utilization relative to people with migraine but not AMO.
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Affiliation(s)
- Todd J Schwedt
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Dawn C Buse
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Charles E Argoff
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Michael L Reed
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Kristina M Fanning
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Cory R Hussar
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Aubrey Manack Adams
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
| | - Richard B Lipton
- Mayo Clinic (TJS), Phoenix, AZ; Albert Einstein College of Medicine (DCB, RBL), Bronx, NY; Albany Medical Center (CEA), NY; Vedanta Research (MLR, KMF), Chapel Hill, NC; Peloton Advantage, LLC, an OPEN Health company (CRH), Parsippany, NJ; and AbbVie (AMA), Irvine, CA
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Bentivegna E, Luciani M, Paragliola V, Baldari F, Lamberti PA, Conforti G, Spuntarelli V, Martelletti P. Recent advancements in tension-type headache: a narrative review. Expert Rev Neurother 2021; 21:793-803. [PMID: 34128449 DOI: 10.1080/14737175.2021.1943363] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
INTRODUCTION Tension-type headache (TTH) is the most common primary headache disorder with a prevalence of up to 78% in general population and huge expenses in terms of health service. Despite its high incidence and impact on life's quality the knowledge on the pathophysiology and efficacious treatment of TTH was still limited. AREAS COVERED In recent years, a series of studies highlighted the heterogeneous nature of this pathology that seems to be determined by a complex interaction between genetic, environmental, and neuromuscular factors, which result in nociceptive system activation. In this setting, alongside the simple analgesic therapies used during the acute attack, a series of therapeutic options based on newly acquired experiences have taken hold. EXPERT REVIEW Not having a single substrate or a typical site of pathophysiology, TTH must be analyzed in a global and multidisciplinary way. Herein, we perform a narrative review of the most recent advancement stimulating the concept of this disease as the tip of the iceberg of a more complex individual malaise secondary to different alterations. Strategies based solely on symptomatic drugs should therefore be avoided by experienced personnel and treatment should aim at taking charge of the patient considering the processes behind this complex pathology.
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Affiliation(s)
- Enrico Bentivegna
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | | | - Vincenzo Paragliola
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Francesco Baldari
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Piera A Lamberti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Giulia Conforti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Valerio Spuntarelli
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy.,Department of clicinal and molecular medicine, Regional Referral Headache Centre, Sant'Andrea Hospital, Rome, Italy
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Abstract
Pediatric headache impacts up to 80% of children, many recurrently, by the time they are 15 years old. Preventing the progression of episodic to chronic headache results in less truancy, staying current with schoolwork and improves children's quality of life. Lifestyle choices can play an important role in headache treatment. Early effective treatment of episodic headache can prevent transformation into a chronic form. While details of a child's headache are critical for making a proper diagnosis; patient education is critical and effective rescue and preventive treatment strategies enable patients to focus on enjoying activities of daily living. Recognizing "red flags" that may suggest a serious underlying etiology is critical in the early stages of diagnosing and preparing to treat children with headaches. Finally directing patients to manage their headaches at home and when to proceed to an emergency department, urgent care or infusion unit can lower the economic burden of acute headache management.
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Affiliation(s)
- Debra M O'Donnell
- Pediatric Neurologist, Dayton Children's Hospital, Division of Neurology, OH, United States.
| | - Anastazia Agin
- Pediatrician and Headache Specialist, Dayton Children's Hospital, Division of Neurology, OH, United States
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Khatatbeh AE, Othman EF, Alalawneh AM, Albdour MQ, Jaradat TF, Al Hazaimeh AM, Ahmed M, Abbas K. Ocular and Dental Causes of Headaches Among School-Age Children in Jordan: A Retrospective Study. Cureus 2021; 13:e15623. [PMID: 34277240 PMCID: PMC8277091 DOI: 10.7759/cureus.15623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/13/2021] [Indexed: 11/29/2022] Open
Abstract
Introduction Headache disorders are becoming increasingly prevalent among the younger population. In this study, we aimed to explore the varying causes of headaches among school-age children in Jordan. Methodology This was a retrospective observational study conducted at the Queen Rania Hospital for Children between June 2019 and June 2020. All the data of the patients were extracted from the patient files with the permission of the administration. All children who were referred to the ophthalmology and dental clinic with headaches as the presenting complaint were included in the study. A detailed history was initially obtained regarding age, gender, medical history, as well as the duration and characteristics of headaches. The patients underwent detailed ocular examination including best-corrected visual acuity (BCVA) using the Snellen chart, anterior and posterior eye segment examination, and intraocular pressure measurement. Refraction under the effect of cyclopentolate was performed for all patients. A detailed dental and oral exam was performed on all children at the dental clinic by the same dentist. Results A total of 712 patients aged between five and 13 years (mean ± SD: 9.3 ± 2.86 years) presented with headaches during the study period. Headaches were more frequent in males [n=441 (61.9%)], but a slight female predominance was found among patients aged 11 years and older. At the ophthalmology clinic, 230 (32.3%) patients with headaches had positive findings; the majority of these patients [n=228 (32%)] had refractive errors with astigmatism as the most common type. Of note, 515 patients (72.3%) had dental caries with a Decayed, Missing, and Filled Permanent Teeth (DMFT) score ranging from 1.5 to 4.3. Conclusion Refractive errors, particularly astigmatism, were found at higher rates among children with headaches. Also, temporomandibular disorders were more prevalent among children with headaches, particularly those aged between 11 and 14 years. Routine ophthalmic and dental assessment is recommended for children presenting with chronic headaches.
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Affiliation(s)
| | | | | | | | | | | | - Moiz Ahmed
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK.,Medicine and Surgery, Sindh Medical College, Karachi, PAK
| | - Kiran Abbas
- Medicine, Jinnah Postgraduate Medical Centre, Karachi, PAK
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Wilkes MJ, Mendis MD, Bisset L, Leung FT, Sexton CT, Hides JA. The prevalence and burden of recurrent headache in Australian adolescents: findings from the longitudinal study of Australian children. J Headache Pain 2021; 22:49. [PMID: 34074243 PMCID: PMC8170988 DOI: 10.1186/s10194-021-01262-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
Background Headache disorders are highly prevalent worldwide, but not well investigated in adolescents. Few studies have included representative nationwide samples. This study aimed to present the prevalence and burden of recurrent headache in Australian adolescents. Methods The prevalence of recurrent headache, headache characteristics (severity and frequency) and burden on health-related quality of life in Australian children aged 10–17 years were presented, using nationally representative data from the Longitudinal Study of Australian children (LSAC). The LSAC, commencing in 2004, collects data every 2 years from a sample of Australian children of two different age cohorts: B ‘baby’ cohort, aged 0–1 years and K ‘kindergarten’ cohort, aged 4–5 years at the commencement of the study. Face-to-face interviews and self-complete questionnaires have been conducted with the study child and parents of the study child (carer-reported data) at each data collection wave, with seven waves of data available at the time of the current study. Wave 7 of the LSAC was conducted in 2016, with B cohort children aged 12–13 years and K cohort children aged 16–17 years. For the current study, data were accessed for four out of seven waves of available data (Wave 4–7) and presented cross-sectionally for the two cohorts of Australian children, for the included age groups (10–11 years, 12–13 years, 14–15 years and 16–17 years). All available carer-reported questionnaire data pertaining to headache prevalence, severity and frequency, general health and health-related quality of life, for the two cohorts, were included in the study, and presented for male and female adolescents. Carer-reported general health status of the study child and health-related quality of life scores, using the parent proxy-report of the Paediatric Quality of Life Inventory™ 4.0, were compared for male and female adolescents with recurrent headache and compared with a healthy group. Finally, health-related quality of life scores were compared based on headache frequency and severity. Results The LSAC study initially recruited 10,090 Australian children (B cohort n = 5107, K cohort n = 4983), and 64.1% of the initial sample responded at wave 7. Attrition rates across the included waves ranged from 26.3% to 33.8% (wave 6 and 7) for the B cohort, and 16.3% to 38.0% (wave 4–7) for the K cohort. Recurrent headache was more common in females, increasing from 6.6% in 10–11 years old females to 13.2% in 16–17 years old females. The prevalence of headache in males ranged from 4.3% to 6.4% across the age groups. Health-related quality of life scores were lower for all functional domains in adolescents with recurrent headache, for both sexes. Headache frequency, but not severity, was significantly associated with lower health-related quality of life scores, in both males and females. Conclusions Recurrent headache was common among Australian adolescents and increased in prevalence for females, across the age groups. Frequent recurrent headache is burdensome for both male and female adolescents. This study provides information regarding the prevalence and burden of recurrent headache in the adolescent population based on findings from the Longitudinal Study of Australian Children.
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Affiliation(s)
- Margot J Wilkes
- School of Health Sciences and Social Work, Griffith University, Nathan, Brisbane, 4111, Australia.
| | - M Dilani Mendis
- School of Health Sciences and Social Work, Griffith University, Nathan, Brisbane, 4111, Australia.,Physiotherapy Department, Mater Health Services, South Brisbane, 4101, Australia.,The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
| | - Leanne Bisset
- School of Health Sciences and Social Work, Griffith University, Nathan, Brisbane, 4111, Australia.,The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
| | - Felix T Leung
- School of Health Sciences and Social Work, Griffith University, Nathan, Brisbane, 4111, Australia
| | - Christopher T Sexton
- The University of Queensland, School of Dentistry, Herston, Brisbane, 4006, Australia
| | - Julie A Hides
- School of Health Sciences and Social Work, Griffith University, Nathan, Brisbane, 4111, Australia.,Physiotherapy Department, Mater Health Services, South Brisbane, 4101, Australia.,The Hopkins Centre, Menzies Health Institute Queensland, Griffith University, Gold Coast, 4222, Australia
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Al Momani M, Almomani BA, Masri AT. The clinical characteristics of primary headache and associated factors in children: A retrospective descriptive study. Ann Med Surg (Lond) 2021; 65:102374. [PMID: 34026104 PMCID: PMC8121873 DOI: 10.1016/j.amsu.2021.102374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Headache is the most encountered manifestation of pain in childhood. The purpose of this study was to investigate the incidence and clinical characteristics of primary headaches. Further, the factors associated with primary headache were examined. MATERIALS AND METHODS A retrospective study was conducted among young children and adolescents over 3 years at a tertiary referral teaching hospital in North Jordan. Relevant patient information was obtained by reviewing patients' medical records. RESULTS This study included 194 children (95 males, 99 females). The incidence rate of primary headache in the current study was 2.815 per 1000 children visited pediatric clinic. The mean age of patients at the time of headache onset was 10 years, and about half of them were males (95/194; 49%). Approximately 30% (56/194) had a family history of headache. Migraine headaches were the most commonly reported types (87/194; 44.8%) and only 17/194; 8.7% suffered from tension type headaches. Approximately, 40% (84/194) of patients reported severe headache and a third of them (67/194; 34.5%) complained of daily headaches. Pain location was reported as bilateral in most patients (153/194; 78.9%). About one fifth (41/194; 21.1%) stated that their headache was precipitated by sleep deprivation. Abnormal serum level of vitamin D and family history of headache were significantly associated with primary headache (p < 0.001). CONCLUSIONS These findings highlight the importance of early detection and management of headaches among pediatric population. In addition, screening vitamin D status should be encouraged for children presented with primary headaches.
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Affiliation(s)
- Miral Al Momani
- Faculty of Medicine, Jordan University of Science and Technology, Department of Pediatrics and Neonatology, Irbid, Jordan
| | - Basima A. Almomani
- Department of Clinical Pharmacy, Faculty of Pharmacy, Jordan University of Science and Technology, Irbid, Jordan
| | - Amira T. Masri
- Faculty of Medicine, Pediatric Department Division of Child Neurology, The University of Jordan, Jordan
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Wijga AH, Gehring U, van de Putte EM, Koppelman GH, Vader S, Schmits RJ, van der Wouden JC, Picavet HSJ. Headache in girls and boys growing up from age 11 to 20 years: the Prevention and Incidence of Asthma and Mite Allergy birth cohort study. Pain 2021; 162:1449-1456. [PMID: 33230003 PMCID: PMC8054541 DOI: 10.1097/j.pain.0000000000002141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/19/2020] [Accepted: 11/02/2020] [Indexed: 01/18/2023]
Abstract
ABSTRACT The striking difference between men and women in headache prevalence is suggested to develop in adolescence. Although headaches are common and affect quality of life and daily functioning, the evidence needed to develop effective counselling and preventive approaches is still limited. Using data collected at age 11, 14, 17, and 20 years in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort study (n = 3064 with ≥ 1 questionnaire), we assessed headache prevalence and incidence in girls and boys and explored associations with early life, environmental, lifestyle, health, and psychosocial factors. Associations were analysed longitudinally with generalized linear mixed models and discrete time hazard models. From age 11 to 20 years, the prevalence of headache increased from 9.4% to 19.8% in girls and hardly changed in boys (7.6%-6.1%). Headache commonly co-occurred with other unfavorable health and psychosocial conditions. Eighty-eight percent of the girls and 76% of boys with headache also reported at least one of the following at age 17: sleeping problems, asthma, hay fever, musculoskeletal complaints, fatigue, low mental health, or worrying. Results suggest higher headache prevalence in adolescents following lower educational tracks, in those who skip breakfast ≥2 days per week, and in boys exposed to tobacco smoke in infancy. In girls, sleeping problems and musculoskeletal complaints were associated with higher odds of incident headache and residential greenness with lower odds of incident headache. The high prevalence and strong female predominance of headache, already in adolescence and often with comorbidities, deserve recognition by professionals in (preventive) health care settings and schools.
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Affiliation(s)
- Alet H. Wijga
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | | | - Gerard H. Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, GRIAC Research Institute, Groningen, the Netherlands
| | - Sarah Vader
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ruben J.H. Schmits
- Division Preventive Youth Health Care, Public Health Services Region Utrecht (GGD Regio Utrecht), the Netherlands
| | - Johannes C. van der Wouden
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - H. Susan J. Picavet
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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Genc D, Vaičienė-Magistris N, Zaborskis A, Şaşmaz T, Tunç AY, Uluduz D, Wöber C, Wöber-Bingöl Ç, Steiner TJ. The burden attributable to headache disorders in children and adolescents in Lithuania: estimates from a national schools-based study. J Headache Pain 2021; 22:24. [PMID: 33849431 PMCID: PMC8045274 DOI: 10.1186/s10194-021-01237-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 04/01/2021] [Indexed: 01/03/2023] Open
Abstract
Background We recently showed headache to be common in children (aged 7–11 years) and adolescents (aged 12–17) in Lithuania. Here we provide evidence from the same study of the headache-attributable burden. Methods Following the generic protocol for Lifting The Burden’s global schools-based study, this cross-sectional survey administered self-completed structured questionnaires to pupils within classes in 24 nationally representative schools selected from seven regions of the country. Headache diagnostic questions were based on ICHD-3 beta criteria but for the inclusion of undifferentiated headache (UdH; defined as mild headache with usual duration < 1 h). Burden enquiry was conducted in multiple domains. Results Questionnaires were completed by 2505 pupils (1382 children, 1123 adolescents; participating proportion 67.4%), of whom 1858 reported headache in the preceding year, with mean frequency (±SD) of 3.7 ± 4.5 days/4 weeks and mean duration of 1.6 ± 1.9 h. Mean proportion of time in ictal state, estimated from these, was 0.9% (migraine 1.5%, probable medication-overuse headache [pMOH] 10.9%). Mean intensity on a scale of 1–3 was 1.6 ± 0.6 (mild-to-moderate). Symptomatic medication was consumed on 1.5 ± 2.8 days/4 weeks. Lost school time was 0.5 ± 1.5 days/4 weeks (migraine 0.7 ± 1.5, pMOH 5.0 ± 7.8) based on recall, but about 50% higher for migraine according to actual absences recorded in association with reported headache on the preceding day. More days were reported with limited activity (overall 1.2 ± 2.4, migraine 1.5 ± 2.2, pMOH 8.4 ± 8.5) than lost from school. One in 30 parents (3.3%) missed work at least once in 4 weeks because of their son’s or daughter’s headache. Emotional impact and quality-of-life scores generally reflected other measures of burden, with pMOH causing greatest detriments, followed by migraine and tension-type headache, and UdH least. Burdens were greater in adolescents than children as UdH differentiated into adult headache types. Conclusions Headache in children and adolescents in Lithuania is mostly associated with modest symptom burden. However, the consequential burdens, in particular lost school days, are far from negligible for migraine (which is prevalent) and very heavy for pMOH (which, while uncommon in children, becomes four-fold more prevalent in adolescents). These findings are of importance to both health and educational policies in Lithuania.
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Affiliation(s)
- Diana Genc
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Nerija Vaičienė-Magistris
- Department of Neurology, Faculty of Medicine, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Apolinaras Zaborskis
- Department of Preventive Medicine and Health Research Institute, Faculty of Public Health, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Tayyar Şaşmaz
- Department of Public Health, Mersin University School of Medicine, Mersin, Turkey
| | - Aylin Yeniocak Tunç
- Department of Public Health, Mersin University School of Medicine, Mersin, Turkey
| | - Derya Uluduz
- Neurology Department, Cerrahpaşa School of Medicine, Istanbul University, Istanbul, Turkey
| | - Christian Wöber
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Çiçek Wöber-Bingöl
- Dr Gönül Bingöl-Dr Muammer Bingöl Çocuk ve Ergen Başağrısı Derneği - Society for Headache in Children and Adolescents, Suadiye, Istanbul, Turkey
| | - Timothy J Steiner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Edvard Griegs gate, Trondheim, Norway. .,Division of Brain Sciences, Imperial College London, London, UK.
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Neß V, Könning A, Hirschfeld G, Wager J. Adolescents' Explanatory Models for Headaches and Associations with Behavioral and Emotional Outcomes. CHILDREN (BASEL, SWITZERLAND) 2021; 8:234. [PMID: 33803573 PMCID: PMC8002924 DOI: 10.3390/children8030234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/08/2021] [Accepted: 03/16/2021] [Indexed: 12/20/2022]
Abstract
More than one-third of adolescents experience recurrent headaches. Usually, these headaches are of primary origin and modulated by different biological and psychosocial factors. While parents are often consulted in scientific research and medical care about the nature of their child's headache, it is unclear to what extent parents and their children agree upon the factors that cause them. Adolescents' own attributions of headaches have rarely been investigated, and it is unclear how those attributions affect behavioral and emotional outcomes. In the present study, adolescents with chronic headaches (N = 248) and their parents (N = 120) rated the influence of various biological and psychosocial factors on the adolescents' headaches. Associations between these factors and several behavioral and emotional outcomes were examined. The most frequently reported factor by both samples was stress; however, concordance between parents and adolescents was generally low. The factor "other disease" was significantly associated with medication consumption and school absence. This study is one of the first to provide insights into adolescents' own attributions of headaches. Furthermore, the significant associations of the factor with behavioral outcomes reveal the importance of understanding personal explanatory models of headache. Future studies should examine associations between subjective headache causes and the individual's experience of the disorder to improve headache interventions.
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Affiliation(s)
- Verena Neß
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany; (A.K.); (J.W.)
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Anna Könning
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany; (A.K.); (J.W.)
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
| | - Gerrit Hirschfeld
- CareTech OWL Center for Health, Welfare and Technology, Faculty of Business, University of Applied Sciences Bielefeld, 33619 Bielefeld, Germany;
| | - Julia Wager
- German Paediatric Pain Centre, Children’s and Adolescents’ Hospital, 45711 Datteln, Germany; (A.K.); (J.W.)
- Department of Children’s Pain Therapy and Paediatric Palliative Care, Faculty of Health, School of Medicine, Witten/Herdecke University, 58448 Witten, Germany
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