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Liu J, Guo Y, Huang Z, Zhu J, Li Y. Childhood abuse and risk of migraine: A systematic review and meta-analysis. CHILD ABUSE & NEGLECT 2024; 155:106961. [PMID: 39096662 DOI: 10.1016/j.chiabu.2024.106961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 05/29/2024] [Accepted: 07/23/2024] [Indexed: 08/05/2024]
Abstract
BACKGROUND Childhood abuse is associated with an increased risk of migraines. However, the literature on this association is limited. OBJECTIVE To determine the pooled effect size of the association between childhood abuse and migraines. PARTICIPANTS AND SETTING System review and meta-analysis. METHODS A systematic literature search for studies published until September 20, 2023, was performed using the Embase, PubMed, and Web of Science databases. Specifically, original articles reporting the statistical effect size (odds ratio) of the association between childhood abuse and migraines were selected. Pooled odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated using random- or fixed-effects models. Publication bias was examined using funnel plots, and sensitivity analysis was used to explore the stability of the pooled results. RESULTS Twelve studies involving 110,776 participants were included. Individuals with childhood abuse (OR = 1.60, 95 % CI: 1.49, 1.71) were at increased risk of migraine when compared with individuals with no childhood abuse. Of the different types of childhood abuse examined, sexual abuse (OR = 1.71, 95 % CI: 1.43, 2.04), physical abuse (OR = 1.47, 95 % CI: 1.38, 1.56), and emotional abuse (OR = 1.71, 95 % CI: 1.52, 1.93) were associated with an increased risk of migraine. CONCLUSIONS Childhood abuse increases migraine risk. Multifaceted interventions to curb abuse and related behaviors can effectively reduce migraine risk. However, considering that multiple factors, such as obesity and anxiety, are causatively associated with both childhood abuse and migraines, our findings should be interpreted with caution.
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Affiliation(s)
- Jianyi Liu
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China.
| | - Yizhi Guo
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China.
| | - Zhihua Huang
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China
| | - Jianming Zhu
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China
| | - Yandeng Li
- Changde Hospital, Xiangya School of Medicine, Central South University, Changde, China; The First People's Hospital of Changde City, Changde, China
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Tutelman PR, Noel M, Bernier E, Schulte FSM, Kopala-Sibley DC. Adverse Childhood Experiences Moderate the Relationship Between Pain and Later Suicidality Severity Among Youth: A Longitudinal High-Risk Cohort Study. THE JOURNAL OF PAIN 2024:104554. [PMID: 38719156 DOI: 10.1016/j.jpain.2024.104554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 03/22/2024] [Accepted: 04/27/2024] [Indexed: 06/16/2024]
Abstract
Pain in adolescence can lead to the development of serious mental health issues, including suicidality. This risk may be strengthened among youth exposed to more adverse childhood experiences (ACEs; abuse, neglect, household challenges). This longitudinal study examined the role of ACEs in the relationship between pain and later suicidality onset and severity among a cohort of adolescents at risk for developing mental health problems. Participants were 139 healthy youth (Mage = 13.74 years, standard deviation = 1.56, 64% female) between the ages of 11 to 17 years, recruited based on parental history of depression or anxiety. Youth completed validated measures of internalizing symptoms, ACEs, and pain characteristics at baseline and follow-up diagnostic interviews 9 and/or 18 months later to assess for onset and severity of suicidality. After controlling for demographics, baseline internalizing symptoms, and ACEs, worse pain interference and increased ACEs at baseline predicted increased suicidality severity at follow-up. Moderation analyses revealed that there was a significant interaction between ACEs and pain interference and pain intensity. Increased pain interference (b = 7.65, P < .0001) or intensity (b = 6.96, P = .0003) was only associated with increased suicidality severity at follow-up in youth with high levels of ACEs. This study demonstrates that ACEs strengthen the relationship between pain and later suicidality severity among youth at risk of developing mental health problems. Findings underscore the critical need to adopt a trauma-informed lens to pediatric pain prevention and treatment (eg, screening for ACEs) and for the pain to be on the child's mental health agenda. PERSPECTIVE: This article provides evidence that, while pain is a risk factor for future increased suicidality severity, it is a particularly strong risk factor in youth who experienced increased childhood adversity. These results may help identify youth at greatest risk for suicidality.
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Affiliation(s)
- Perri R Tutelman
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada; Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Melanie Noel
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada; Owerko Centre, Calgary, Alberta, Canada
| | - Emily Bernier
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Fiona S M Schulte
- Department of Oncology, University of Calgary, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada
| | - Daniel C Kopala-Sibley
- Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada; Hotchkiss Brain Institute, Calgary, Alberta, Canada; Mathison Centre for Mental Health Research and Education, Calgary, Alberta, Canada; Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada.
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Sedley W, Kumar S, Jones S, Levy A, Friston K, Griffiths T, Goldsmith P. Migraine as an allostatic reset triggered by unresolved interoceptive prediction errors. Neurosci Biobehav Rev 2024; 157:105536. [PMID: 38185265 DOI: 10.1016/j.neubiorev.2024.105536] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 12/19/2023] [Accepted: 01/03/2024] [Indexed: 01/09/2024]
Abstract
Until now, a satisfying account of the cause and purpose of migraine has remained elusive. We explain migraine within the frameworks of allostasis (the situationally-flexible, forward-looking equivalent of homeostasis) and active inference (interacting with the environment via internally-generated predictions). Due to its multimodality, and long timescales between cause and effect, allostasis is inherently prone to catastrophic error, which might be impossible to correct once fully manifest, an early indicator which is elevated prediction error (discrepancy between prediction and sensory input) associated with internal sensations (interoception). Errors can usually be resolved in a targeted manner by action (correcting the physiological state) or perception (updating predictions in light of sensory input); persistent errors are amplified broadly and multimodally, to prioritise their resolution (the migraine premonitory phase); finally, if still unresolved, progressive amplification renders further changes to internal or external sensory inputs intolerably intense, enforcing physiological stability, and facilitating accurate allostatic prediction updating. As such, migraine is an effective 'failsafe' for allostasis, however it has potential to become excessively triggered, therefore maladaptive.
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Affiliation(s)
- William Sedley
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom.
| | - Sukhbinder Kumar
- Department of Neurosurgery, University of Iowa, Iowa City, IA 52242, USA
| | - Siobhan Jones
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom
| | - Andrew Levy
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, United Kingdom
| | - Karl Friston
- Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, United Kingdom
| | - Tim Griffiths
- Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, United Kingdom; Wellcome Centre for Human Neuroimaging, University College London, London WC1N 3AR, United Kingdom; Department of Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, United Kingdom
| | - Paul Goldsmith
- Department of Neurology, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, United Kingdom; Institute of Global Health Innovation, Imperial College, London, United Kingdom
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Bussières A, Hancock MJ, Elklit A, Ferreira ML, Ferreira PH, Stone LS, Wideman TH, Boruff JT, Al Zoubi F, Chaudhry F, Tolentino R, Hartvigsen J. Adverse childhood experience is associated with an increased risk of reporting chronic pain in adulthood: a stystematic review and meta-analysis. Eur J Psychotraumatol 2023; 14:2284025. [PMID: 38111090 PMCID: PMC10993817 DOI: 10.1080/20008066.2023.2284025] [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: 05/11/2023] [Accepted: 08/22/2023] [Indexed: 12/20/2023] Open
Abstract
Background: Adverse childhood experiences (ACEs) have been shown to negatively affect health in adulthood. Estimates of associations between ACEs and chronic painful conditions are lacking.Objectives: This systematic review and meta-analysis aimed to evaluate associations between exposure to ACEs and chronic pain and pain-related disability in adults.Methods: We searched 10 electronic databases from inception to February 2023. We included observational studies assessing associations between direct ACEs (childhood sexual, physical, emotional abuse, or neglect) alone or in combination with indirect ACEs (witnessing domestic violence, household mental illness), and adult chronic pain (≥3 months duration) and pain-related disability (daily activities limited by chronic pain). Pairs of reviewers independently extracted data and assessed study risks of bias. Random-effect models were used to calculate pooled adjusted odds ratios [aOR]. Tau square [T2], 95% prediction intervals [95%PI] and I2 expressed the amount of heterogeneity, and meta-regressions and subgroup meta-analyses investigated sources of heterogeneity (PROSPERO: CRD42020150230).Results: We identified 85 studies including 826,452 adults of which 57 studies were included in meta-analyses. Study quality was generally good or fair (n = 70). The odds of reporting chronic pain in adulthood were significantly higher among individuals exposed to a direct ACE (aOR, 1.45, 95%CI, 1.38-1.53). Individuals reporting childhood physical abuse were significantly more likely to report both chronic pain (aOR, 1.50, 95CI, 1.39-1.64) and pain-related disability (1.46, 95CI, 1.03-2.08) during adulthood. Exposure to any ACEs alone or combined with indirect ACEs significantly increase the odds of adult chronic painful conditions (aOR, 1.53, 95%CI, 1.42-1.65) and pain-related disability (aOR, 1.29; 95%CI, 1.01-1.66). The risk of chronic pain in adulthood significantly increased from one ACE (aOR, 1.29, 95%CI, 1.22-1.37) to four or more ACEs (1.95, 95%CI, 1.73-2.19).Conclusions: Single and cumulative ACEs are significantly associated with reporting of chronic pain and pain-related disability as an adult.
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Affiliation(s)
- André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Mark J. Hancock
- Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, Australia
| | - Ask Elklit
- National Centre for Psychotraumatology, Department of Psychology, University of Southern DenmarkOdense, Denmark
| | - Manuela L. Ferreira
- Sydney Musculoskeletal Health, The Kolling Institute, School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Paulo H. Ferreira
- Musculoskeletal Health, Faculty of Health Sciences, Charles Perkins Centre, The University of Sydney, Sydney, Australia
| | - Laura S. Stone
- Faculty of Dentistry, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
- Department of Anesthesiology, Faculty of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Timothy H. Wideman
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, Canada
| | - Jill T. Boruff
- Schulich Library of Physical Sciences, Life Sciences, and Engineering, McGill University, Montreal, Canada
| | - Fadi Al Zoubi
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Fauzia Chaudhry
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Raymond Tolentino
- Department of Family Medicine, Faculty of Medicine and Health Sciences, McGill University, Montreal
| | - Jan Hartvigsen
- Center for Muscle and Joint Health, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Chiropractic Knowledge Hub, Odense, Denmark
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5
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Lipton RB, Buse DC, Nahas SJ, Tietjen GE, Martin VT, Löf E, Brevig T, Cady R, Diener HC. Risk factors for migraine disease progression: a narrative review for a patient-centered approach. J Neurol 2023; 270:5692-5710. [PMID: 37615752 PMCID: PMC10632231 DOI: 10.1007/s00415-023-11880-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/12/2023] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
BACKGROUND In individuals with migraine, attacks may increase in frequency, severity, or both. Preventing migraine progression has emerged as a treatment goal in headache subspecialty practice, but there may be less awareness in general neurology or primary care settings where most people with migraine who seek treatment consult. Herein, we review the definition of and risk factors for migraine progression and consider strategies that could reduce its risk. METHODS A group of headache expert healthcare professionals, clinicians, and researchers reviewed published evidence documenting factors associated with increased or decreased rates of migraine progression and established expert opinions for disease management recommendations. Strength of evidence was rated as good, moderate, or based solely on expert opinion, using modified criteria for causation developed by AB Hill. RESULTS Migraine progression is commonly operationally defined as the transition from ≤ 15 to ≥ 15 monthly headache days among people with migraine; however, this does not necessarily constitute a fundamental change in migraine biology and other definitions should be considered. Established and theoretical key risk factors for migraine progression were categorized into five domains: migraine disease characteristics, treatment-related factors, comorbidities, lifestyle/exogenous factors, and demographic factors. Within these domains, good evidence supports the following risk factors: poorly optimized acute headache treatment, cutaneous allodynia, acute medication overuse, selected psychiatric symptoms, extra-cephalic chronic pain conditions, metabolism-related comorbidities, sleep disturbances, respiratory conditions, former/current high caffeine intake, physical inactivity, financial constraints, tobacco use, and personal triggers as risk factors. Protective actions that may mitigate migraine progression are sparsely investigated in published literature; our discussion of these factors is primarily based on expert opinion. CONCLUSIONS Recognizing risk factors for migraine progression will allow healthcare providers to suggest protective actions against migraine progression (Supplementary Fig. 1). Intervention studies are needed to weight the risk factors and test the clinical benefit of hypothesized mitigation strategies that emerge from epidemiological evidence.
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Affiliation(s)
- Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Dawn C Buse
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Vector Psychometric Group, LLC, Chapel Hill, NC, USA
| | - Stephanie J Nahas
- Department of Neurology, Thomas Jefferson University, Jefferson Headache Center, Philadelphia, PA, USA
| | - Gretchen E Tietjen
- University of Toledo College of Medicine and Life Sciences, Toledo, OH, USA
| | - Vincent T Martin
- University of Cincinnati Headache and Facial Pain Center, Cincinnati, OH, USA
| | - Elin Löf
- H. Lundbeck A/S, Copenhagen, Denmark
| | | | - Roger Cady
- Lundbeck LLC, Deerfield, IL, USA
- RK Consults, Ozark, MO, USA
- Missouri State University, Springfield, MO, USA
| | - Hans-Christoph Diener
- Institute for Medical Informatics, Biometry and Epidemiology, Medical Faculty, University Duisburg-Essen, Essen, Germany.
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6
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Fuller-Thomson E, Marshall DJ, Moses M, Abudiab S. Flourishing mental health despite disabling chronic pain: Findings from a nationally representative sample of Canadians with arthritis. PLoS One 2023; 18:e0291722. [PMID: 37819867 PMCID: PMC10566723 DOI: 10.1371/journal.pone.0291722] [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: 07/04/2022] [Accepted: 09/05/2023] [Indexed: 10/13/2023] Open
Abstract
This study aims to determine the prevalence of, and factors associated with, the "absence of psychiatric disorders" (APD) and "complete mental health" (CMH) among individuals with arthritis who report disabling chronic pain. There are three aspects of CMH: a) APD; b) happiness and/or life satisfaction in the past month on a daily or almost daily basis, and c) high levels of psychological and social well-being. A secondary analysis of a nationally representative sample (n = 620) of individuals with arthritis who report chronic and debilitating pain was conducted. Data were drawn from the Canadian Community Health Survey-Mental Health. The results of this study indicate that many people with arthritis who are living with disabling chronic pain are free of psychiatric disorders (76%) and are in CMH (56%). Factors associated with higher odds of APD and CMH among the sample include having a confidant, being free from insomnia, and having no lifetime history of major depressive disorder and/or generalized anxiety disorder. White respondents were almost 3-fold more likely to be in a state of CMH compared to racialized individuals. Respondents in the top 50% of household incomes were almost 4-fold more likely to be APD compared to the lowest 10%. In conclusion, many individuals with arthritis have excellent mental health despite disabling pain. Clinicians should be attuned to the mental health of their patients, with particular focus on those who may be more vulnerable to adverse mental health outcomes, such as racialized individuals, those in impoverished households, and those who lack social support.
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Affiliation(s)
- Esme Fuller-Thomson
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
- Institute for Life Course & Aging, University of Toronto, Toronto, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Denise J. Marshall
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Matthew Moses
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
| | - Sally Abudiab
- Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Canada
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Zamir O, Yarns BC, Lagman-Bartolome AM, Jobanputra L, Lawler V, Lay C. Understanding the gaps in headache and migraine treatment with psychological and behavioral interventions: A narrative review. Headache 2023; 63:1031-1039. [PMID: 37638484 DOI: 10.1111/head.14624] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/25/2023] [Accepted: 07/28/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVE In this narrative review, we summarize relevant literature pertaining to psychosocial risk factors for headache and migraine progression, current behavioral and psychological treatments, and consider promising treatments. BACKGROUND Headache and migraine are common and associated with significant burden and disability. Current treatments targeting psychosocial risk factors show modest outcomes and do not directly address the impact of early life adversity, including the development of maladaptive emotional processing. An intervention that could address these factors and include components of current evidence-based interventions may lead to improved outcomes. METHODS We searched PubMed and Google Scholar for articles through December 2022. Search terms included headache, migraine, psychological interventions, behavioral interventions, cognitive-behavioral therapy, mindfulness, psychiatric comorbidities, adverse childhood experiences, trauma, and emotional processing. RESULTS Trauma and childhood adversity show a correlation with headache and migraine progression. Developmental adversity and trauma interfere with adaptive emotional processing, which may worsen headache and migraine symptoms, while adaptive ways of experiencing emotions are shown to improve symptoms. Current behavioral and psychological interventions, such as cognitive-behavioral and mindfulness therapies, are effective treatments for headache, but they produce small to medium effect sizes and do not directly address the impact of trauma and emotional conflicts-common factors that contribute to chronicity and disability, especially among certain subpopulations of headache patients such as those with migraine. Thus, there exists a gap in current treatment. CONCLUSION There is a gap in headache and migraine treatment for those patients who have a history of trauma, childhood adversity, and maladaptive emotional processing. We suggest that an integrated psychological treatment that includes components of current evidence-based interventions and addresses gaps by focusing on processing trauma-related emotions may improve chronic and debilitating symptoms.
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Affiliation(s)
- Orit Zamir
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
- Wasser Pain Medicine Clinic, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
- Department of Psychiatry, Women's College Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Brandon C Yarns
- Department of Mental Health, VA Greater Los Angeles Healthcare System, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Ana Marissa Lagman-Bartolome
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
- Division of Neurology, Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
- Department of Pediatrics, Division of Neurology, Children's Hospital, London Health Sciences Center, University of Western Ontario, London, Ontario, Canada
| | - Lina Jobanputra
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Valerie Lawler
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Christine Lay
- Centre for Headache, Women's College Hospital, University of Toronto, Toronto, Ontario, Canada
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Frick JM, Eller OC, Foright RM, Levasseur BM, Yang X, Wang R, Winter MK, O'Neil MF, Morris EM, Thyfault JP, Christianson JA. High-fat/high-sucrose diet worsens metabolic outcomes and widespread hypersensitivity following early-life stress exposure in female mice. Am J Physiol Regul Integr Comp Physiol 2023; 324:R353-R367. [PMID: 36693166 PMCID: PMC9970659 DOI: 10.1152/ajpregu.00216.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 12/21/2022] [Accepted: 01/13/2023] [Indexed: 01/25/2023]
Abstract
Exposure to stress early in life has been associated with adult-onset comorbidities such as chronic pain, metabolic dysregulation, obesity, and inactivity. We have established an early-life stress model using neonatal maternal separation (NMS) in mice, which displays evidence of increased body weight and adiposity, widespread mechanical allodynia, and hypothalamic-pituitary-adrenal axis dysregulation in male mice. Early-life stress and consumption of a Western-style diet contribute to the development of obesity; however, relatively few preclinical studies have been performed in female rodents, which are known to be protected against diet-induced obesity and metabolic dysfunction. In this study, we gave naïve and NMS female mice access to a high-fat/high-sucrose (HFS) diet beginning at 4 wk of age. Robust increases in body weight and fat were observed in HFS-fed NMS mice during the first 10 wk on the diet, driven partly by increased food intake. Female NMS mice on an HFS diet showed widespread mechanical hypersensitivity compared with either naïve mice on an HFS diet or NMS mice on a control diet. HFS diet-fed NMS mice also had impaired glucose tolerance and fasting hyperinsulinemia. Strikingly, female NMS mice on an HFS diet showed evidence of hepatic steatosis with increased triglyceride levels and altered glucocorticoid receptor levels and phosphorylation state. They also exhibited increased energy expenditure as observed via indirect calorimetry and expression of proinflammatory markers in perigonadal adipose. Altogether, our data suggest that early-life stress exposure increased the susceptibility of female mice to develop diet-induced metabolic dysfunction and pain-like behaviors.
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Affiliation(s)
- Jenna M Frick
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Olivia C Eller
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Rebecca M Foright
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Brittni M Levasseur
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Xiaofang Yang
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Ruipeng Wang
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Michelle K Winter
- Kansas Intellectual and Developmental Disabilities Research Association, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - Maura F O'Neil
- Department of Pathology and Laboratory Medicine, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - E Matthew Morris
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
| | - John P Thyfault
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
- Research Service, Kansas City Veterans Affairs Medical Center, Kansas City, Kansas, United States
| | - Julie A Christianson
- Department of Cell Biology and Physiology, School of Medicine, University of Kansas Medical Center, Kansas City, Kansas, United States
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9
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Greger HK, Kristianslund SK, Stensland SØ. Interpersonal violence and recurrent headache among adolescents with a history of psychiatric problems. Ann Gen Psychiatry 2023; 22:2. [PMID: 36694246 PMCID: PMC9872394 DOI: 10.1186/s12991-023-00432-7] [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: 09/14/2022] [Accepted: 01/14/2023] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND Interpersonal violence (IPV) is found to be associated with mental health problems and pain disorders such as headache among children and adolescents. It is well-known that adolescents in need of mental health services have experienced IPV more often than adolescents in the general population. However, there has not been much focus on pain conditions in child and adolescent psychiatric populations. METHODS Data from the current study are based on a 3-year follow-up of the CAP-survey, which is a study of adolescents in the child and adolescent psychiatric unit population of St. Olavs Hospital (Trondheim University Hospital). The baseline study was conducted between 2009 and 2011, with 717 participants between 13 and 18 years. All participants were enrolled, or newly referred to the child and adolescent psychiatric clinic. At follow-up, 570 participants completed questionnaire, and 550 completed a diagnostic interview. The participants were aged 16-21 years (mean age 18.6 years). RESULTS A third of the adolescents reported frequent headaches (weekly or daily). Adolescents with more severe mental problems were more likely to experience frequent headaches. Adolescents exposed to unpleasant sexual acts or bullying, reported more frequent headaches than non-exposed participants. Participants exposed to three or more types of IPV seemed to be at particularly high risk of experiencing frequent headache. CONCLUSIONS Both experiences of interpersonal violence and headache are common in this clinical psychiatric population. Clinicians should assess for headache disorders in addition to psychiatric and trauma assessment and provide need-based treatment to enhance chance of recovery among adolescents in mental health services.
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Affiliation(s)
- Hanne Klæboe Greger
- Regional Centre for Child and Youth Mental Health and Child Welfare, Institute of Mental Health, Norwegian University of Science and Technology, Norway and St.Olavs Hospital, Trondheim, Norway.
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10
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Graves EB, Gerber BR, Berrigan PS, Shaw E, Cowling TM, Ladouceur MP, Bougie JK. Epidemiology and treatment utilization for Canadian patients with migraine: a literature review. J Int Med Res 2022; 50:3000605221126380. [PMID: 36173008 PMCID: PMC9528037 DOI: 10.1177/03000605221126380] [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: 11/16/2022] Open
Abstract
The objective of this narrative review was to identify real-world evidence regarding the burden of migraine in Canada. We conducted a literature search in MEDLINE, Embase, and the Cochrane Database of Systematic Reviews for studies published between August 2010 and August 2020. Of the 3269 publications identified, 29 studies were included. Prevalence estimates varied widely across Canada, and mental health comorbidities were common. Individuals with migraine have a lower quality of life, detrimental impact on workforce productivity, and higher rates of health care resource utilization (HCRU), with HCRU and costs highest among those with chronic migraine. We found inconsistencies in care, including underutilization of medications such as triptans, and varied utilization of over-the-counter and prescription medications. Increased medication use was identified among those with chronic migraine, and only a small number of patients used migraine preventive medications. The burden of migraine in Canada is substantial. Reduced quality of life and workforce productivity, increased HCRU and costs, and underutilization of triptans and migraine preventive medications highlight an important need for more effective management of individuals with migraine.
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Affiliation(s)
- Erin B Graves
- Medlior Health Outcomes Research Ltd., Calgary, AB, Canada
| | | | | | - Eileen Shaw
- Medlior Health Outcomes Research Ltd., Calgary, AB, Canada
| | - Tara M Cowling
- Medlior Health Outcomes Research Ltd., Calgary, AB, Canada
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11
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Poorer physical and mental health among older adults decades after experiencing childhood physical abuse. AGING AND HEALTH RESEARCH 2022. [DOI: 10.1016/j.ahr.2022.100088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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12
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Rosignoli C, Ornello R, Onofri A, Caponnetto V, Grazzi L, Raggi A, Leonardi M, Sacco S. Applying a biopsychosocial model to migraine: rationale and clinical implications. J Headache Pain 2022; 23:100. [PMID: 35953769 PMCID: PMC9367111 DOI: 10.1186/s10194-022-01471-3] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 08/02/2022] [Indexed: 12/23/2022] Open
Abstract
Migraine is a complex condition in which genetic predisposition interacts with other biological and environmental factors determining its course. A hyperresponsive brain cortex, peripheral and central alterations in pain processing, and comorbidities play a role from an individual biological standpoint. Besides, dysfunctional psychological mechanisms, social and lifestyle factors may intervene and impact on the clinical phenotype of the disease, promote its transformation from episodic into chronic migraine and may increase migraine-related disability.Thus, given the multifactorial origin of the condition, the application of a biopsychosocial approach in the management of migraine could favor therapeutic success. While in chronic pain conditions the biopsychosocial approach is already a mainstay of treatment, in migraine the biomedical approach is still dominant. It is instead advisable to carefully consider the individual with migraine as a whole, in order to plan a tailored treatment. In this review, we first reported an analytical and critical discussion of the biological, psychological, and social factors involved in migraine. Then, we addressed the management implications of the application of a biopsychosocial model discussing how the integration between non-pharmacological management and conventional biomedical treatment may provide advantages to migraine care.
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Affiliation(s)
- Chiara Rosignoli
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Raffaele Ornello
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Agnese Onofri
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Valeria Caponnetto
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
| | - Licia Grazzi
- Neuroalgology Unit and Headache Centre, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Alberto Raggi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Matilde Leonardi
- Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
| | - Simona Sacco
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
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13
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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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14
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Early life adversity drives sex-specific anhedonia and meningeal immune gene expression through mast cell activation. Brain Behav Immun 2022; 103:73-84. [PMID: 35339629 PMCID: PMC9149134 DOI: 10.1016/j.bbi.2022.03.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 02/25/2022] [Accepted: 03/16/2022] [Indexed: 01/06/2023] Open
Abstract
Exposure to early life adversity (ELA) in the form of physical and/or psychological abuse or neglect increases the risk of developing psychiatric and inflammatory disorders later in life. It has been hypothesized that exposure to ELA results in persistent, low grade inflammation that leads to increased disease susceptibility by amplifying the crosstalk between stress-processing brain networks and the immune system, but the mechanisms remain largely unexplored. The meninges, a layer of three overlapping membranes that surround the central nervous system (CNS)- dura mater, arachnoid, and piamater - possess unique features that allow them to play a key role in coordinating immune trafficking between the brain and the peripheral immune system. These include a network of lymphatic vessels that carry cerebrospinal fluid from the brain to the deep cervical lymph nodes, fenestrated blood vessels that allow the passage of molecules from blood to the CNS, and a rich population of resident mast cells, master regulators of the immune system. Using a mouse model of ELA consisting of neonatal maternal separation plus early weaning (NMSEW), we sought to explore the effects of ELA on sucrose preference behavior, dura mater expression of inflammatory markers and mast cell histology in adult male and female C57Bl/6 mice. We found that NMSEW alone does not affect sucrose preference behavior in males or females, but it increases the dura mater expression of the genes coding for mast cell protease CMA1 (cma1) and the inflammatory cytokine TNF alpha (tnf alpha) in females. When NMSEW is combined with an adult mild stress (that does not affect behavior or gene expression in NH animals) females show reduced sucrose preference and even greater increases in meningeal cma1 levels. Interestingly, systemic administration of the mast cell stabilizer Ketotifen before exposure to adult stress prevents both, reduction in sucrose preference an increases in cma1 expression in NMSEW females, but facilitates stress-induced sucrose anhedonia in NMSEW males and NH females. Finally, histological analyses showed that, compared to males, females have increased baseline activation levels of mast cells located in the transverse sinus of the dura mater, where the meningeal lymphatics run along, and that, in males and females exposed to adult stress, NMSEW increases the number of mast cells in the interparietal region of the dura mater and the levels of mast cell activation in the sagittal sinus regions of the dura mater. Together, our results indicate that ELA induces long-term meningeal immune gene changes and heightened sensitivity to adult stress-induced behavioral and meningeal immune responses and that these effects could mediated via mast cells.
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15
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Tietjen GE. The relationship of childhood adversity and migraine and the value of prospective studies. Headache 2022; 62:223-224. [DOI: 10.1111/head.14268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 11/30/2022]
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16
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Migraine and Neuroticism: A Scoping Review. Behav Sci (Basel) 2022; 12:bs12020030. [PMID: 35200282 PMCID: PMC8869701 DOI: 10.3390/bs12020030] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 01/10/2022] [Accepted: 01/26/2022] [Indexed: 02/07/2023] Open
Abstract
Headache is the first cause of consultation in neurology, and one of the most frequent reasons for consultation in general medicine. Migraine is one of the most common, prevalent, and socioeconomically impactful disabling primary headache disorders. Neuroticism can be conceptualized as a disposition to suffer anxiety and emotional disorders in general. Neuroticism has been associated with various mental and physical disorders (e.g., chronic pain, depression), including migraine. With the aim to explore in depth the relationship between migraine and neuroticism, and contribute to the understanding of this relation in order to provide a better treatment for migraine patients based on a personalized and more comprehensive approach, a scoping review was performed using PubMed, Scopus, and Web of Science. Databases were searched independently by the two researchers, reaching a final set of 18 articles to be included. The search terms were: migraine and neuroticism. Neuroticism seems to be highly prevalent in migraine patients. Findings reveal that migraine patients with comorbid depression and anxiety showed higher levels of neuroticism. Depression has been associated with an increased risk of transformation from episodic to chronic migraine whereas neuroticism might be a mediator factor. Neuroticism also might be a mediator factor between childhood maltreatment and migraine. The revision conducted confirms that: (1) Migraine patients usually have a higher level of neuroticism and vulnerability to negative affect, compared to non-migraineurs and tension-type headache patients. (2) Neuroticism is associated with migraine. Nonetheless, more research is needed to clarify potential moderators of this relationship and the role of neuroticism itself in this disease. This knowledge might be useful in order to promote a better management of negative emotions as part of intervention programs in migraine.
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17
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Wei Q, Pan Y, Zhang S, Yin W, Lin Q, Pan S, Dai C, Zhou L, Wu J. Epidemiology of childhood trauma and its association with insomnia and psychotic-like experiences in Chinese Zhuang adolescents. Front Psychiatry 2022; 13:974674. [PMID: 36072448 PMCID: PMC9441791 DOI: 10.3389/fpsyt.2022.974674] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 08/03/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Adolescents who have experienced childhood trauma are more likely to have insomnia and psychotic-like experiences (PLEs) than adolescents from other ethnic groups. However, little is known about the youth of ethnic minorities. This study aimed to investigate the epidemiology of childhood trauma and its relationship with insomnia and PLEs in Chinese Zhuang adolescents, focusing on the role of a specific type of trauma and accumulation. METHODS A questionnaire of Childhood Trauma Questionnaire-Short Form (CTQ-SF), Athens Insomnia Scale (AIS), and Chinese Version Community assessment psychic experiences-8 (CCAPE- 8) were all completed by 1,493 Chinese Zhuang adolescents. Chi-square and multivariate logistic regression analyses examined the association between childhood trauma and insomnia/PLEs. RESULTS The incidences of emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN) occurred at rates of 5.63, 5.02, 6.56, 23.98, and 33.15%, respectively. EA, SA, EN, and PN were all positively related to insomnia (OR: 1.314-7.720, all p < 0.05). EA and SA were positively associated with PLEs (OR: 2.131-3.202, all p < 0.001). Adolescents who had experienced three or more types of traumas were more likely to have insomnia (OR = 6.961, p < 0.001) and PLEs (OR = 3.558, p < 0.001). CONCLUSION The most common type of childhood trauma is PN. Childhood trauma has the primary effect on insomnia/PLE. A significant dose-response relationship was found between Childhood trauma and insomnia/ PLEs. This association varied depending on the type and accumulation of exposure.
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Affiliation(s)
- Qiaoyue Wei
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Yuli Pan
- Department of Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, China
| | - Shengjie Zhang
- Department of Graduate Management, Guangxi Medical University Cancer Hospital, Nanning, China
| | - Wenwen Yin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Qinghong Lin
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Shuibo Pan
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Chenyangzi Dai
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Linhua Zhou
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China
| | - Junduan Wu
- Department of Psychology, School of Public Health, Guangxi Medical University, Nanning, China.,Department of Psychology, School of Medicine, Guangxi Medical College, Nanning, China
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18
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The Psychiatric Comorbidities of Migraine in Children and Adolescents. Curr Pain Headache Rep 2021; 25:69. [PMID: 34766216 DOI: 10.1007/s11916-021-00983-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2021] [Indexed: 10/19/2022]
Abstract
PURPOSE OF REVIEW Understanding comorbidities in migraine is important because it can help us understand disease pathophysiology while also aiding the development of more effective treatment strategies. Additionally, it can provide greater awareness about appropriate diagnosis, the need for additional disease screening, and the natural history of migraine. Psychiatric comorbidities have been independently studied in both adults and children with migraine because their presentations can be distinct, and the physiology in these two groups can be different. RECENT FINDINGS While symptoms of anxiety and depression seem to be comorbid with migraine in children, clinically significant disease does not appear to be, though the clarity of these data is limited by overlap between migraine symptomatology and that assessed by many screening tools. Functional neurologic disorders like psychogenic non-epileptic episodes (PNEE) and other functional movement disorders are not common but can be comorbid with migraine in this population and tend to improve with migraine treatment. The number of adverse childhood experiences (ACEs) a child is exposed to seems to be near-linearly associated with risk of migraine, but not with tension-type headache (TTH). The findings from these studies underscore the importance of utilizing appropriate screening methodologies for identifying psychiatric disorders in children with migraine. Additionally, the role of the insula, the hypothalamic-pituitary-adrenal axis, the serotonergic system, and the instability of hyperactivated neural networks may underlie the pathophysiology of both migraine and its psychiatric comorbidities.
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Abstract
Injury-free pain conditions, defined as functional pain syndromes, are more prevalent and more disabling in women. Mechanisms of sexual dimorphism in functional pain are now emerging from preclinical studies, suggesting an opportunity to advance the development of sex-specific therapies that may improve treatment of pain in women.
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Affiliation(s)
- Edita Navratilova
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
| | | | - Frank Porreca
- Department of Pharmacology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA
- Mayo Clinic, Scottsdale, AZ 85259, USA
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20
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Anto M, Jaffee S, Tietjen G, Mendizabal A, Szperka C. Adverse Childhood Experiences and Frequent Headache by Adolescent Self-Report. Pediatr Neurol 2021; 121:51-55. [PMID: 34147819 PMCID: PMC10061365 DOI: 10.1016/j.pediatrneurol.2021.04.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 04/07/2021] [Accepted: 04/11/2021] [Indexed: 12/31/2022]
Abstract
BACKGROUND The association between exposure to adverse childhood experiences (ACEs) and increased headache in adults has been well characterized. Childhood adversity and its effect on headache in children have not been as robustly investigated. This study examines the relationship of self-reported ACEs to frequent headache in an adolescent cohort. METHODS We performed a retrospective cohort study using data from the National Longitudinal Study of Adolescent to Adult Health Wave I (n = 20,745) to examine self-reported ACE exposures and their relationship to frequent headache. RESULTS The study population was composed of 20,745 participants; 50.6% male and 49.4% female. The mean age of respondents was 15.9 years (range 12 to 21 years, standard error: 0.12 years). Frequent headache was reported in 29.3% of respondents, and 45% of respondents reported one or more ACE exposures. For each increase in cumulative ACE score, odds of frequent headache increased by 1.22 (95% confidence interval [CI] 1.15 to 1.30). The ACEs that individually showed an association with frequent headache after adjusting for demographic factors were lack of maternal warmth (odds ratio [OR] 1.40, 95% CI 1.12 to 1.74, P = 0.002), lack of paternal warmth (OR 1.47, 95% CI 1.20 to 1.81, P < 0.001), paternal alcoholism (OR 1.21, 95% CI 1.05 to 1.40, P = 0.007), suicide attempt of family member (OR 1.51, 95% CI 1.22 to 1.87, P < 0.001), and living in an unsafe neighborhood (OR 1.22, 95% CI 1.06 to 1.39, P = 0.004). CONCLUSIONS Several ACE exposures were associated with frequent headache in adolescents. An increase in cumulative ACE exposure increased the odds of having frequent headache.
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Affiliation(s)
- Marissa Anto
- Department of Neurology, Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania.
| | - Sara Jaffee
- Department of Psychology, University of Pennsylvania, Philadelphia, Pennsylvania
| | | | - Adys Mendizabal
- Department of Neurology, University of California Los Angeles (UCLA), Los Angeles, California; Department of Neurology, PADDREC, Veterans Affair Administration of Greater Los Angeles, Los Angeles, California
| | - Christina Szperka
- Department of Neurology, Children's Hospital of Philadelphia (CHOP), Philadelphia, Pennsylvania
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21
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Siego CV, Sanchez SE, Jimenez ML, Rondon MB, Williams MA, Peterlin BL, Gelaye B. Associations between adverse childhood experiences and migraine among teenage mothers in Peru. J Psychosom Res 2021; 147:110507. [PMID: 34020343 PMCID: PMC8852843 DOI: 10.1016/j.jpsychores.2021.110507] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/28/2021] [Accepted: 05/02/2021] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the association between (1) different types of ACEs and migraine, and (2) the number of ACEs and migraine among adolescent mothers in Lima, Peru. METHODS Our cross-sectional study included 787 adolescent mothers (14- to 18-years of age) in Peru. In-person interviews were conducted postpartum, in hospital, within 2-days of delivery. Nine types of ACEs were assessed, including exposure to three categories of abuse, two categories of neglect, and four categories of household dysfunction. Multivariable logistic regression procedures were used to estimate odds ratios (ORs) and 95% confidence intervals (95% CI) for the association between ACEs and migraine while adjusting for putative confounders. RESULTS Approximately 75% of adolescent mothers reported having experienced at least one type of ACE. Adolescent mothers who reported any childhood abuse had 1.49-fold increased odds of migraine (aOR = 1.49; 95% CI 1.03-2.18) compared to those with no history of childhood abuse. Adolescent mothers who reported experiencing household dysfunction had 1.56-fold increase odds of migraine (aOR = 1.56; 95% CI 1.09-2.24). Compared to participants who reported no ACE, those who experienced four or more ACEs had 3.09-fold (aOR = 3.09; 95% CI 1.80-5.40) increased odds of migraine (ptrend < 0.001). CONCLUSION Exposure to ACEs is highly prevalent in adolescent-aged mothers postpartum and is associated with increased odds of migraine. These findings support the importance of screening for ACEs and migraine among adolescent mothers; and the need for providing culturally appropriate, trauma-informed headache care.
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Affiliation(s)
| | - Sixto E. Sanchez
- Universidad Peruana de Ciencias Aplicadas, Lima, Peru,Asociación Civil PROESA, Lima, Peru
| | | | - Marta B. Rondon
- Department of Medicine, Cayetano Heredia Peruvian University, Lima, Peru
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA
| | - B. Lee Peterlin
- Department of Neuroscience, Penn Medicine Lancaster General Headache Center, Lancaster, PA
| | - Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA; The Chester M. Pierce, M.D. Division of Global Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
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22
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Eller OC, Yang X, Fuentes IM, Pierce AN, Jones BM, Brake AD, Wang R, Dussor G, Christianson JA. Voluntary Wheel Running Partially Attenuates Early Life Stress-Induced Neuroimmune Measures in the Dura and Evoked Migraine-Like Behaviors in Female Mice. Front Physiol 2021; 12:665732. [PMID: 34122137 PMCID: PMC8194283 DOI: 10.3389/fphys.2021.665732] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/29/2021] [Indexed: 12/13/2022] Open
Abstract
Migraine is a complex neurological disorder that affects three times more women than men and can be triggered by endogenous and exogenous factors. Stress is a common migraine trigger and exposure to early life stress increases the likelihood of developing chronic pain disorders later in life. Here, we used our neonatal maternal separation (NMS) model of early life stress to investigate whether female NMS mice have an increased susceptibility to evoked migraine-like behaviors and the potential therapeutic effect of voluntary wheel running. NMS was performed for 3 h/day during the first 3 weeks of life and initial observations were made at 12 weeks of age after voluntary wheel running (Exercise, -Ex) or sedentary behavior (-Sed) for 4 weeks. Mast cell degranulation rates were significantly higher in dura mater from NMS-Sed mice, compared to either naïve-Sed or NMS-Ex mice. Protease activated receptor 2 (PAR2) protein levels in the dura were significantly increased in NMS mice and a significant interaction of NMS and exercise was observed for transient receptor potential ankyrin 1 (TRPA1) protein levels in the dura. Behavioral assessments were performed on adult (>8 weeks of age) naïve and NMS mice that received free access to a running wheel beginning at 4 weeks of age. Facial grimace, paw mechanical withdrawal threshold, and light aversion were measured following direct application of inflammatory soup (IS) onto the dura or intraperitoneal (IP) nitroglycerin (NTG) injection. Dural IS resulted in a significant decrease in forepaw withdrawal threshold in all groups of mice, while exercise significantly increased grimace score across all groups. NTG significantly increased grimace score, particularly in exercised mice. A significant effect of NMS and a significant interaction effect of exercise and NMS were observed on hindpaw sensitivity following NTG injection. Significant light aversion was observed in NMS mice, regardless of exercise, following NTG. Finally, exercise significantly reduced calcitonin gene-related peptide (CGRP) protein level in the dura of NMS and naïve mice. Taken together, these findings suggest that while voluntary wheel running improved some measures in NMS mice that have been associated with increased migraine susceptibility, behavioral outcomes were not impacted or even worsened by exercise.
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Affiliation(s)
- Olivia C. Eller
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Xiaofang Yang
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Isabella M. Fuentes
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Angela N. Pierce
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Physiology, Kansas City University of Medicine and Biosciences, Joplin, MO, United States
| | - Brittni M. Jones
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Aaron D. Brake
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Ruipeng Wang
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
| | - Gregory Dussor
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, TX, United States
| | - Julie A. Christianson
- Department of Anatomy and Cell Biology, University of Kansas Medical Center, Kansas City, KS, United States
- Department of Anesthesiology, University of Kansas Medical Center, Kansas City, KS, United States
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23
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Baiden P, Tarbet Z, Chakravarty S, LaBrenz CA, Okumu M. Functional difficulties mediate the association between exposure to adverse childhood experiences and headaches among children: Findings from a population-based study. Headache 2021; 61:673-682. [PMID: 33891349 DOI: 10.1111/head.14098] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 01/15/2021] [Accepted: 02/08/2021] [Indexed: 12/21/2022]
Abstract
BACKGROUND Adverse childhood experiences (ACEs) are commonly observed in the general population and often have lasting neurological and physiological effects. Previous studies have found links between exposure to ACEs, headaches, and functional difficulties in adults. However, little is known about the mechanisms through which exposure to ACEs is associated with headaches among children. OBJECTIVE To examine the association between exposure to ACEs and headaches in children, and whether functional difficulties mediate this association. METHODS Data for this cross-sectional secondary analysis study came from the 2017-2018 National Survey of Children's Health. The sample analyzed in this study was 40,953 children who were between ages 3 and 17 years. We adjusted for the complexity of the sampling design and used structural equation modeling to examine the mediating effect of functional difficulties in the association between exposure to ACEs and headaches. RESULTS Based on parent reports, we found that 4.1% (1697/40,953) of the children reported frequent or severe headaches, and 9.5% (3906/40,953) were exposed to three or more ACEs. About one in four children (23.4%; 9601/40,953) had at least one functional difficulty. The results show that exposure to ACEs was directly positively associated with functional difficulties (β = 0.16, p < 0.001, 95% CI = 0.15-0.17), and functional difficulties were in turn positively associated with headaches (β = 0.17, p < 0.001, 95% CI = 0.12-0.22). The Sobel test of indirect effect showed that functional difficulties partially mediated the association between exposure to ACEs and headaches (β = 0.027, p < 0.001, 95% CI = 0.022-0.029). Also, older children and children with brain injury were more likely to report experiencing headaches. CONCLUSIONS The findings from this study suggest an association between exposure to ACEs and headaches among children, and functional difficulties partially mediate this association.
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Affiliation(s)
- Philip Baiden
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Zachary Tarbet
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | | | - Catherine A LaBrenz
- School of Social Work, The University of Texas at Arlington, Arlington, TX, USA
| | - Moses Okumu
- University of North Carolina, at Chapel Hill, School of Social Work, Chapel Hill, NC, USA
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Rittenberger M, Ostrowski-Delahanty S, Woods K. The impact of trauma exposure on headache outcomes. CHILDRENS HEALTH CARE 2021. [DOI: 10.1080/02739615.2021.1913163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Morgan Rittenberger
- NeuroDevelopmental Science Center, Akron Children’s Hospital, Akron, Ohio, USA
- Speech and Hearing, Cleveland State University, Cleveland, Ohio, USA
| | | | - Kristine Woods
- NeuroDevelopmental Science Center, Akron Children’s Hospital, Akron, Ohio, USA
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Trivedi M, Dumkrieger G, Chong CD, Dodick DW, Schwedt TJ. Impact of abuse on migraine-related sensory hypersensitivity symptoms: Results from the American Registry for Migraine Research. Headache 2021; 61:740-754. [PMID: 33779989 DOI: 10.1111/head.14100] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 01/15/2021] [Accepted: 02/08/2021] [Indexed: 01/22/2023]
Abstract
BACKGROUND AND OBJECTIVES Prior studies have established an association between a history of abuse and the development of migraine. This cross-sectional observational study explored the relationship between self-reported abuse history with migraine-related sensory hypersensitivity symptoms. METHODS In total, 588 adult patients with migraine from the American Registry for Migraine Research completed questionnaires: Generalized Anxiety Disorder-7, Patient Health Questionnaire-2 for depression, Photosensitivity Assessment Questionnaire, Hyperacusis Questionnaire, and Allodynia Symptom Checklist. Using four binary screening questions, patients were asked to self-report if they believed they had suffered emotional, physical, or sexual abuse in their lifetime. Differences in questionnaire scores between groups with and without a history of abuse were determined. Regression models adjusted for age, sex, and basic headache features analyzed the relationship between abuse history and sensory hypersensitivity symptoms. Moderation analysis explored the role of headache frequency in this relationship. Mediation analysis assessed the indirect (Mediated) effect (IE) of abuse on sensory hypersensitivity through depression or anxiety. Additional models analyzed relationships between sensory hypersensitivity symptoms and abuse subtypes or the number of abuse subtypes. RESULTS Of 588 participants, 222 (38%) reported a history of abuse. Patients with a history of abuse reported statistically significantly greater average headache frequency (7.6 vs. 4.7 days, p = 0.030). Patients with a history of abuse also reported higher average or median questionnaire scores: anxiety (7.6 vs. 4.7, p < 0.001, d = 0.56), depression (1.7 vs. 1.3, p = 0.009, d = 0.24), photophobia (0.54 vs. 0.44, p < 0.001, d = 0.32), hyperacusis (19.6 vs. 14.9, p < 0.001, d = 0.49), ictal allodynia (6.0 vs. 3.0, p < 0.001, d = 0.46), and interictal allodynia (1.0 vs. 0.0, p < 0.001, d = 0.30). After controlling for patient age, sex and years lived with headache, abuse maintained a significant association with every sensory hypersensitivity measure. Headache frequency significantly moderated the relationship between a history of abuse with increased ictal allodynia (p = 0.036). Anxiety significantly mediated the relationships between abuse with photophobia (IE = 0.03, 95% CI = 0.01-0.04), hyperacusis (IE = 1.51, 95% CI = 0.91-2.24), ictal allodynia (IE = 0.02, 95% CI = 0.01-0.04), and interictal allodynia (IE = 0.02, 95% CI = 0.01-0.06). Depression significantly mediated the relationship between abuse with photophobia (IE = 0.02, 95% CI = 0.01-0.03) and with hyperacusis (IE = 0.45, 95% CI = 0.11-0.88). The association between the individual subtypes of abuse and the number of subtypes of abuse with sensory hypersensitivity symptoms varied. CONCLUSION A history of abuse is associated with greater migraine-related sensory hypersensitivity symptoms. To reduce the impact of abuse on migraine symptoms, future studies should explore mechanistic connections between abuse and migraine-associated symptoms.
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Cozzi G, Lucarelli A, Borrometi F, Corsini I, Passone E, Pusceddu S, Morabito G, Barbi E, Benini F. How to recognize and manage psychosomatic pain in the pediatric emergency department. Ital J Pediatr 2021; 47:74. [PMID: 33766115 PMCID: PMC7992953 DOI: 10.1186/s13052-021-01029-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 03/15/2021] [Indexed: 01/19/2023] Open
Abstract
Aim Children and adolescents affected by somatization and somatic symptom disorder commonly refer to emergency services. Due to the absence of specific guidelines for the emergency setting and to a possible lack of knowledge, these patients are at risk of being unrecognized and mismanaged. This study aims at proposing a clinical practice to approach and manage these patients and their families in the emergency setting. Methods This manuscript derived from the work of a research group of italian pediatric emergency physicians and anesthesiologists, with an expertise in pain management, members of the PIPER group. The research group reviewed the literature about psychosomatic pain and somatic symptom disorder and developed a clinical practice specific for the pediatric emergency setting. Results The manuscript provides information about the main clinical features shared by patients with psychosomatic pain and about current diagnostic criteria and appropriate management in the emergency setting. Furthermore, it highlights the possible pitfalls in which the emergency physician may run into dealing with these patients. Conclusion This clinical practice should be seen as a starting point toward a better understanding of patients with psychosomatic pain and a standardization of care in the pediatric emergency setting.
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Affiliation(s)
- Giorgio Cozzi
- Pediatric Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.
| | - Annunziata Lucarelli
- Department of Paediatrics and Emergency, Giovanni XXIII Children's Hospital, University of Bari, Bari, Italy
| | - Fabio Borrometi
- Pediatric Pain Service and Palliative Care, Department of Oncology, Pausilipon Hospital, AORN Santobono Pausilipon, Naples, Italy
| | - Ilaria Corsini
- Pediatric Emergency Unit, Department of Medical and Surgical Sciences (DIMEC), Sant'Orsola-Malpighi Hospital, University of Bologna, Bologna, Italy
| | - Eva Passone
- Pediatric Clinic, Department of Clinical and Experimental Sciences, DAME, ASUFC S. Maria Della Misericordia, University of Udine, Udine, Italy
| | - Sara Pusceddu
- Pediatric Department, Ospedale S. Maria della Scaletta AUSL, Imola, Italy
| | - Giuliana Morabito
- Pediatric and Neonatology Division, Azienda Ospedaliera Santa Maria degli Angeli, Pordenone, Italy
| | - Egidio Barbi
- Pediatric Emergency Department, Institute for Maternal and Child Health IRCCS Burlo Garofolo, Via dell'Istria 65/1, 34137, Trieste, Italy.,Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy
| | - Franca Benini
- Paediatric Palliative Care - Pain Service Department of Women's and Children's Health, University of Padua, Padua, Italy
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Yamanaka G, Morichi S, Suzuki S, Go S, Takeshita M, Kanou K, Ishida Y, Oana S, Kawashima H. A Review on the Triggers of Pediatric Migraine with the Aim of Improving Headache Education. J Clin Med 2020; 9:jcm9113717. [PMID: 33228144 PMCID: PMC7699367 DOI: 10.3390/jcm9113717] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 11/14/2020] [Accepted: 11/16/2020] [Indexed: 12/18/2022] Open
Abstract
Although migraines are common in children and adolescents, they have a robustly negative impact on the quality of life of individuals and their families. The current treatment guidelines outline the behavioral and lifestyle interventions to correct common causative factors, such as negative emotional states, lack of exercise and sleep, and obesity; however, the evidence of their effectiveness is insufficient. To create a plan for disseminating optimal pediatric headache education, we reviewed the current evidence for factors correlated with migraine. We assessed three triggers or risk factors for migraines in children and adolescents: stress, sleep poverty, and alimentation (including diet and obesity). While there is a gradual uptick in research supporting the association between migraine, stress, and sleep, the evidence for diet-related migraines is very limited. Unless obvious dietary triggers are defined, clinicians should counsel patients to eat a balanced diet and avoid skipping meals rather than randomly limiting certain foods. We concluded that there is not enough evidence to establish a headache education plan regarding behavioral and lifestyle interventions. Clinicians should advise patients to avoid certain triggers, such as stress and sleep disorders, and make a few conservative dietary changes.
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Stone J, Warlow C, Deary I, Sharpe M. Predisposing Risk Factors for Functional Limb Weakness: A Case-Control Study. J Neuropsychiatry Clin Neurosci 2020; 32:50-57. [PMID: 31466514 DOI: 10.1176/appi.neuropsych.19050109] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Functional limb weakness is a common symptom of functional neurological disorder. Few controlled studies have examined possible predisposing factors to determine their specificity for this symptom. METHODS In this prospective case-control study, patients with functional limb weakness (<2 years duration, N=107) were compared with a control group (comprising patients with weakness attributable to neurological disease, N=46, and healthy individuals, N=39). A structured clinical interview and questionnaires assessed potential predisposing factors, including family structure and childhood abuse and neglect (Childhood Trauma Questionnaire [CTQ]), personality traits (NEO Five-Factor Inventory), medical and surgical comorbidity, and exposure to a symptom model. RESULTS The patients with functional limb weakness and the control subjects were similar in gender and age. Self-reported childhood sexual abuse (15% versus 5%, p<0.01), and physical abuse (18% versus 7%, p<0.01; CTQ "moderate or above") were more common in the functional limb weakness group, although the absolute frequency was lower than anticipated. In the functional limb weakness group, there were modest differences in two personality traits, compared with the control group: higher neuroticism (p=0.02) and lower openness (p=0.01). Medical comorbidity, including appendectomy (33% versus 5%), irritable bowel syndrome (36% versus 18%), and chronic back pain (40% versus 16%), was more frequent in the functional limb weakness group. There were no differences in birth order or exposure to a symptom model. CONCLUSIONS Medical and surgical comorbidity and adverse childhood experience are risk factors, but not essential, for the development of functional limb weakness. However, evidence for personality traits or exposure to a symptom model is less robust.
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Affiliation(s)
- Jon Stone
- The Centre for Clinical Brain Sciences, University of Edinburgh, Royal Infirmary, Edinburgh, United Kingdom (Stone, Warlow); the Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, United Kingdom (Deary); the Department of Psychological Medicine Research, University of Oxford, United Kingdom (Sharpe)
| | - Charles Warlow
- The Centre for Clinical Brain Sciences, University of Edinburgh, Royal Infirmary, Edinburgh, United Kingdom (Stone, Warlow); the Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, United Kingdom (Deary); the Department of Psychological Medicine Research, University of Oxford, United Kingdom (Sharpe)
| | - Ian Deary
- The Centre for Clinical Brain Sciences, University of Edinburgh, Royal Infirmary, Edinburgh, United Kingdom (Stone, Warlow); the Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, United Kingdom (Deary); the Department of Psychological Medicine Research, University of Oxford, United Kingdom (Sharpe)
| | - Michael Sharpe
- The Centre for Clinical Brain Sciences, University of Edinburgh, Royal Infirmary, Edinburgh, United Kingdom (Stone, Warlow); the Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, United Kingdom (Deary); the Department of Psychological Medicine Research, University of Oxford, United Kingdom (Sharpe)
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Lee DH, Kim KM, Cho SJ, Kim WJ, Yang KI, Yun CH, Chu MK. Impacts of migraine on the prevalence and clinical presentation of depression: A population-based study. J Affect Disord 2020; 272:215-222. [PMID: 32553361 DOI: 10.1016/j.jad.2020.03.102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 01/29/2020] [Accepted: 03/28/2020] [Indexed: 01/16/2023]
Abstract
BACKGROUND A close association has been reported between depression and migraine. However, information concerning the impacts of migraine on the clinical presentation and prevalence of depression in a population-based study is currently limited. METHODS Data from the Korean Headache-Sleep Study, a nationwide survey about headache and sleep for adults aged 19-69 years were used. Depression was defined when Patient Health Questionnaire-9 score ≥ 10. RESULTS Of 2,695 participants who included in this study, 116 (4.3%), 143 (5.3%), and 1130 (41.9%) had depression, migraine, and non-migraine headache, respectively. Migraine (24/116 [20.5%] vs. 119/2579 [4.7%], p < 0.001) and non-migraine headache (67/116 [58.1%] vs. 1063/2579 [41.3%], p < 0.001) was more prevalent in the group of participants with depression than among participants without depression. Among participants with depression, there was no statistically differences in total Patient Health Questionnaire-9 (PHQ-9) scores among migraine, non-migraine headache, and non-headache groups (median with interquartile range, 12.0 [10.2-18.0] vs. 13.0 [11.0-16.0] vs. 12.0 [10.0-15.2], p = 0.514). Among subcomponent scores of PHQ-9, all subcomponent scores did not significantly differ by headache status except feeling tired or having little energy scores (non-migraine headache 2.0 [2.0-3.0] vs. non-headache 2.0 [1.0-2.0], p = 0.010). LIMITATIONS Diagnosis of depression based on PHQ-9 questionnaire and small sample size in subgroup analyses. CONCLUSIONS Participants with depression exhibit an increased risk of migraine and non-migraine headache compared with participants without depression. Among participants with depression, the severity of depression did not significantly differ on the basis of headache status.
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Affiliation(s)
- Dong Hyun Lee
- Department of Neurology, Yeungnam University of College of Medicine, Daegu, Korea
| | - Kyung Min Kim
- Department of Neurology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea
| | - Soo-Jin Cho
- Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Korea
| | - Won-Joo Kim
- Department of Neurology, Gangnam Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea
| | - Kwang Ik Yang
- Department of Neurology, Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan, Korea
| | - Chang-Ho Yun
- Department of Neurology, Bundang Clinical Neuroscience Institute, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Min Kyung Chu
- Department of Neurology, Severance Hospital, Yonsei University, College of Medicine, Seoul, Korea.
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When a Head Is about to Burst: Attachment Mediates the Relationship Between Childhood Trauma and Migraine. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17124579. [PMID: 32630556 PMCID: PMC7344657 DOI: 10.3390/ijerph17124579] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/21/2020] [Accepted: 06/23/2020] [Indexed: 12/18/2022]
Abstract
Background: People exposed to childhood trauma show insecure attachment patterns and are more prone to chronic and pain-related conditions, including migraine. The aim of this study was to explore the mediating role of attachment in the association between childhood trauma and adulthood chronic health conditions, with a focus on migraine. Methods: Respondents from a representative sample of citizens of the Czech Republic (n = 1800, mean age: 46.6 years, 48.7% male) were asked to report various chronic and pain-related conditions, childhood trauma (The Childhood Trauma Questionnaire, CTQ), and attachment anxiety and avoidance (The Experience in Close Relationships Revised, ECR-R) in a cross-sectional, questionnaire-based survey conducted in 2016. Structural equation models (SEM) adjusted for sociodemographic variables were used to assess the relationship between childhood trauma, adulthood attachment, and adulthood chronic health conditions (migraine, other pain-related conditions, chronic health conditions other than pain, no chronic health complaints). Results: After adjusting for sociodemographic variables, SEM confirmed a significant mediation of the relationship between childhood trauma and migraine through adulthood attachment. There was no mediation effect of adulthood attachment found in other health complaints. Conclusion: This study highlights the mediation effect of attachment in the link between childhood trauma and migraine. Attachment-based therapeutic interventions can be useful in the treatment of patients with migraine.
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Hammond NG, Colman I. The Role of Positive Health Behaviors in the Relationship Between Early Life Stress and Migraine. Headache 2020; 60:1111-1123. [PMID: 32320053 DOI: 10.1111/head.13808] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 03/18/2020] [Accepted: 03/22/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND The use of diet and physical activity in alleviating the burden of migraine is unclear, therefore, more scientific study on the role of positive health behaviors in migraine management is needed. OBJECTIVE To explore the potential moderating influence of positive health behaviors on the early life stress-migraine relationship in a sample of the Canadian adult population. METHODS This study used data from the 2011-2012 Canadian Community Health Survey - Annual Component, a National cross-sectional survey. Adults ≥18 years of age residing in British Columbia were surveyed about stressors experienced as children/teenagers (eg, parental divorce and substance abuse exposure). Migraine was self-report of health-professional diagnosis. Positive health behaviors were measured using an index of transportation and leisure time physical activity, and self-reported frequency of vegetable and fruit consumption. Population survey weights were employed throughout and analytic models were adjusted for known confounders (nunweighted = 11,910). RESULTS The weighted prevalence of migraine was 9.7% (95% CI: 9.1%, 10.2%). Odds of migraine increased as number of stressors increased: 1 early life stressor (OR = 1.18, 95% CI: 1.01, 1.39), and ≥ 2 early life stressors (OR = 1.51, 95% CI: 1.29, 1.76), compared to no stress. There was evidence of effect modification by physical activity (χ2 (4) = 16.02, P < .001). The association between 1 early life stressor and migraine was lower for those who were physically active (moderately active: OR = 1.20, 95% CI: 0.90, 1.61; active: OR = 0.82, 95% CI: 0.61, 1.11). This difference was not apparent for those who experienced 2 or more early life stressors (moderately active: OR = 1.67, 95% CI: 1.28, 2.17; active: OR = 1.55, 95% CI: 1.21, 1.99). Across all levels of early life stress, physically active respondents had lower odds of migraine than moderately active respondents. There was no effect modification by vegetable, fruit, and total fruit/vegetable consumption. CONCLUSIONS Stressors experienced early in life are associated with migraine, and physical activity may ameliorate this relationship, particularly for those with exposure to a minimal level of early life stress. A higher dose of physical activity may yield greater benefit than a less intensive dose (ie, moderate activity level). However, the cross-sectional nature of this study precludes us from inferring causality, and future investigation requires prospectively collected data.
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Affiliation(s)
- Nicole G Hammond
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.,Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
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Mansuri F, Nash MC, Bakour C, Kip K. Adverse Childhood Experiences (ACEs) and Headaches Among Children: A Cross‐Sectional Analysis. Headache 2020; 60:735-744. [DOI: 10.1111/head.13773] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/09/2020] [Accepted: 01/09/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Fahad Mansuri
- College of Public Health University of South Florida Tampa FL USA
| | | | - Chighaf Bakour
- College of Public Health University of South Florida Tampa FL USA
| | - Kevin Kip
- College of Public Health University of South Florida Tampa FL USA
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Fuller-Thomson E, Hodgins GA. Suicide Attempts among Those with Migraine: Findings from a Nationally Representative Canadian Study. Arch Suicide Res 2020; 24:360-379. [PMID: 30945611 DOI: 10.1080/13811118.2019.1578710] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
The objectives of this study were to identify the gender-specific prevalence of suicide attempts among those with migraine and to examine what factors are associated with suicide attempts among migraineurs. This study was a nationally representative analysis of the 2012 Canadian Community Health Survey - Mental Health (CCHS-MH) with 21,744 respondents, of whom 2,223 had migraine. Bivariate and logistic regression analyses were conducted. Those with migraine had a much higher prevalence of ever attempting suicide than those without migraine (men: 7.5% vs 1.9%; women; 9.3% vs 2.7%, p < .001). Among migraineurs, the odds of suicide attempts were higher among poorer respondents, those in chronic pain and those with a history of childhood adversities, substance dependence and/or mental illness. Targeted outreach is needed to reduce suicidality in this vulnerable population.
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Hammond NG, Orr SL, Colman I. Early Life Stress in Adolescent Migraine and the Mediational Influence of Symptoms of Depression and Anxiety in a Canadian Cohort. Headache 2019; 59:1687-1699. [DOI: 10.1111/head.13644] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2019] [Indexed: 11/27/2022]
Affiliation(s)
- Nicole G. Hammond
- School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada
| | - Serena L. Orr
- Department of Pediatrics University of Calgary Calgary AB Canada
| | - Ian Colman
- School of Epidemiology and Public Health University of Ottawa Ottawa ON Canada
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Dresler T, Caratozzolo S, Guldolf K, Huhn JI, Loiacono C, Niiberg-Pikksööt T, Puma M, Sforza G, Tobia A, Ornello R, Serafini G. Understanding the nature of psychiatric comorbidity in migraine: a systematic review focused on interactions and treatment implications. J Headache Pain 2019; 20:51. [PMID: 31072313 PMCID: PMC6734261 DOI: 10.1186/s10194-019-0988-x] [Citation(s) in RCA: 102] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 03/27/2019] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Migraine is a highly prevalent and disabling neurological disorder which is commonly linked with a broad range of psychiatric comorbidities, especially among subjects with migraine with aura or chronic migraine. Defining the exact nature of the association between migraine and psychiatric disorders and bringing out the pathophysiological mechanisms underlying the comorbidity with psychiatric conditions are relevant issues in the clinical practice. METHODS A systematic review of the most relevant studies about migraine and psychiatric comorbidity was performed using "PubMed", "Scopus", and "ScienceDirect" electronic databases from 1 January 1998 to 15 July 2018. Overall, 178 studies met our inclusion criteria and were included in the current review. RESULTS According to the most relevant findings of our overview, the associations with psychiatric comorbidities are complex, with a bidirectional association of major depression and panic disorder with migraine. Importantly, optimizing the pharmacological and non-pharmacological treatment of either migraine or its psychiatric comorbidities might help clinicians to attenuate the burden of both these conditions. CONCLUSIONS The available data highlight the need for a comprehensive evaluation of psychiatric disorders in migraine in order to promote an integrated model of care and carefully address the burden and psychosocial impairment related to psychiatric comorbidities in migraine.
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Affiliation(s)
- Thomas Dresler
- Department of Psychiatry & Psychotherapy, University Hospital Tuebingen, Tuebingen, Germany.,LEAD Graduate School & Research Network, University of Tuebingen, Tuebingen, Germany
| | - Salvatore Caratozzolo
- Neurology Unit - Neurological and Vision Sciences Department, ASST Spedali Civili of Brescia, Brescia, Italy
| | - Kaat Guldolf
- Department of Neurology, University Hospital Brussels, Jette, Belgium
| | - Jana-Isabel Huhn
- Praxis Gendolla, Specialized care for Psychiatry, Neurology, Psychotherapy and Pain Therapy, Essen, Germany
| | - Carmela Loiacono
- Child Neuropsychiatry school, University of Palermo, Palermo, Italy
| | | | - Marta Puma
- Headache Centre & Neurocritical Care Unit, Department of Human Neurosciences, Sapienza - University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Giorgia Sforza
- Child Neurology Unit, Department of Neuroscience and Neurorehabilitation, Headache Center, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Anna Tobia
- Child Neuropsychiatry Unit, ASL 3, Turin, Italy
| | - Raffaele Ornello
- Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, L'Aquila, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), Section of Psychiatry, University of Genoa, Genoa, Italy. .,IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy.
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Fuller-Thomson E, Kotchapaw LD. Remission From Suicidal Ideation Among Those in Chronic Pain: What Factors Are Associated With Resilience? THE JOURNAL OF PAIN 2019; 20:1048-1056. [PMID: 30979638 DOI: 10.1016/j.jpain.2019.02.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 01/27/2019] [Accepted: 02/15/2019] [Indexed: 10/27/2022]
Abstract
Although there have been many studies on the link between chronic pain and suicidality, surprisingly little research has focused on resilience and recovery among those in chronic and disabling pain who have had suicidal thoughts. The objectives of this study were to identify the prevalence and correlates of recovery from suicidal thoughts among those in chronic pain. A secondary analysis of a nationally representative sample of Canadians in chronic and disabling pain who had ever had serious suicidal thoughts (N = 635) was conducted to identify the prevalence and characteristics of those who are no longer considering suicide. Data were drawn from the Canadian Community Health Survey-Mental Health. Three in five Canadians in chronic pain (63%) who had seriously considered suicide at some point in their life had been free of these thoughts in the past year. Those free of suicidal ideation were significantly more likely to be older, women, white, better educated, with a confidant, and to use spirituality to cope, but less likely to have low household incomes, difficulties meeting basic expenses, and a history of depression and anxiety disorders. PERSPECTIVE: Almost two-thirds of formerly suicidal Canadians with chronic pain were free from suicidal thoughts in the past year. These findings provide a hopeful message of resilience and recovery in the context of disabling pain and help to improve targeted outreach to those most at risk for unremitting suicidality.
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Affiliation(s)
- Esme Fuller-Thomson
- Institute for Life Course & Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.
| | - Lyndsey D Kotchapaw
- Institute for Life Course & Aging, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada
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Riedl D, Beck T, Exenberger S, Daniels J, Dejaco D, Unterberger I, Lampe A. Violence from childhood to adulthood: The influence of child victimization and domestic violence on physical health in later life. J Psychosom Res 2019; 116:68-74. [PMID: 30654997 DOI: 10.1016/j.jpsychores.2018.11.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 11/26/2018] [Accepted: 11/27/2018] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Previous research has shown a detrimental effect of child victimization (CV) on physical disease and mortality. Additionally, individuals with adverse experiences in childhood frequently face domestic violence (DV) in later life. As DV has also been observed to harm physical health, a potential cumulative effect has been proposed. Currently, however, only limited data on such a cumulative effect and its impact on patients' physical health are available. METHODS A cross-sectional observational study at the University Hospital of Innsbruck was conducted. Data on CV, DV and physical health were collected using self-report questionnaires. To evaluate the impact of CV and DV on patients' health, odds ratios (OR) were calculated using binary logistic regression. RESULTS A total of 1480 patients from various departments participated in the study. CV was found for 38% and DV for 16% of participants. A significantly higher occurrence of physical disease was observed in patients with poly-victimization (4+ CVs). When accounting for the cumulative effect of CV and DV, the occurrence was further increased for musculoskeletal disorders (OR:5.1), chronic pain (OR:5.0), gastrointestinal diseases (OR:3.0), metabolic diseases (OR:2.8) and respiratory diseases (OR:2.4). CONCLUSION CV and DV were found to be prevalent and highly correlated in patients treated in a primary care hospital. CV and DV - individually, combined and cumulatively - may thus present risks for physical health. Screening patients for the risk of DV as well as assessing CV may aid in early identification and initiation of psychosocial interventions to avoid further aggravation of physical and psychological problems.
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Affiliation(s)
- David Riedl
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Thomas Beck
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Silvia Exenberger
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria
| | - Judith Daniels
- Department of Clinical Psychology, University of Groningen, Groningen, The Netherlands
| | - Daniel Dejaco
- Department of Otorhinolaryngology - Head and Neck Surgery, Medical University of Innsbruck, Innsbruck, Austria
| | - Iris Unterberger
- Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Astrid Lampe
- University Clinic of Medical Psychology, Medical University of Innsbruck, Innsbruck, Austria.
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Häuser W, Brähler E, Schmutzer G, Glaesmer H. The association of adverse childhood experiences and of resilience with chronic noncancer pain in the German adult population - A cross-sectional survey. Eur J Pain 2018; 23:555-564. [DOI: 10.1002/ejp.1329] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2018] [Revised: 09/18/2018] [Accepted: 10/10/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Winfried Häuser
- Department Psychosomatic Medicine and Psychotherapy; Technische Universität München; Munich Germany
- Department Internal Medicine 1; Klinikum Saarbrücken; Saarbrücken Germany
| | - Elmar Brähler
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
- Clinic for Psychosomatic Medicine and Psychotherapy; University Medical Center Johannes Gutenberg University Mainz; Mainz Germany
| | - Gabriele Schmutzer
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
| | - Heide Glaesmer
- Department of Medical Psychology and Medical Sociology; University of Leipzig; Leipzig Germany
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A Critical Exploration of Migraine as a Health Disparity: the Imperative of an Equity-Oriented, Intersectional Approach. Curr Pain Headache Rep 2018; 22:79. [PMID: 30291549 DOI: 10.1007/s11916-018-0731-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
PURPOSE OF REVIEW Despite recognition of rising prevalence and significant burden, migraine remains underestimated, underdiagnosed, and undertreated. This is especially true among groups who have been historically, socially, and economically marginalized such as communities of color, women, people experiencing poverty, people with lower levels of education, and people who hold more than one of these marginalized identities. While there is growing public and professional interest in disparities in migraine prevalence, there is a paucity of research focusing on racial/ethnic and socioeconomic disparities, and the social and structural determinants of health and equity that perpetuate these disparities. From a health equity perspective, migraine research and treatment require an examination not only of biological and behavioral factors, but of these identities and underlying, intersecting social and structural determinants of health. RECENT FINDINGS Significant disparities in migraine incidence, prevalence, migraine-related pain and disability, access to care, and quality of care persist among marginalized and underserved groups: African Americans, Hispanics, people experiencing poverty, un- or under-employment, the un- and under-insured, people who have been exposed to stressful and traumatic events across the lifespan, and people experiencing multiple, overlapping marginalized identities. These same groups are largely underrepresented in migraine research, despite bearing disproportionate burden. Current approaches to understanding health disparities in migraine largely assume an essentializing approach, i.e., documenting differences between single identity groups-e.g., race or income or education level-rather than considering the mechanisms of disparities: the social and structural determinants of health. While disparities in migraine are becoming more widely acknowledged, we assert that migraine is more aptly understood as a health equity issue, that is, a condition in which many of the health disparities are avoidable. It is important in research and clinical practice to consider perspectives that incorporate a cultural understanding of racial, ethnic, and socioeconomic identity within and across all levels of society. Incorporating perspectives of intersectionality provides a strong foundation for understanding the role of these complex combination of factors on migraine pain and treatment. We urge the adoption of intersectional and systems perspectives in research, clinical practice, and policy to examine (1) interplay of race, gender, and social location as key factors in understanding, diagnosing, and treating migraine, and (2) the complex configurations of social and structural determinants of health that interact to produce health inequities in migraine care. An intentional research and clinical focus on these factors stands to improve how migraine is identified, documented, and treated among marginalized populations.
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Hawkins JL, Moore NJ, Miley D, Durham PL. Secondary traumatic stress increases expression of proteins implicated in peripheral and central sensitization of trigeminal neurons. Brain Res 2018. [PMID: 29522721 DOI: 10.1016/j.brainres.2018.03.003] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The pathology of migraine, a common neurological disease, involves sensitization and activation of trigeminal nociceptive neurons to promote hyperalgesia and allodynia during an attack. Migraineurs often exhibit characteristics of a hyperexcitable or hypervigilant nervous system. One of the primary reported risk factors for development of a hyperexcitable trigeminal system is chronic, unmanaged stress and anxiety. While primary traumatic stress is a commonly cited risk factor for many pain conditions, exposure to secondary traumatic stress early in life is also thought to be a contributing risk factor. The goal of this study was to investigate cellular changes within the spinal trigeminal nucleus and trigeminal ganglion mediated by secondary traumatic stress. Male Sprague Dawley rats (sender) were subjected to forced swim testing (primary traumatic stress) and were then housed in close visual, olfactory, and auditory proximity to the breeding male and female rats, pregnant female rats, or female rats and their nursing offspring (all receivers). In response to secondary stress, levels of calcitonin gene-related peptide, active forms of the mitogen activated protein kinases ERK, JNK, and p38, and astrocyte expression of glial fibrillary acidic protein were significantly elevated in the spinal trigeminal nucleus in day 45 offspring when compared to naïve offspring. In addition, increased nuclear expression of ERK and p38 was observed in trigeminal ganglion neurons. Our results demonstrate that secondary traumatic stress promotes cellular events associated with prolonged trigeminal sensitization in the offspring, and provides a mechanism of how early life stress may function as a risk factor for migraine.
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Affiliation(s)
- J L Hawkins
- Missouri State University, JVIC-CBLS, 524 North Boonville Avenue, Springfield, MO 65806, United States
| | - N J Moore
- Missouri State University, JVIC-CBLS, 524 North Boonville Avenue, Springfield, MO 65806, United States
| | - D Miley
- Missouri State University, JVIC-CBLS, 524 North Boonville Avenue, Springfield, MO 65806, United States
| | - P L Durham
- Missouri State University, JVIC-CBLS, 524 North Boonville Avenue, Springfield, MO 65806, United States.
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Xie P, Wu K, Zheng Y, Guo Y, Yang Y, He J, Ding Y, Peng H. Prevalence of childhood trauma and correlations between childhood trauma, suicidal ideation, and social support in patients with depression, bipolar disorder, and schizophrenia in southern China. J Affect Disord 2018; 228:41-48. [PMID: 29223913 DOI: 10.1016/j.jad.2017.11.011] [Citation(s) in RCA: 124] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2017] [Revised: 09/20/2017] [Accepted: 11/04/2017] [Indexed: 01/19/2023]
Abstract
BACKGROUND Childhood trauma has long-term adverse effects on physical and psychological health. Previous studies demonstrated that suicide and mental disorders were related to childhood trauma. In China, there is insufficient research available on childhood trauma in patients with mental disorders. METHODS Outpatients were recruited from a psychiatric hospital in southern China, and controls were recruited from local communities. The demographic questionnaire, the Childhood Trauma Questionnaire-Short Form (CTQ-SF), and the Social Support Rating Scale (SSRS) were completed by all participants, and the Self-rating Idea of Suicide Scale (SIOSS) were completed only by patients. Prevalence rates of childhood trauma were calculated. Kruskal-Wallis test and Dunnett test were used to compare CTQ-SF and SSRS scores between groups. Logistic regression was used to control demographic characteristics and examine relationships between diagnosis and CTQ-SF and SSRS scores. Spearman's rank correlation test was conducted to analyze relationships between suicidal ideation and childhood trauma and suicidal ideation and social support. RESULTS The final sample comprised 229 patients with depression, 102 patients with bipolar, 216 patient with schizophrenia, and 132 healthy controls. In our sample, 55.5% of the patients with depression, 61.8% of the patients with bipolar disorder, 47.2% of the patients with schizophrenia, and 20.5% of the healthy people reported at least one type of trauma. In patient groups, physical neglect (PN) and emotional neglect (EN) were most reported, and sexual abuse (SA) and physical abuse (PA) were least reported. CTQ-SF and SSRS total scores, and most of their subscale scores in patient groups were significantly different from the control group. After controlling demographic characteristics, mental disorders were associated with higher CTQ-SF scores and lower SSRS scores. CTQ-SF scores and number of trauma types were positively correlated with the SIOSS score. Negative correlations existed between SSRS scores and the SIOSS score. LIMITATIONS Our sample may not be sufficiently representative. Some results might have been interfered by demographic characteristics. The SIOSS was not completed by controls. Data from self-report scales were not sufficiently objective. CONCLUSIONS In southern China, childhood trauma is more severe and more prevalent in patients with mental disorders (depression, bipolar disorder and schizophrenia) than healthy people. Among patients with mental disorders in southern China, suicidal ideation is associated with childhood trauma and poor social support.
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Affiliation(s)
- Peng Xie
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Kai Wu
- Department of Biomedical Engineering, School of Materials Science and Engineering, South China University of Technology, Guangzhou, China
| | - Yingjun Zheng
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yangbo Guo
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yuling Yang
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Jianfei He
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Yi Ding
- Department of Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China
| | - Hongjun Peng
- Department of Clinical Psychology, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou 510370, China.
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Dos Santos Gomes C, Pirkle CM, Zunzunegui MV, Taurino Guedes D, Fernandes De Souza Barbosa J, Hwang P, Oliveira Guerra R. Frailty and life course violence: The international mobility in aging study. Arch Gerontol Geriatr 2018; 76:26-33. [PMID: 29454241 DOI: 10.1016/j.archger.2018.02.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 01/04/2018] [Accepted: 02/04/2018] [Indexed: 12/22/2022]
Abstract
OBJECTIVE To estimate the prevalence of frailty in older adults in the IMIAS population, to examine associations between lifelong domestic violence and frailty and possible pathways to explain these associations. METHODS A cross-sectional study with 2002 men and women in the International Mobility in Aging Study, aged between 65 and 74 years old living in five cities of Tirana (Albania), Natal (Brazil), Kingston and Saint-Hyacinthe (Canada), and Manizales (Colombia). Domestic physical and psychological violence by family and intimate partner was assessed by the Hurt, Insult, Threaten and Scream (HITS) scale. Fried's phenotype was adopted to define frailty. Logistic regressions were fitted to estimate between frailty and lifelong violence. Mediation analyses using the Preacher and Hayes method was used to examine potential health pathways. RESULTS Frailty prevalence varies across cities, being lowest in Saint-Hyacinthe and Kingston, and highest in women in Natal. Women had a higher prevalence in Tirana and Natal. Adjusting for age, sex, education and research city, those reporting childhood physical abuse (CPA) had higher odds of frailty (OR = 1.68; 95% CI: 1.01; 2.78); those who had been exposed to psychological violence by their intimate partner had also higher odds of frailty (OR = 2.07; 95% CI: 1.37; 3.12). CPA effect on frailty was totally mediated by chronic conditions and depression symptoms. Effects of psychological violence by intimate partner were partially mediated by chronic conditions and depression symptoms. CONCLUSIONS Childhood physical abuse and psychological violence during adulthood leave marks on life trajectory, being conducive to adverse health outcomes and frailty in old age.
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Affiliation(s)
- Cristiano Dos Santos Gomes
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil.
| | - Catherine McLean Pirkle
- Office of Public Health Studies, University of Hawaii, 2500 Campus Rd., Honolulu, HI 96822, United States
| | - Maria Vitoria Zunzunegui
- Department of Social Medicine, Montreal University, 2900 Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Dimitri Taurino Guedes
- Department of Physioterapy, Faculty of Health Sciences of Trairí, Federal University of Rio Grande Do Norte, R. Teodorico Bezerra, 2-122, Santa Cruz, RN, 59200-000, Brazil
| | - Juliana Fernandes De Souza Barbosa
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil
| | - Phoebe Hwang
- Department of Social Medicine, Montreal University, 2900 Boulevard Edouard-Montpetit, Montréal, QC, H3T 1J4, Canada
| | - Ricardo Oliveira Guerra
- Department of Physioterapy, Federal University of Rio Grande Do Norte, Avenida Senador Salgado Filho, 3000, Lagoa Nova, Natal, RN, 59064-741, Brazil
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A Conceptual Framework for Understanding the Role of Adverse Childhood Experiences in Pediatric Chronic Pain. Clin J Pain 2017; 33:264-270. [PMID: 27275737 DOI: 10.1097/ajp.0000000000000397] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES This review outlines a conceptual framework adapted from the biopsychosocial model of pain to examine the relationship between adverse childhood experiences (ACEs) and chronic pain in youth to highlight the state of current research and guide future efforts. METHODS A review of the literature was performed in the areas of ACEs and health outcomes with general adult and pediatric populations in addition to studies within the pain literature. Potential relationships between ACEs, chronic pain, and its impact in youth are outlined and discussed. RESULTS The literature suggests an association between adverse outcomes of ACEs and chronic pain in children and adolescents although causal links have not been confirmed. However, ACEs are associated with multiple risk factors identified in the biopsychosocial model of pain, and may serve to exacerbate or confer heightened risk for pain and poor outcomes. DISCUSSION Adverse experiences in childhood may be associated with greater risk for the development/maintenance of chronic pain in youth. More research is needed on ACEs and how they uniquely affect the biopsychosocial mechanisms underlying chronic pain in children throughout the lifespan.
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Karmakar M, Elhai JD, Amialchuk AA, Tietjen GE. Do Personality Traits Mediate the Relationship Between Childhood Abuse and Migraine? An Exploration of the Relationships in Young Adults Using the Add Health Dataset. Headache 2017; 58:243-259. [DOI: 10.1111/head.13206] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/20/2017] [Indexed: 12/22/2022]
Affiliation(s)
- Monita Karmakar
- Department of Neurology; University of Toledo; Toledo OH USA
- School of Population Health; University of Toledo; Toledo, OH USA
| | - Jon D. Elhai
- Department of Psychology; University of Toledo; Toledo OH USA
- Department of Psychiatry; University of Toledo; Toledo OH USA
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Tietjen GE, Karmakar M, Amialchuk AA. Emotional Abuse History and Migraine Among Young Adults: A Retrospective Cross-Sectional Analysis of the Add Health Dataset. Headache 2016; 57:45-59. [DOI: 10.1111/head.12994] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 09/06/2016] [Accepted: 10/14/2016] [Indexed: 11/30/2022]
Affiliation(s)
| | - Monita Karmakar
- Department of Health and Recreation Professions; University of Toledo; Toledo OH USA
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Fuller-Thomson E, Ramzan N, Baird SL. Arthritis and suicide attempts: findings from a large nationally representative Canadian survey. Rheumatol Int 2016; 36:1237-48. [DOI: 10.1007/s00296-016-3498-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2015] [Accepted: 05/12/2016] [Indexed: 10/21/2022]
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Gelaye B, Do N, Avilla S, Velez JC, Zhong QY, Sanchez SE, Peterlin BL, Williams MA. Childhood Abuse, Intimate Partner Violence and Risk of Migraine Among Pregnant Women: An Epidemiologic Study. Headache 2016; 56:976-86. [PMID: 27242154 PMCID: PMC4907863 DOI: 10.1111/head.12855] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 04/11/2016] [Accepted: 04/11/2016] [Indexed: 01/03/2023]
Abstract
OBJECTIVE To examine the independent and joint associations of childhood abuse and intimate partner violence with migraine among pregnant women. BACKGROUND Childhood abuse and intimate partner violence have each been associated with migraine headaches in previous studies, but these associations have not been explored among pregnant women. METHODS A cross-sectional study was conducted among a cohort of 2970 pregnant women attending prenatal clinics in Lima, Peru. History of childhood abuse (ie, physical or sexual abuse) was assessed using the Childhood Physical and Sexual Abuse Questionnaire. Intimate partner violence (IPV) was assessed using the World Health Organization questionnaire. Migraine classification (including migraine and probable migraine) was based on International Classification of Headache Disorders (ICHD)-III beta criteria. Multivariable logistic regression analyses were performed to estimate odd ratios (OR) and 95% confidence intervals (95% CI). RESULTS The prevalence of any migraine was 33.5% while approximately 70% of participants reported a history of childhood abuse and 36.7% a history of IPV. Women with a history of any childhood abuse had a 38% increased odds of any migraine compared to women with no history of childhood abuse (OR = 1.38; 95% CI 1.15-1.64). The odds of migraine increased with increasing numbers of experienced childhood abuse events (Ptrend < .001). Additionally, after adjusting for confounders women with a history of IPV had a 43% increased odds of any migraine as compared to women without intimate partner violence (OR = 1.43; 95%CI 1.02-2.02). Women with a joint positive history of childhood abuse and IPV, as compared with the reference group, had a 88% increased odds of migraine (aOR = 1.88, 95%CI: 1.51-2.35). CONCLUSION Childhood abuse and IPV are associated with increased odds of migraine in pregnant women. Our findings highlight the importance of screening for abuse among pregnant migraineurs to help guide treatment strategies.
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Affiliation(s)
- Bizu Gelaye
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Ngan Do
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Samantha Avilla
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Juan Carlos Velez
- Hospital del Trabajador, Asociación Chilena de Seguridad, Santiago, Chile
| | - Qiu-Yue Zhong
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Sixto E. Sanchez
- Asociación Civil PROESA, Lima, Peru
- Universidad Peruana de Ciencias Aplicados, Lima, Peru
| | - B. Lee Peterlin
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michelle A. Williams
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
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Abstract
OPINION STATEMENT Maltreatment during childhood increases vulnerability to a host of health disorders, including migraine. Putative mechanisms linking maltreatment and migraine include stress-induced dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis, as well as disruption of other stress-mediating homeostatic systems, including those involving endocannabinoids, monoamine neurotransmitters, oxytocin, and inflammation. Prolonged elevation of glucocorticoids alters the neural architecture of the limbic system, resulting in the structural as well as functional changes described in both maltreatment and in migraine. Although treatment trials for migraine have not stratified participants by abuse history, strategies, such as cognitive behavioral therapy, which alter stress responsivity, may be particularly effective in this subgroup. Some therapies involving the endocannabinoid, serotonergic, oxytonergic, and inflammatory systems are under investigation for migraine. Anti-epileptic drugs such as valproate and topiramate, which are FDA approved for migraine treatment, are also known to interfere with epigenetic changes induced by stress. Discerning the role for this mechanism in treatment of maltreated migraineurs may introduce another therapeutic avenue.
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Affiliation(s)
- Gretchen E Tietjen
- Department of Neurology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave. MS 1195, Toledo, OH, 43615, USA.
| | - Dawn C Buse
- Albert Einstein College of Medicine, Bronx, NY, USA.,Montefiore Headache Center, Bronx, NY, USA
| | - Stuart A Collins
- Department of Neurology, University of Toledo College of Medicine and Life Sciences, 3000 Arlington Ave. MS 1195, Toledo, OH, 43615, USA
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