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Nilles C, Williams JV, Patten SB, Pringsheim TM, Orr SL. Lifestyle Factors Associated With Frequent Recurrent Headaches in Children and Adolescents: A Canadian Population-Based Study. Neurology 2024; 102:e209160. [PMID: 38417103 DOI: 10.1212/wnl.0000000000209160] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 12/07/2023] [Indexed: 03/01/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Lifestyle behaviors have been postulated to affect headache frequency in youth and are often the primary target of self-management recommendations. Our study aimed to assess the association between various lifestyle factors and frequent recurrent headaches in children and youth. METHODS Children and adolescents aged 5-17 years were enrolled in a large cross-sectional Canadian population-based health survey, completed on January 31, 2019. Headache frequency was dichotomized into "approximately once/week or less" or ">once/week" (defined as frequent recurrent headaches). The association between frequent headaches and meal schedules, screen exposure, physical activity, chronotype, and frequent substance use/exposure (alcohol, cigarettes, electronic cigarettes, and cannabis) was assessed using both unadjusted logistic regression models and models adjusted for age/sex. Fully adjusted models examined the odds of frequent headaches according to all exposures. Survey design effects were accounted for using bootstrap replicate weighting. RESULTS There were an estimated nweighted = 4,978,370 eligible participants in the population. The mean age was 10.9 years (95% CI 10.9-11.0); 48.8% were female; 6.1% had frequent headaches. Frequent headaches were associated with older age (odds ratio [OR] = 1.31, 95% CI 1.28-1.34, p < 0.001) and female sex (OR = 2.39, 95% CI 2.08-2.75, p < 0.001). In models adjusted for age/sex, the odds of frequent headaches decreased with meal regularity (adjusted OR [aOR] = 0.90, 95% CI 0.89-0.92, p < 0.001) and increased with later chronotype (aOR = 1.10, 95% CI 1.05-1.15, p < 0.001) and excess screen exposure (≥21 hours vs none in past week: aOR = 2.97, 95% CI 1.53-5.77, p = 0.001); there was no significant association with reported physical activity (aOR = 0.95, 95% CI 0.67-1.34, p = 0.77). In 12- to 17-year-olds, frequent headaches were associated with frequent alcohol use (≥1/wk vs never: aOR = 3.50, 95% CI 2.18-5.62, p < 0.001), binge drinking (≥5 times in past month vs never: aOR = 5.52, 95% CI 2.95-10.32, p < 0.001), smoking cigarettes (daily vs never: aOR = 3.81, 95% CI 1.91-7.62, p < 0.001), using e-cigarettes (daily vs never: aOR = 3.10, 95% CI 2.29-4.20, p < 0.001), and cannabis use (daily vs never: aOR = 3.59, 95% CI 2.0-6.45, p < 0.001). In the entire sample, daily exposure to smoking inside the house was associated with frequent headaches (aOR = 2.00, 95% CI 1.23-3.27, p = 0.005). DISCUSSION Several lifestyle behaviors were associated with frequent headaches in children and youth, such as meal irregularity, late chronotype, prolonged screen exposure, and frequent substance use/exposure, suggesting that these are potential modifiable risk factors to target in this population.
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Affiliation(s)
- Christelle Nilles
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Jeanne V Williams
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Scott B Patten
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Tamara M Pringsheim
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
| | - Serena L Orr
- From the Department of Clinical Neurosciences (C.N., S.B.P., T.M.P.), Psychiatry, Pediatrics and Community Health Sciences; Department of Community Health Sciences (J.V.W.), University of Calgary; Mathison Centre for Mental Health Research and Education (S.B.P., T.M.P., S.L.O.); Hotchkiss Brain Institute (T.M.P., S.L.O.); Department of Clinical Neurosciences (T.M.P., S.L.O.); and Departments of Pediatrics and Community Health Sciences (S.L.O.), Cumming School of Medicine, University of Calgary, Alberta, Canada
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Zhang Y, Huang W, Pan S, Shan Z, Zhou Y, Gan Q, Xiao Z. New management strategies for primary headache disorders: Insights from P4 medicine. Heliyon 2023; 9:e22285. [PMID: 38053857 PMCID: PMC10694333 DOI: 10.1016/j.heliyon.2023.e22285] [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] [Received: 06/05/2023] [Revised: 09/21/2023] [Accepted: 11/08/2023] [Indexed: 12/07/2023] Open
Abstract
Primary headache disorder is the main cause of headache attacks, leading to significant disability and impaired quality of life. This disorder is increasingly recognized as a heterogeneous condition with a complex network of genetic, environmental, and lifestyle factors. However, the timely diagnosis and effective treatment of these headaches remain challenging. Precision medicine is a potential strategy based on P4 (predictive, preventive, personalized, and participatory) medicine that may bring new insights for headache care. Recent machine learning advances and widely available molecular biology and imaging data have increased the usefulness of this medical strategy. Precision medicine emphasizes classifying headaches according to their risk factors, clinical presentation, and therapy responsiveness to provide individualized headache management. Furthermore, early preventive strategies, mainly utilizing predictive tools, are critical in reducing headache attacks and improving the quality of life of individuals with headaches. The current review comprehensively discusses the potential application value of P4 medicine in headache management.
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Affiliation(s)
| | | | - Songqing Pan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zhengming Shan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Yanjie Zhou
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Quan Gan
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
| | - Zheman Xiao
- Department of Neurology, Renmin Hospital of Wuhan University, Wuhan, Hubei Province, China
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Błaszczyk B, Straburzyński M, Więckiewicz M, Budrewicz S, Niemiec P, Staszkiewicz M, Waliszewska-Prosół M. Relationship between alcohol and primary headaches: a systematic review and meta-analysis. J Headache Pain 2023; 24:116. [PMID: 37612595 PMCID: PMC10463699 DOI: 10.1186/s10194-023-01653-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 08/15/2023] [Indexed: 08/25/2023] Open
Abstract
BACKGROUND Headache is one of the most common neurological symptoms. Many previous studies have indicated a relationship between primary headaches and alcohol. Drinking has been associated with increased risk of tension-type headache (TTH) and migraine. However, recently published studies have not confirmed this relationship. The existing literature is inconclusive; however, migraine patients avoid alcohol. Therefore, the primary objective was to provide a reliable assessment of alcohol intake in people with primary headaches; the secondary objective was to identify any potential relationship between alcohol consumption and headache risk. METHODS This study was based on PubMed, Embase and Web of Science database searches performed on 11 July 2023. This systematic review was registered in PROSPERO (CRD42023412926). Risk of bias for the included studies was assessed using the Joanna Briggs Institute critical appraisal tools. Meta-analyses were performed using Statistica software. The Risk Ratio (RR) was adopted as the measure of the final effect. Analyses were based on a dichotomous division of the respondents into "non-drinkers" and "drinkers" for headache patients and matched non-headache groups. RESULTS From a total of 1892 articles, 22 were included in the meta-analysis. The majority demonstrated a moderate or high risk of bias. The first part of the meta-analysis was performed on data obtained from 19 migraine studies with 126 173 participants. The risk of migraine in alcohol drinkers is approximately 1.5 times lower than in the group of non-drinkers (RR = 0.71; 95% CI: 0.57-0.89). The second part involved 9 TTH studies with 28 715 participants. No relationship was found between TTH diagnosis and alcohol consumption (RR = 1.09; 95% CI: 0.93-1.27). Two of the included cluster-headache articles had inconclusive results. CONCLUSIONS Alcohol consumption and migraine are inversely correlated. The exact mechanism behind this observation may indicate that migraine leads to alcohol-avoidance, rather than alcohol having any protective role against migraine. There was no relationship between TTH and drinking. However, further studies related to primary headaches and alcohol consumption with low risk of bias are required. Additionally, patients and physicians should consider the latest medical data, in order to avoid the myths about alcohol consumption and primary headaches.
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Affiliation(s)
| | - Marcin Straburzyński
- Department of Family Medicine and Infectious Diseases, University of Warmia and Mazury, Olsztyn, Poland
| | - Mieszko Więckiewicz
- Department of Experimental Dentistry, Wroclaw Medical University, Wroclaw, Poland
| | - Sławomir Budrewicz
- Department of Neurology, Wroclaw Medical University, Borowska 213 Str, 50-556, Wroclaw, Poland
| | - Piotr Niemiec
- Faculty of Medicine, Wroclaw Medical University, Wroclaw, Poland
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Physical Activity and Recurrent Pain in Children and Adolescents in Germany—Results from the MoMo Study. CHILDREN 2022; 9:children9111645. [PMID: 36360373 PMCID: PMC9689024 DOI: 10.3390/children9111645] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Revised: 10/20/2022] [Accepted: 10/27/2022] [Indexed: 11/05/2022]
Abstract
Recurrent pain can be a significant disruption in the activities of daily life, and is not only a health problem in adults but also in children and adolescents. This study analyzed the prevalence of recurrent pain in the current sample (n = 1516; 11–17 years (meanage = 14.4 ± 2.0 years); 50.8% female) of a nationwide study in Germany, evaluated the association of participants’ device-based physical activity (PA) with the prevalence of recurrent pain, and assessed whether children and adolescents who reported pain for the last three months accumulated less PA than those who did not. A higher prevalence was found in girls for recurrent headaches (42.2% vs. 28.7%), abdominal pain (28.2% vs. 20.1%), and back pain (26.9% vs. 19.5%). We found higher odds for recurrent headaches in girls (OR = 1.54) and in participants that did not reach at least 60 min of moderate to vigorous PA (MVPA) per day (OR = 2.06). Girls who reported recurrent headaches accumulated 4.7 min less MVPA per day than those without. The prevalence of pain remains at a high level in the German youth and underscores the need for interventions to improve the health situations of children and adolescents.
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Implication of High Body Fat Percentage on Migraine Chronification in Premenopausal Females. Neurol Res Int 2022; 2022:8219254. [PMID: 36284543 PMCID: PMC9588375 DOI: 10.1155/2022/8219254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Revised: 08/10/2022] [Accepted: 09/29/2022] [Indexed: 11/18/2022] Open
Abstract
Background Chronic migraine, being a debilitating headache disorder, needs assessment of the risk factors implicated in its occurrence. We investigated the potential role of obesity as a risk for chronic migraine in premenopausal females with episodic migraine. Methods In this analytical study, body fat% was compared between episodic and chronic migraine patient groups. The standard criteria of the international classification of headache disorder were used for the diagnosis. Demographic data, clinical details of migraine, and anthropometric measurements were collected using structured questions and standardized techniques. Pearson's correlation (r) was estimated to assess the concordance between body fat% and migraine frequency. High body fat%'s implication on chronic migraine which was adjusted for body mass index (BMI), and the use of oral contraceptives was determined using logistic regression analysis. Results A total of 168 premenopausal female migraineurs, with a mean (Standard deviation) age of 33.0 (±9.0) years, were enrolled in the study. BMI and high body fat% were significantly associated with chronic migraine (p < 0.05). There was a weak positive, but significant, correlation between body fat% and migraine frequency (r = 0.185, p < 0.017). The presence of high body fat was found to increase the risk of chronic migraine by 2.8 times (confidence interval 1.4–5.6; p < 0.003). Conclusion The amount of fat mass in the body relates to the clinical characteristics of migraine. There is an increased risk of developing chronic migraine in patients having high body fat. Weight control measures can be targeted for the prevention of migraine worsening.
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Lund J, Berring-Uldum A, Colak M, Debes NMM. Headache in Children and Adolescents: The Association between Screen Time and Headache within a Clinical Headache Population. Neuropediatrics 2022; 53:221-226. [PMID: 34905787 DOI: 10.1055/s-0041-1740550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND More than half of children and adolescents have experienced headache within the last 3 months. Several risk factors for headache have been identified, including obesity and lack of sleep. The association between screen time and headache in children and adolescents is sparsely investigated. The aim of this study was to assess this association and evaluate if it varied according to headache diagnosis. METHOD This cross-sectional study was performed at the tertiary pediatric outpatient clinic for headache at Herlev University Hospital. A total of 139 participants who answered a questionnaire on lifestyle factors and their daily living were included. Diagnoses of migraine and tension-type headache (TTH) were made according to the International Classification of Headache Disorders-3. Children with both migraine and TTH were allocated to a mixed headache group. We differentiated between total, leisure, and school-related screen time. RESULTS The mean age was 13.20 ± 3.38 years and 53.2% were girls. Note that 25.2% were diagnosed with migraine without aura, 23.0% migraine with aura, 28.1% TTH, 15.8% mixed headache, and 7.9% had an unclassified headache diagnosis at the time of inclusion. There was no statistically significant difference in screen time across the five headache groups. An association between screen time and headache frequency was found in children with migraine with aura. CONCLUSION In this study, we investigated the association between screen time and headache in children and adolescents. More screen time was associated with more frequent headaches in children with migraine with aura. Future prospective studies are needed to determine the causality of this association.
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Affiliation(s)
- Josefine Lund
- Department of Pediatrics, Herlev University Hospital, Copenhagen, Denmark
| | | | - Merve Colak
- Department of Pediatrics, Herlev University Hospital, Copenhagen, Denmark
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Bonfert MV, Sollmann N, Renner T, Börner C, Urban G, Schandelmaier P, Hannibal I, Huß K, Parisi C, Gerstl L, Vill K, Blaschek A, Koenig H, Klose B, Heinen F, Landgraf MN, Albers L. Burden of disease and lifestyle habits in adolescents and young adults prone
to frequent episodic migraine: A secondary comparative analysis. J Child Health Care 2022; 26:215-227. [PMID: 33955272 PMCID: PMC9194962 DOI: 10.1177/13674935211008712] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to assess the burden of disease and prevalence of lifestyle factors for adolescents and young adults with frequent episodic migraine. We conducted a secondary comparative analysis of data collected during two previous studies. Inclusion criteria for this analysis were age 15-35 years, 15 to 44 migraine episodes within 12 weeks, and completeness of Migraine Disability Assessment and lifestyle questionnaire data. Datasets of 37 adults (median age [interquartile range]: 25 [6]) and 27 adolescents (median age [interquartile range]: 15 [1]) were analyzed. 81% (n = 30) of adults reported severe disability (16% [n = 3] of adolescents; p < 0.001). Headache frequency (24 vs. 17 days; p = 0.005) and prevalence of regular analgesic use (60% [n = 22] vs. 18% [n = 5]; p = 0.002) were significantly higher in adults. In adults, sleep duration on weekdays was significantly lower (8.5 vs. 10 h; p < 0.001). Any consumption of caffeine tended to be higher in adolescents and alcohol consumption tended to be higher in adults (p > 0.05). This study underlines the importance of educating adolescents and young adults with migraine about lifestyle habits that are likely to interfere with the condition.
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Affiliation(s)
- Michaela V Bonfert
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Michaela V Bonfert, Department of Pediatric
Neurology and Developmental Medicine and LMU Center for Children with Medical Complexity,
Dr von Hauner Children’s Hospital, LMU Hospital, Lindwurmstraße 4, Munich, Bavaria 80337,
Germany.
| | - Nico Sollmann
- Department of Diagnostic and Interventional
Neuroradiology, Klinikum Rechts der Isar, Technical University of Munich, Germany,TUM-Neuroimaging Center, Klinikum Rechts
der Isar, Technical University of Munich, Germany,Department of Diagnostic and Interventional
Radiology, University Hospital Ulm, Germany
| | - Tabea Renner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Corinna Börner
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Giada Urban
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Paul Schandelmaier
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Iris Hannibal
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Kristina Huß
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Carmen Parisi
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Gerstl
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Katharina Vill
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Astrid Blaschek
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Helene Koenig
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Birgit Klose
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Florian Heinen
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Mirjam N Landgraf
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany
| | - Lucia Albers
- Department of Pediatric Neurology and
Developmental Medicine and LMU Center for Children with Medical Complexity, Dr von Hauner
Children’s Hospital, Ludwig-Maximilians-Universität, Germany,Department of Neurosurgery, Klinikum Rechts
der Isar, Technical University of Munich, Germany
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Frobel W, Grafe N, Meigen C, Vogel M, Hiemisch A, Kiess W, Poulain T. Substance use in childhood and adolescence and its associations with quality of life and behavioral strengths and difficulties. BMC Public Health 2022; 22:275. [PMID: 35144574 PMCID: PMC8831000 DOI: 10.1186/s12889-022-12586-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substance use in childhood and adolescence continues to be a current health concern. The aims of the present study were to identify trends in the use of alcohol, cigarettes, and cannabis in children and adolescents in the last 10 years and to assess associations between substance use and quality of life and behavioral strengths and difficulties. METHODS Substance use was examined in 1829 9- to 18-year-old German children and adolescents participating in the LIFE Child cohort study between 2011 and 2020. Quality of life was investigated using the KIDSCREEN-27 questionnaire. The Strength and Difficulties Questionnaire was used to assess behavioral strengths and difficulties. Associations were assessed using linear regression analyses. All effects were adjusted for age, gender, and family socio-economic status. RESULTS 38.44% of participants reported drinking alcohol at least sometimes. Smoking (6.23%) and the use of cannabis (3.94%) were less frequent. While we observed no significant changes in smoking between 2011 and 2021, the consumption of cannabis and the frequent consumption of alcohol has increased in this time period. Cigarette and cannabis use were associated with additional symptoms of hyperactivity/inattention and reduced prosocial behavior. For all three substances, usage was associated with more conduct problems. We also found significant associations between substance use and a lower quality of life in the areas of physical wellbeing, psychological wellbeing, parent relation and autonomy, and school environment. One noteworthy finding was that cigarette consumption and frequent alcohol use were associated with higher quality of life in terms of social support/peer group relations. Some significant interactions between substance use and child age indicated that associations between substance use and quality of life or behavioral difficulties were stronger in younger than in older children. CONCLUSIONS The results show that quality of life and behavioral difficulties are associated with substance use and should be considered when developing or implementing preventive measures to counter substance use. Furthermore, the findings indicate that substance use can be accompanied by improved peer relations. Therefore, the influence of peers, especially of peers who use these substances, should not be underestimated.
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Affiliation(s)
- Wiebke Frobel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany. .,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany.
| | - Nico Grafe
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Christof Meigen
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany
| | - Mandy Vogel
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Andreas Hiemisch
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Wieland Kiess
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
| | - Tanja Poulain
- LIFE Leipzig Research Center for Civilization Diseases, Leipzig University, Philipp-Rosenthal-Strasse 27, 04103, Leipzig, Germany.,Department of Women and Child Health, University Hospital for Children and Adolescents and Center for Pediatric Research, Leipzig University, Liebigstrasse 20a, 04103, Leipzig, Germany
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Landgraf MN, Heinen F, Gerstl L, Kainz C, Ruscheweyh R, Straube A, Scheidt J, von Mutius S, Obermeier V, von Kries R. Comparison of a pediatric practice-based therapy and an interdisciplinary ambulatory treatment in social pediatric centers for migraine in children: a nation-wide randomized-controlled trial in Germany: "moma - modules on migraine activity". BMC Pediatr 2021; 21:294. [PMID: 34193110 PMCID: PMC8241883 DOI: 10.1186/s12887-021-02757-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 06/06/2021] [Indexed: 11/22/2022] Open
Abstract
Background Migraine is common in childhood, peaks in adolescents and persists into adulthood in at least 40% of patients. There is need for early interventions to improve the burden of disease and, if possible, reduce chronification. The aim of the project is to compare two types of ambulatory treatment strategies regarding their effect on headache days and quality of life in 6 to 11 year old children with migraine: 1) the routine care in pediatricians’ practices (intervention group A) and 2) a structured interdisciplinary multimodal intervention administered at social pediatric centers (intervention group B). Methods The study is a nation-wide cluster-randomized study. Based on the postal codes the regions are randomly assigned to the two intervention-strategies. Children with migraine are recruited in the pediatric practices, as common outpatient-care in the German health-care system. Parents rate headache frequency, intensity and acute medication intake at a daily basis via a digital smartphone application specifically designed for the study. Migraine-related disability and quality of life are assessed every 3 months. Study duration is 9 months for every participant: 3 months of baseline at the pediatric practice (both groups); 3 months of intervention at the pediatric practice (intervention group A) or at the social pediatric center (intervention group B), respectively; 3 months of follow-up at the pediatric practice (both groups). Discussion Results of the planned comparison of routine care in pediatric practices and interdisciplinary social pediatric centers will be relevant for treatment of children with migraine, both for the individual and for the health care system. Trial registration The study was approved by the ethics committee at the Ludwig-Maximilians-University Munich (number 18–804) and was retrospectively registered on 27 April 2021 in the WHO approved German Clinical Trials Register (number DRKS00016698).
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Affiliation(s)
- Mirjam N Landgraf
- Department for Neuropediatrics, Developmental Medicine and Social Pediatrics, LMU Center for Development and Children with Medical Complexity - iSPZ Hauner, Dr. von Haunersches Kinderspital, Kinderklinik und Kinderpoliklink der Ludwig Maximilians Universitat Munchen, Munich, Germany.
| | - Florian Heinen
- Department for Neuropediatrics, Developmental Medicine and Social Pediatrics, LMU Center for Development and Children with Medical Complexity - iSPZ Hauner, Dr. von Haunersches Kinderspital, Kinderklinik und Kinderpoliklink der Ludwig Maximilians Universitat Munchen, Munich, Germany
| | - Lucia Gerstl
- Department for Neuropediatrics, Developmental Medicine and Social Pediatrics, LMU Center for Development and Children with Medical Complexity - iSPZ Hauner, Dr. von Haunersches Kinderspital, Kinderklinik und Kinderpoliklink der Ludwig Maximilians Universitat Munchen, Munich, Germany
| | - Christine Kainz
- Department for Neuropediatrics, Developmental Medicine and Social Pediatrics, LMU Center for Development and Children with Medical Complexity - iSPZ Hauner, Dr. von Haunersches Kinderspital, Kinderklinik und Kinderpoliklink der Ludwig Maximilians Universitat Munchen, Munich, Germany
| | - Ruth Ruscheweyh
- Department of Neurology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Andreas Straube
- Department of Neurology, Ludwig-Maximilians-Universitat Munchen, Munich, Germany
| | - Joerg Scheidt
- Hochschule Hof, Institute of Information Systems, Hof, Germany
| | - Sabine von Mutius
- Ludwig-Maximilians-Universitat Munchen, Institute for Social Pediatrics and Adolescent Medicine, Munich, Germany
| | - Viola Obermeier
- Ludwig-Maximilians-Universitat Munchen, Institute for Social Pediatrics and Adolescent Medicine, Munich, Germany
| | - Ruediger von Kries
- Ludwig-Maximilians-Universitat Munchen, Institute for Social Pediatrics and Adolescent Medicine, Munich, Germany
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Wijga AH, Gehring U, van de Putte EM, Koppelman GH, Vader S, Schmits RJ, van der Wouden JC, Picavet HSJ. Headache in girls and boys growing up from age 11 to 20 years: the Prevention and Incidence of Asthma and Mite Allergy birth cohort study. Pain 2021; 162:1449-1456. [PMID: 33230003 PMCID: PMC8054541 DOI: 10.1097/j.pain.0000000000002141] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2020] [Revised: 10/19/2020] [Accepted: 11/02/2020] [Indexed: 01/18/2023]
Abstract
ABSTRACT The striking difference between men and women in headache prevalence is suggested to develop in adolescence. Although headaches are common and affect quality of life and daily functioning, the evidence needed to develop effective counselling and preventive approaches is still limited. Using data collected at age 11, 14, 17, and 20 years in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort study (n = 3064 with ≥ 1 questionnaire), we assessed headache prevalence and incidence in girls and boys and explored associations with early life, environmental, lifestyle, health, and psychosocial factors. Associations were analysed longitudinally with generalized linear mixed models and discrete time hazard models. From age 11 to 20 years, the prevalence of headache increased from 9.4% to 19.8% in girls and hardly changed in boys (7.6%-6.1%). Headache commonly co-occurred with other unfavorable health and psychosocial conditions. Eighty-eight percent of the girls and 76% of boys with headache also reported at least one of the following at age 17: sleeping problems, asthma, hay fever, musculoskeletal complaints, fatigue, low mental health, or worrying. Results suggest higher headache prevalence in adolescents following lower educational tracks, in those who skip breakfast ≥2 days per week, and in boys exposed to tobacco smoke in infancy. In girls, sleeping problems and musculoskeletal complaints were associated with higher odds of incident headache and residential greenness with lower odds of incident headache. The high prevalence and strong female predominance of headache, already in adolescence and often with comorbidities, deserve recognition by professionals in (preventive) health care settings and schools.
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Affiliation(s)
- Alet H. Wijga
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ulrike Gehring
- Institute for Risk Assessment Sciences, Utrecht University, the Netherlands
| | | | - Gerard H. Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, University of Groningen, University Medical Center Groningen, Beatrix Children's Hospital, GRIAC Research Institute, Groningen, the Netherlands
| | - Sarah Vader
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
| | - Ruben J.H. Schmits
- Division Preventive Youth Health Care, Public Health Services Region Utrecht (GGD Regio Utrecht), the Netherlands
| | - Johannes C. van der Wouden
- Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - H. Susan J. Picavet
- Centre for Nutrition, Prevention, and Health Services, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
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11
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The Influence of Lifestyle Factors on the Burden of Pediatric Migraine. J Pediatr Nurs 2021; 57:79-83. [PMID: 33353788 DOI: 10.1016/j.pedn.2020.12.003] [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: 05/08/2020] [Revised: 12/02/2020] [Accepted: 12/03/2020] [Indexed: 11/21/2022]
Abstract
There is a gap in patient education and coaching of lifestyle factors related to pediatric migraine, which nurses are in a unique position to fill in order to provide comprehensive care to these patients. In order to help fill this gap, we conducted a targeted review of studies examining migraine and lifestyle factors in children and adolescents. Studies older than 2010, studies examining adults above the age of 18, studies not available in the English language, and secondary sources were excluded from the review. A final sample of 42 studies was included in this review. Lifestyle factors including stress, sleep, obesity, and diet were identified as playing a significant role in increasing the frequency, severity, and duration of migraine attacks in pediatric patients. Based on these findings, a framework is discussed for practical applications of this knowledge by nursing staff working in primary and specialty care clinics.
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12
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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13
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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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14
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Landgraf MN, Kainz C, Gerstl L, Klose B, Mathonia N, Bonfert M, Ruscheweyh R, Straube A, von Mutius S, von Kries R, Heinen F. Kinder mit Migräne. Monatsschr Kinderheilkd 2020. [DOI: 10.1007/s00112-020-00994-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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15
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Hancı F, Kabakuş N, Türay S, Bala KA, Dilek M. The role of obesity and vitamin D deficiency in primary headaches in childhood. Acta Neurol Belg 2020; 120:1123-1131. [PMID: 30963478 DOI: 10.1007/s13760-019-01134-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2019] [Accepted: 04/02/2019] [Indexed: 02/01/2023]
Abstract
This study evaluates the role of obesity, overweight and vitamin D deficiency in primary headaches in childhood. This retrospective observational study included pediatric patients aged 5-17 years admitted to the pediatric neurology clinic with headaches between January 2015 and August 2018 and diagnosed with primary headache based on ICHD III-beta criteria. The control group consisted of healthy children without headache admitted to the pediatric outpatient clinic for check-ups before engaging in athletic or school activities. The control and patient groups were at the same risk of low 25(OH)D3 levels. The study population was divided into three groups-patients with migraine (group A), patients with tension-type headache (TTH) (group B) and the control group (group C). Participants' demographic data, medical histories, physical examination findings and laboratory results were retrieved retrospectively from the patient charts. BMI was significantly higher in patients with primary headache, the risk of primary headache increasing in patients with a BMI in excess of 25. Comparison of the patients with primary headache and the control group revealed lower 25(OH)D levels in the primary headache group, although the difference was not statistically significant. Girls with primary headache had significantly lower 25(OH)D levels than boys. A relationship may be present between overweight, obesity and primary headache, while female gender may be suggested as a negative factor for primary headache. Patients should be advised to lose weight if BMI indicates overweight or obesity.
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16
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[Migraine in childhood and adolescence-neurostimulation as a future innovative approach in terms of a multimodal treatment regimen]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2020; 63:872-880. [PMID: 32504242 DOI: 10.1007/s00103-020-03169-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Although migraine is a relevant health issue in children and adolescents, clinical care and research are still underrepresented and underfunded in this field. Quality of life can be significantly reduced when living with frequent episodes of pain. Due to the high level of vulnerability of the developing brain during adolescence, the risk of chronification and persistence into adulthood is high. In this narrative review, we describe the corner stones of a patient-centered, multimodular treatment regimen. Further, an update on the pathophysiology of migraine is given considering the concept of a periodically oscillating functional state of the brain in migraine patients ("migraine is a brain state"). Besides central mechanisms, muscular structures with the symptoms of muscular pain, tenderness, or myofascial trigger points play an important role. Against this background, the currently available nonpharmacological and innovative neuromodulating approaches are presented focusing on the method of repetitive peripheral magnetic stimulation.
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17
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Walter SM, Banvard-Fox C, Cundiff C. Evaluation and Treatment of Primary Headaches in Adolescents. Prim Care 2020; 47:241-256. [PMID: 32423712 DOI: 10.1016/j.pop.2020.02.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Headache is a common episodic and chronic pain syndrome in adolescents. Evaluation of headaches in primary care requires a comprehensive assessment including lifestyle behaviors and physical examination, as well as an understanding of when to pursue appropriate testing. Primary headache disorders seen in adolescents include migraine and tension-type headache. Pharmacologic management for primary headache includes both acute and prophylactic treatment strategies.
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Affiliation(s)
- Suzy Mascaro Walter
- West Virginia University School of Nursing, 64 Medical Center Drive, Morgantown, WV 26505, USA.
| | - Christine Banvard-Fox
- Department of Pediatrics, Division of Adolescent Medicine, WVU Medicine, West Virginia University, 6040 University Town Center Drive, Morgantown, WV 26501, USA
| | - Courtney Cundiff
- Department of Emergency Medicine, WVU Medicine, West Virginia University, 1 Medical Center Drive, Morgantown, WV, 26505, USA
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18
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Headache Hygiene in Pediatrics: Brushing Up on the Basics. Pediatr Neurol 2020; 103:3-7. [PMID: 31843350 DOI: 10.1016/j.pediatrneurol.2019.10.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 10/02/2019] [Accepted: 10/10/2019] [Indexed: 01/18/2023]
Abstract
Headache hygiene refers to self-management behaviors and practices aimed at reducing headache-related disability and improving self-efficacy. Although self-management interventions have an established place in the management of a wide range of chronic conditions, there is still not a standardized approach to this in pediatric headache. In this article, we focus on headache hygiene approaches including education, lifestyle interventions, and psychologic interventions. We also present our center's resource compilation, made available to patients by quick response code technology, as an example of a structured approach to headache hygiene. Further work should explore a standardized approach to headache hygiene and strategies to support adherence, including the use of technology as an innovative health care delivery pathway.
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La Touche R, Fernández Pérez JJ, Proy Acosta A, González Campodónico L, Martínez García S, Adraos Juárez D, Serrano García B, Angulo‐Díaz‐Parreño S, Cuenca‐Martínez F, Suso‐Martí L, Paris‐Alemany A. Is aerobic exercise helpful in patients with migraine? A systematic review and meta‐analysis. Scand J Med Sci Sports 2020; 30:965-982. [DOI: 10.1111/sms.13625] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Revised: 12/18/2019] [Accepted: 01/02/2020] [Indexed: 12/20/2022]
Affiliation(s)
- Roy La Touche
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN) Madrid Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ) Madrid Spain
| | - Juan José Fernández Pérez
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Alejandro Proy Acosta
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Lisandro González Campodónico
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Sergio Martínez García
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Daniel Adraos Juárez
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Beatriz Serrano García
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Santiago Angulo‐Díaz‐Parreño
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Facultad de Medicina Universidad CEU San Pablo Madrid Spain
| | - Ferran Cuenca‐Martínez
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
| | - Luis Suso‐Martí
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Departamento de Fisioterapia Universidad CEU Cardenal Herrera CEU Universities Valencia Spain
| | - Alba Paris‐Alemany
- Departamento de Fisioterapia Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Motion in Brains Research Group Institute of Neuroscience and Sciences of the Movement (INCIMOV) Centro Superior de Estudios Universitarios La Salle Universidad Autónoma de Madrid Madrid Spain
- Instituto de Neurociencia y Dolor Craneofacial (INDCRAN) Madrid Spain
- Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ) Madrid Spain
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20
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[Headache, abdominal and back pain in children and adolescents in Germany : Results from KiGGS Wave 2 and trends]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2019; 62:1184-1194. [PMID: 31529183 DOI: 10.1007/s00103-019-03007-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Pain not only causes suffering in children and adolescents, but also leads to school absenteeism, medication intake, medical treatment, and an increased risk of recurrent pain in adulthood. OBJECTIVES Based on data from the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS Wave 2, 2014-2017), the 3‑month prevalence of recurrent headache, abdominal and back pain in girls and boys is reported, and is compared with the prevalence from the KiGGS baseline survey (2003-2006). The consequences of recurrent headache were also explored. MATERIALS AND METHODS Data from >11,000 participants (KiGGS Wave 2) and from >12,000 (KiGGS baseline) participants aged between 3 and 17 years were analyzed. For 3‑ to 10-year-olds, parents/guardians answered the questions, while 11- to 17-year-olds provided information themselves. RESULTS In 3‑ to 10-year-olds, recurrent abdominal pain was most prevalent, affecting one third of girls and one quarter of boys. Headache was the most frequent type of pain in 11- to 17-year-olds, affecting almost every second girl and about every third boy. The 3‑month prevalence of recurrent headache, abdominal and back pain has increased in girls and boys, especially in the age groups 7 to 10 years and 11 to 13 years. Among recurrent headache sufferers, adolescents take medication almost twice as often as children. CONCLUSIONS Headache, abdominal, and back pain are still and with increasing prevalence very common symptoms in children and adolescents in Germany. Their prevention requires a holistic view of children's health in the psychosocial living environment, and healthcare context.
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21
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Evans DS, O'Farrell A, Sheridan A, Kavanagh P. Comparison of the health and well-being of smoking and non-smoking school-aged children in Ireland. Child Care Health Dev 2019; 45:694-701. [PMID: 31039602 DOI: 10.1111/cch.12681] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 04/23/2019] [Accepted: 04/25/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Although most young people are aware of the long-term consequences of smoking, it has been shown that young smokers expect to give up before any health damage occurs. Little is known in an Irish context about the association between smoking and young people's current health. This could be helpful to help reduce smoking initiation and encouraging quitting. The study aimed to determine the association between smoking and health and well-being indicators among Irish school-aged children. METHODS The 2014 Irish Health Behaviour in School-aged Children study was analysed, which comprised a random stratified sample of 9,623 schoolchildren (aged 10-18). The prevalence of eight self-reported health complaints and two subjective well-being measures were compared across strata classified by self-reported smoking status using Pearson's chi square and independent t tests. Logistic regression and ordinal regression were used to control for age, gender, and social class. RESULTS A significantly larger proportion of smokers (p < .001) reported fair to poor health (32% versus 11% for non-smokers), lower mean life satisfaction scores (6.2 compared with 7.5), and each of eight health complaints at least once a week (range = 25-50% compared with 15-21%). These patterns remained significant after adjusting for differences in age, gender, and social class profile (p < .001). CONCLUSIONS The study demonstrates the potential of developing initiatives, which target smoking in adolescence as opposed to the longer term health effects of smoking which are well known. The findings can be utilized to counteract positive perceptions of smoking among schoolchildren. This, combined with providing supports to help children quit, may help achieve government targets to reduce smoking prevalence.
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Affiliation(s)
- David S Evans
- Merlin Park Hospital, Department of Public Health, Health Service Executive West, Galway, Republic of Ireland
| | - Anne O'Farrell
- Health Intelligence Unit, Strategic Planning and Transformation, Research and Development, Health Service Executive, Dublin, Republic of Ireland
| | - Aishling Sheridan
- Tobacco Free Ireland Programme, Health Service Executive, Navan, Republic of Ireland
| | - Paul Kavanagh
- Tobacco Free Ireland Programme, Health Service Executive, Dublin, Republic of Ireland
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Koller LS, Diesner SC, Voitl P. Quality of life in children and adolescents with migraine: an Austrian monocentric, cross-sectional questionnaire study. BMC Pediatr 2019; 19:164. [PMID: 31126268 PMCID: PMC6533686 DOI: 10.1186/s12887-019-1537-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 05/14/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Migraine is a disabling primary headache disorder that occurs in about 10 % of children and might lead to a lower quality of life. There are several possible migraine triggers in a patient's environment, which should be avoided where possible. The objective of this Austrian monocentric study was to identify migraine triggers and the areas, in which children and adolescents with migraine have a lower quality of life than healthy, headache-free children. METHODS In this cross-sectional, questionnaire study, 76 children from ages 8 to 17 years were included. Thirty-seven were classified as migraineurs, 39 as non-migraineurs. Participants filled in a questionnaire surveying the areas of physical, socio-economic and school functioning. Migraineurs further answered migraine-specific questions. RESULTS The study included 33 (43.4%) males and 43 (56.6%) females. Median age was 13.00 (10.00-16.00) years. Average age of onset for migraine was 9.22 ± 3.34 years. Non-migraineurs skipped trendwise fewer meals (p.adjust = 0.108) and exercised more often (p.adjust = 0.108). In socio-economic functioning, the father's nationality being Austrian might be related to migraine (p.adjust = 0.108). Children with migraine had a significantly lower quality of life in school functioning (PedsQL 4.0 questionnaire, p.adjust = 0.04) and had significantly less often "good" grades than children without migraine (p.adjust = 0.048). CONCLUSION Children with migraine show a reduced quality of life in the areas of physical, socio-economic and school functioning.
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Affiliation(s)
- Lydia Stella Koller
- First Vienna Pediatric Medical Center, Donau-City Straße 1, 1220 Vienna, Austria
| | - Susanne C. Diesner
- First Vienna Pediatric Medical Center, Donau-City Straße 1, 1220 Vienna, Austria
| | - Peter Voitl
- First Vienna Pediatric Medical Center, Donau-City Straße 1, 1220 Vienna, Austria
- Sigmund Freud University Vienna, Freudplatz 1, 1020 Vienna, Austria
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23
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Skogvold L, Magnussen LH. Chronic tension-type headache and coping strategies in adolescents: A qualitative interview study. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2019; 24:e1778. [PMID: 31012240 DOI: 10.1002/pri.1778] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 01/22/2019] [Accepted: 03/17/2019] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Headache is the most common cause of chronic pain in children and adolescents and may influence on several of the life's arenas such as high absence from school and inability to maintain leisure time activities. Adolescents with chronic headache also report co-morbidities such as anxiety, depression, insomnia, and reduced quality of life. This study aimed to explore which strategies adolescents use to cope with chronic tension-type headache in everyday life. METHODS A qualitative design with semistructured individual interviews was used. A strategic sample of 17 adolescents aged 14-19 with tension-type headache participated in the study. The interviews were audiotaped and transcribed verbatim. Transcripts were analysed using systematic text condensation. RESULTS To deal with the headache in everyday life, the adolescence expressed that it is important to have a good structure during the day, especially regarding regular meals and enough sleep. Sufficient rest and relaxation were also highlighted as crucial. Some of the adolescence had tried different therapies to help ease the pain but with varying effect. All of the adolescents had used or were using pain relievers, but they were ambivalent to the benefits. Low-intensity physical activity was perceived as beneficial and gave increased overall well-being. Such activity also gave release and distraction from the headache. CONCLUSION The adolescents used both problem-focused active strategies and emotion-focused passive strategies to deal with their headache in daily life. Through exploration and awareness of the types of behaviour that worked and did not work, they had arrived at strategies that helped them cope with their headache and its consequences.
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Affiliation(s)
- Lars Skogvold
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway of Applied and Sciences, Post Box 7030, N-Bergen, Norway
| | - Liv Heide Magnussen
- Faculty of Health and Social Sciences, Department of Health and Functioning, Western Norway of Applied and Sciences, Post Box 7030, N-Bergen, Norway
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Orr SL, Turner A, Kabbouche MA, Horn PS, O'Brien HL, Kacperski J, LeCates S, White S, Weberding J, Miller MN, Powers SW, Hershey AD. Predictors of Short-Term Prognosis While in Pediatric Headache Care: An Observational Study. Headache 2019; 59:543-555. [PMID: 30671933 DOI: 10.1111/head.13477] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVES To characterize the short-term prognosis of a clinical population of pediatric and young adult patients with migraine and explore predictors of clinical worsening while in care. METHODS This was a retrospective study of all migraine patients seen at the Cincinnati Children's Hospital Headache Center from 09/01/2006 to 12/31/2017, who had at least 1 follow-up visit within 1-3 months of the index visit analyzed. Included data were: age, sex, race, primary ICHD diagnosis, chronic migraine, medication overuse, history of status migrainosus, BMI percentile, headache frequency, headache severity, PedMIDAS score, allodynia, preventive treatment type, lifestyle habits, disease duration, depressive and anxiety symptoms. Clinical worsening was defined as an increase in 4 or more headache days per month between the index visit and the follow-up visit. RESULTS Data for 13,160 visit pairs (index and follow-up), from 5316 patients, were analyzed. Clinical worsening occurred in only 14.5% (1908/13,160), whereas a reduction in headache frequency was observed in 56.8% of visit intervals (7475/13,160), with 34.8% of the intervals (4580/13,160) showing a reduction of 50% or greater. The change in headache frequency was minimal (increase in 0-3 headaches/month) in 28.7% of intervals (3737/13,160). In the multivariable model, the odds of worsening were significantly higher with increasing age, female sex, chronic migraine, status migrainosus, depressive symptoms, higher PedMIDAS scores, and use of nutraceuticals, whereas the odds of worsening were lower for summer visits, caffeine drinkers, higher headache frequencies, and use of pharmaceuticals. CONCLUSIONS The majority of pediatric patients who receive multimodal interdisciplinary care for migraine improve over time. Our findings highlight a set of clinical features that may help in identifying specific factors that may contribute to an unfavorable short-term prognosis.
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Affiliation(s)
- Serena L Orr
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Abigail Turner
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Marielle A Kabbouche
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Paul S Horn
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Hope L O'Brien
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joanne Kacperski
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Susan LeCates
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Shannon White
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Jessica Weberding
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Mimi N Miller
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Scott W Powers
- University of Cincinnati College of Medicine, Cincinnati, OH, USA.,Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA
| | - Andrew D Hershey
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.,University of Cincinnati College of Medicine, Cincinnati, OH, USA
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25
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Perry MC, Yaeger SK, Toto RL, Suresh S, Hickey RW. A Modern Epidemic: Increasing Pediatric Emergency Department Visits and Admissions for Headache. Pediatr Neurol 2018; 89:19-25. [PMID: 30343832 PMCID: PMC8485652 DOI: 10.1016/j.pediatrneurol.2018.07.015] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 07/28/2018] [Accepted: 07/28/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE Headaches represent 0.9% to 2.6% of visits to a pediatric emergency department (PED). We noted a trend of increasing visits for headache in our tertiary care PED and sought to further characterize this trend. METHODS We identified PED visits with International Classification of Disease, Ninth Revision, Clinical Modification diagnoses for headache at 25 hospitals in Pediatric Health Information System between 2003 and 2013. To further characterize demographics and treatment trends over time we used the electronic health record in our emergency department to identify children ages four to 18 between January 2007 and December 2014 with International Classification of Disease, Ninth Revision codes for headache: a random sample of 50 visits per year were chosen for chart review. RESULTS Pediatric Health Information System visits for headache increased by 166% (18,041 in 2003 and 48,020 in 2013); by comparison, total PED visits increased by 57.6%. The percent admission increased by 300% (2020 admissions in 2003 and 8087 admissions in 2013). At our hospital, headache visits increased 111% from 896 visits in 2007 to 1887 visits in 2014; total PED visits increased 30.2%. The admission percentage for headache increased 187% with 156 admissions in 2007 and 448 in 2014. Management over time differed in the frequency of head computed tomography which decreased 3.7% per year (r = -0.93, 95% CI -0.99, -0.64) from 34% in 2007 to 18% in 2014. CONCLUSION Pediatric emergency department visits for headache are increasing and a growing proportion of these patients are admitted. This finding identifies a potential patient population to target for interventions to improve outpatient management and reduce pediatric emergency department utilization.
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Affiliation(s)
- Michelle C Perry
- A Children's Hospital of Pittsburgh of UPMC, Department of Pediatrics, Pittsburgh, Pennsylvania.
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26
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Orr SL, Kabbouche MA, O’Brien HL, Kacperski J, Powers SW, Hershey AD. Paediatric migraine: evidence-based management and future directions. Nat Rev Neurol 2018; 14:515-527. [DOI: 10.1038/s41582-018-0042-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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27
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Abstract
PURPOSE OF REVIEW The purpose of this work was to review the current literature on the epidemiology and pathophysiology of pediatric obesity and migraine, underlying pathogenic mechanisms that may explain the association between the two disorders, and the effects of treatment. RECENT FINDINGS In children and adolescents, the bulk of the available data support an association between obesity and headache disorders in general, though a small number of studies contradict these findings. Relative to the adult population, however, few studies have focused specifically on migraine, and no wide-ranging meta-analyses have been conducted to date. It seems that the pathophysiology of obesity and migraine in adults holds true for the pediatric population as well. The association between obesity and migraine in the pediatric population is likely to be multifactorial and to involve both central and peripheral mechanisms. More attention is currently being addressed to the role of the hypothalamus and the bioactive neurotransmitters and neuropeptides that modulate energy homeostasis, namely serotonin, orexin, and the adiponectins, in migraine. A few innovative studies have demonstrated some benefit for migraine from weight reduction treatments such as exercise and lifestyle management. Many open questions remain regarding the modifiable nature of the obesity-migraine relationship and its implications in clinical practice. Further studies of these issues are needed.
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Affiliation(s)
- Tal Eidlitz Markus
- Pediatric Headache Clinic, Day Hospitalization Department, Schneider Children's Medical Center of Israel, 4920235, Petach Tikva, Israel. .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
| | - Irene Toldo
- Juvenile Headache Centre, Department of Woman's and Child's Health, University Hospital of Padua, Padua, Italy
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28
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Lippi G, Mattiuzzi C, Sanchis-Gomar F. Physical exercise and migraine: for or against? ANNALS OF TRANSLATIONAL MEDICINE 2018; 6:181. [PMID: 29951503 DOI: 10.21037/atm.2018.04.15] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Camilla Mattiuzzi
- Service of Clinical Governance, Provincial Agency for Sanitary Services, Trento, Italy
| | - Fabian Sanchis-Gomar
- Leon H. Charney Division of Cardiology, New York University School of Medicine, New York, USA.,Department of Physiology, Faculty of Medicine, University of Valencia and INCLIVA Biomedical Research Institute, Valencia, Spain
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29
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Holstein BE, Andersen A, Denbaek AM, Johansen A, Michelsen SI, Due P. Short communication: Persistent socio-economic inequality in frequent headache among Danish adolescents from 1991 to 2014. Eur J Pain 2018; 22:935-940. [PMID: 29349882 DOI: 10.1002/ejp.1179] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND The association between socio-economic status (SES) and headache among adolescents is an understudied issue, and no study has examined whether such an association changes over time. The aim was to examine trends in socio-economic inequality in frequent headache among 11- to 15-year-olds in Denmark from 1991 to 2014, using occupational social class (OSC) as indicator of SES. METHODS The study applies data from the Danish part of the international Health Behaviour in School-aged Children (HBSC) study. HBSC includes nationally representative samples of 11-, 13- and 15-year-olds. This study combines data from seven data survey years from 1991 to 2014, participation rate 88.6%, n = 31,102. We report absolute inequality as per cent difference in frequent headache between high and low OSC and relative inequality as odds ratio for frequent headache by OSC. RESULTS In the entire study population, 10.4% reported frequent headache. There was a significant increase in frequent headache from 8.0% in 1991 to 12.9% in 2014, test for trend, p < 0.0001. This increasing trend was significant in all OSCs. The prevalence of frequent headache was significantly higher in low than high OSC, OR = 1.50 (95% CI: 1.34-1.67). This socio-economic inequality in frequent headache was persistent from 1991 to 2014. CONCLUSION There was a significant and persistent socio-economic inequality, i.e. increasing prevalence of frequent headache with decreasing OSC. The association between socio-economic position and headache did not significantly change over time, i.e. the statistical interaction between OSC and survey year was insignificant. SIGNIFICANCE The prevalence of frequent headache among adolescents increases with decreasing SES. This socio-economic inequality has been persistent among adolescents in Denmark from 1991 to 2014. Clinicians should be aware of this social inequality.
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Affiliation(s)
- B E Holstein
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A Andersen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A M Denbaek
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - A Johansen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - S I Michelsen
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - P Due
- National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
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30
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Filippopulos FM, Albers L, Straube A, Gerstl L, Blum B, Langhagen T, Jahn K, Heinen F, von Kries R, Landgraf MN. Vertigo and dizziness in adolescents: Risk factors and their population attributable risk. PLoS One 2017; 12:e0187819. [PMID: 29131843 PMCID: PMC5683632 DOI: 10.1371/journal.pone.0187819] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Accepted: 10/26/2017] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To assess potential risk factors for vertigo and dizziness in adolescents and to evaluate their variability by different vertigo types. The role of possible risk factors for vertigo and dizziness in adolescents and their population relevance needs to be addressed in order to design preventive strategies. STUDY DESIGN The study population consisted of 1482 school-children between the age of 12 and 19 years, who were instructed to fill out a questionnaire on different vertigo types and related potential risk factors. The questionnaire specifically asked for any vertigo, spinning vertigo, swaying vertigo, orthostatic dizziness, and unspecified dizziness. Further a wide range of potential risk factors were addressed including gender, stress, muscular pain in the neck and shoulder region, sleep duration, migraine, coffee and alcohol consumption, physical activity and smoking. RESULTS Gender, stress, muscular pain in the neck and shoulder region, sleep duration and migraine were identified as independent risk factors following mutual adjustment: The relative risk was 1.17 [1.10-1.25] for female sex, 1.07 [1.02-1.13] for stress, 1.24 [1.17-1.32] for muscular pain, and 1.09 [1.03-1.14] for migraine. The population attributable risk explained by these risk factors was 26%, with muscular pain, stress, and migraine accounting for 11%, 4%, and 3% respectively. CONCLUSION Several established risk factors in adults were also identified in adolescents. Risk factors amenable to prevention accounted for 17% of the total population risk. Therefore, interventions targeting these risk factors may be warranted.
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Affiliation(s)
- Filipp M. Filippopulos
- Department of Neurology, University Hospital, LMU, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
| | - Lucia Albers
- Institute of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, LMU, Munich, Germany
| | - Andreas Straube
- Department of Neurology, University Hospital, LMU, Munich, Germany
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
| | - Lucia Gerstl
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
| | - Bernhard Blum
- Department of Neurology, University Hospital, LMU, Munich, Germany
| | - Thyra Langhagen
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
| | - Klaus Jahn
- German Center for Vertigo and Balance Disorders, LMU, Munich, Germany
- Department of Neurology, Schön Klinik Bad Aibling, Bad Aibling, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
| | - Rüdiger von Kries
- Institute of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, LMU, Munich, Germany
| | - Mirjam N. Landgraf
- Department of Paediatric Neurology and Developmental Medicine, Hauner Children’s Hospital, LMU, Munich, Germany
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31
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Richter M, Gruhl E, Lautenschläger E, Müller T, Schumann F, Skiera D, Theisinger A, Zimmer U, Berner R, von der Hagen M, Sabatowski R, Hähner A, Gossrau G. [DreKiP - an outpatient treatment program for children and adolescents with headache]. Schmerz 2017; 32:17-29. [PMID: 28956173 DOI: 10.1007/s00482-017-0245-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Headaches are a frequent health problem among children and adolescents. The ocurrence of headaches and the resulting impairments in the quality of life and activities of daily living are modulated by biopsychosocial interactions, which necessitate a complex treatment program. The Dresden Childrens Headache Program (DreKiP) is a multidisciplinary therapy program consisting of eight modules for children and adolescents: education, stress relief, relaxation techniques, physical fitness, climbing therapy, art therapy and sensory training. In addition, there are six modules containing parallel workshops for parents. This outpatient program lasts 2-3 months and is performed parallel to the daily and school routine. Therapy groups consist of 6-8 patients in each age group. In total patients receive 15 h and the parents 7 h of therapy. Concomitant with the program, headache-associated data, such as headache frequency, medication use and school absence are documented. So far 32 children and adolescents in groups of 11, 14-15, 14-16, 17 and 17-18 years old completed the program. Of the 32 patients 19 presented with migraine and tension type headache, 6/32 with migraine and 7/32 with tension type headache only. The median number of headache days was 15 per month and 4 official school absence days per month. Preliminary results 6 months after the end of the therapy program showed reduced frequency of headaches in three quarters of our patients. The headache frequency was reduced from an initial median of 15 days per month to a median of 8 days per month after the program. The multidisciplinary program DreKiP improves the use of therapeutic means in children and adolescents with primary headaches. Children and adolescents with headache-related impairment in activities of daily life in school and leisure times constitute the target group of this therapy.
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Affiliation(s)
- M Richter
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - E Gruhl
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - E Lautenschläger
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - T Müller
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Kinder- und Jugendpsychiatrie und -psychotherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - F Schumann
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - D Skiera
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - A Theisinger
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - U Zimmer
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland
| | - R Berner
- Klinik und Poliklinik für Kinder- und Jugendmedizin, Universitätsklinikum Dresden, Dresden, Deutschland
| | - M von der Hagen
- Abteilung Neuropädiatrie, Medizinische Fakultät Carl Gustav Carus, Technische Universität Dresden, Dresden, Deutschland
| | - R Sabatowski
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.,Klinik und Poliklinik für Anästhesiologie und Intensivtherapie, Universitätsklinikum Dresden, Dresden, Deutschland
| | - A Hähner
- Interdisziplinäres Zentrum für Riechen und Schmecken, Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Dresden, Dresden, Deutschland
| | - G Gossrau
- UniversitätsSchmerzCentrum, Universitätsklinikum Dresden, Fetscherstr. 74, 01307, Dresden, Deutschland.
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Xavier MKA, Pitangui ACR, Silva GRR, Oliveira VMAD, Beltrão NB, Araújo RCD. Prevalence of headache in adolescents and association with use of computer and videogames. CIENCIA & SAUDE COLETIVA 2017; 20:3477-86. [PMID: 26602725 DOI: 10.1590/1413-812320152011.19272014] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2014] [Accepted: 10/01/2014] [Indexed: 01/03/2023] Open
Abstract
The aim of this study was to determine the prevalence of headache in adolescents and its association with excessive use of electronic devices and games. The sample comprised 954 adolescents of both sexes (14 to 19 years) who answered a questionnaire about use of computers and electronic games, presence of headache and physical activity. The binary and multinomial logistic regression, with significance level of 5% was used for inferential analysis. The prevalence of headache was 80.6%. The excessive use of electronics devices proved to be a risk factor (OR = 1.21) for headache. Subjects aged between 14 and 16 years were less likely to report headache (OR = 0.64). Regarding classification, 17.9% of adolescents had tension-type headache, 19.3% had migraine and 43.4% other types of headache. The adolescents aged form 14 to 16 years had lower chance (OR ≤ 0.68) to report the tension-type headache and other types of headache. The excessive use of digital equipment, electronic games and attending the third year of high school proved to be risk factors for migraine-type development (OR ≥ 1.84). There was a high prevalence of headache in adolescents and high-time use of electronic devices. We observed an association between excessive use of electronic devices and the presence of headache, and this habit is considered a risk factor, especially for the development of migraine-type.
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Lazdowsky L, Rabner J, Caruso A, Kaczynski K, Gottlieb S, Mahoney E, LeBel A. "Headache Tools to Stay in School": Assessment, Development, and Implementation of an Educational Guide for School Nurses. THE JOURNAL OF SCHOOL HEALTH 2016; 86:645-652. [PMID: 27492933 DOI: 10.1111/josh.12420] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 02/04/2016] [Accepted: 03/24/2016] [Indexed: 06/06/2023]
Abstract
BACKGROUND Headache is the most common type of pain reported in the pediatric population, and chronic headache is an increasingly prevalent and debilitating pain condition in children and adolescents. With large numbers of students experiencing acute headaches and more students with chronic headache reentering typical school settings, greater availability of tailored evidence-based practice guidelines for school nurses is imperative. METHODS A 2-armed study was developed to assess the need for and evaluate the use and favorability of a headache-driven school nurse guide. Students and their parents were first surveyed on their school nurse's headache knowledge and management skills. School nurses were also interviewed on their desire for a headache educational tool. This feedback aided in developing a headache resource guide. Next, the guide was distributed to school nurses who provided feedback after a 3-month trial. RESULTS Results indicate that "Headache Tools to Stay in School" is a useful resource in facilitating communication among health care providers, students, families, and school personnel on how to best meet the complex needs of students with headaches. CONCLUSIONS Given the guide's favorability, we encourage school nurses to demand the creation of additional evidence-based resources. Continued dissemination of this guide may improve students' headache management under the informed care of school nurses, and may encourage the development of more evidence-based guides across various medical conditions.
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Affiliation(s)
- Lori Lazdowsky
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
| | - Jonathan Rabner
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
| | - Alessandra Caruso
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
| | - Karen Kaczynski
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
- Department of Psychiatry, Harvard Medical School, 9 Hope Avenue, Waltham, MA 02453.
| | - Sarah Gottlieb
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
| | - Elyse Mahoney
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
| | - Alyssa LeBel
- Pediatric Headache Program, Department of Anesthesiology, Perioperative and Pain Medicine, Boston Children's Hospital, 9 Hope Avenue, Waltham, MA 02453.
- Department of Neurology, Harvard Medical School, 9 Hope Avenue, Waltham, MA 02453.
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Abstract
The objectives of this systematic review were to examine age dependency of headache prevalence in school age children and to assess secular trends of headache prevalence in the last decade, gender and regional differences. A literature search was performed in MEDLINE to identify all prevalence studies in children and adolescents. Five hundred seventy studies were found, of which 37 studies could be included for this review. Headache prevalence in school children increases with their age as demonstrated in cohorts of identical children and cross-sectional surveys covering different age groups of children in one population. Regarding a potential general increase in the prevalence of headache in children and adolescents in the last decade, there are four studies which all show some increase of headache prevalence; however, the degree of increase is varying. Prevalence of headache in girls appears to be higher than in boys. There were no clear regional differences in the prevalence of headache.
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36
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Bondi CO, Semple BD, Noble-Haeusslein LJ, Osier ND, Carlson SW, Dixon CE, Giza CC, Kline AE. Found in translation: Understanding the biology and behavior of experimental traumatic brain injury. Neurosci Biobehav Rev 2015; 58:123-46. [PMID: 25496906 PMCID: PMC4465064 DOI: 10.1016/j.neubiorev.2014.12.004] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2014] [Revised: 10/26/2014] [Accepted: 12/02/2014] [Indexed: 12/14/2022]
Abstract
The aim of this review is to discuss in greater detail the topics covered in the recent symposium entitled "Traumatic brain injury: laboratory and clinical perspectives," presented at the 2014 International Behavioral Neuroscience Society annual meeting. Herein, we review contemporary laboratory models of traumatic brain injury (TBI) including common assays for sensorimotor and cognitive behavior. New modalities to evaluate social behavior after injury to the developing brain, as well as the attentional set-shifting test (AST) as a measure of executive function in TBI, will be highlighted. Environmental enrichment (EE) will be discussed as a preclinical model of neurorehabilitation, and finally, an evidence-based approach to sports-related concussion will be considered. The review consists predominantly of published data, but some discussion of ongoing or future directions is provided.
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Affiliation(s)
- Corina O Bondi
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States
| | - Bridgette D Semple
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States; Department of Medicine (Royal Melbourne Hospital), University of Melbourne, Parkville, VIC, Australia
| | - Linda J Noble-Haeusslein
- Neurological Surgery and the Graduate Program in Physical Medicine & Rehabilitation Science, University of California, San Francisco, San Francisco, CA, United States
| | - Nicole D Osier
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; School of Nursing, University of Pittsburgh, Pittsburgh, PA, United States
| | - Shaun W Carlson
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States
| | - C Edward Dixon
- Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Neurological Surgery, University of Pittsburgh, Pittsburgh, PA, United States; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, United States
| | - Christopher C Giza
- Pediatric Neurology and Neurosurgery, University of California, Los Angeles, Los Angeles, CA, United States; UCLA Brain Injury Research Center, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Anthony E Kline
- Physical Medicine & Rehabilitation, University of Pittsburgh, Pittsburgh, PA, United States; Safar Center for Resuscitation Research, University of Pittsburgh, Pittsburgh, PA, United States; Center for Neuroscience, University of Pittsburgh, Pittsburgh, PA, United States; Center for the Neural Basis of Cognition, University of Pittsburgh, Pittsburgh, PA, United States; Psychology, University of Pittsburgh, Pittsburgh, PA, United States; Critical Care Medicine, University of Pittsburgh, Pittsburgh, PA, United States.
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Constantinides V, Anagnostou E, Bougea A, Paraskevas G, Kapaki E, Evdokimidis I, Kararizou E. Migraine and tension-type headache triggers in a Greek population. ARQUIVOS DE NEURO-PSIQUIATRIA 2015. [DOI: 10.1590/0004-282x20150093] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
Migraine and tension type headache are the two most common primary headaches. The purpose of this study was to detect differences in clinical characteristics and headache triggers and in a Greek cohort of 51 migraineurs and 12 patients with tension-type headache. (TTH) Migraine patients had a significantly lower age at headache onset and frequency, higher mean visual analogue scale (VAS) and greater maximum duration of headache episodes compared to TTH patients. They did not differ from (TTH) patients in quality of headache, laterality of pain, way of headache installation and progression and temporal pattern of headaches. Nausea, vomiting and phonophobia were more frequent in migraine. Triggering of headaches by dietary factors was associated with migraine, whereas there was no difference between the two groups in any of the other headache triggers. Stress, both physical and psychological, were particularly common in both patient groups.
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Abstract
BACKGROUND Migraineurs variably attribute the cause of their headache to tobacco exposure, whereas tobacco is often stated to cause headache-related disability worldwide. Given tobacco's physiological and emotional addictiveness and migraine's substantial economic impact, improved functionality can be difficult for those with migraine exposed to tobacco products. Environmental tobacco exposure in indoor spaces and workplaces is associated with exacerbation of headache. Avoidance of headache triggers is included in most comprehensive migraine treatment programs, yet tobacco awareness, avoidance, or coping is rarely emphasized as part of that regimen. OBJECTIVE The aims of this study were to examine the various types of tobacco products to which headache sufferers are exposed and the known basic mechanisms by which tobacco (nicotine) exposure promotes headache pain, and to review the extensive literature on tobacco related to headache with a detailed descriptive narrative providing the basis for conclusions regarding association of noncluster headache-related tobacco exposure. Tobacco-related recommendations are offered. METHODS MEDLINE, EMBASE, and Google Scholar databases were searched without yearly restriction through the date of submission (May 2015), using the MeSH terms "tobacco," "tobacco products," "smoking," "tobacco use," "headache," and "headache disorders." The selection of articles was not limited to English studies or to humans. Articles were excluded when "headache" and "tobacco" were not both mentioned with data provided. Case series were included. Bibliographies of all articles were screened for additional relevant articles. RESULTS Although migraineurs worldwide report tobacco smoke among triggers, it is rarely among the highest in frequency, and biases abound with predominantly noncontrolled retrospective data. Prospective population-based diary data are extremely limited, and no controlled trials exist to confirm a cause and effect for headache of any type. Although some studies are nonsupportive and even conflicting, headache, pain, and tobacco exposure currently remain associated. CONCLUSION Conflicting data support the validity of patient-reported environmental tobacco exposure as a headache trigger. Prospective controlled studies are needed, but unlikely to be performed, to determine the extent that tobacco influences the headache process, in addition to other under-recognized factors. Meanwhile, because of numerous other negative health effects, decreased tobacco exposure should be recommended to headache patients of all ages in hopes of decreasing disability and improving functionality.
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Affiliation(s)
- Frederick R Taylor
- Department of Neurology, University of Minnesota School of Medicine, Minneapolis, MN, USA
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Albers L, Straube A, Landgraf MN, Filippopulos F, Heinen F, von Kries R. Migraine and tension type headache in adolescents at grammar school in Germany - burden of disease and health care utilization. J Headache Pain 2015; 16:534. [PMID: 26055241 PMCID: PMC4467810 DOI: 10.1186/s10194-015-0534-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Accepted: 05/25/2015] [Indexed: 01/03/2023] Open
Abstract
Background Tension-type headache and migraine are among the most prevalent chronic disorders in children/adolescents. Data on health care utilization for headache in this age group, however, are sparse. Methods In 1399 grammar school students (aged 12–19 years) with headache in the last six months in Germany a) the burden of disease for headache (mean intensity, mean frequency in the last three months and PedMIDAS means), b) medical care utilization defined by proportion of students consulting a physician in the last 12 months and/or taking analgetic drugs in the last three months by headache types (migraine and tension-type headache) and by burden of disease were assessed. Results Primary headache substantially impaired daily living activities in adolescents which was mainly related to migraine. Medical care utilization and drug use, however, was low (consulting a physician: 12.0 %, 95 %-CI = [10.3-13.8]; taking analgetic drugs: 29.9 %, 95 %-CI = [27.5-32.4]) - even among students with severe headache (physician consultation: <35 %; taking analgetic drugs: <63 %). Two thirds of students with any headache and 40 % of those with migraine had neither seen a physician nor used analgetic drugs because of their headache in the preceding 12 months. Conclusions Adolescents with headache might too rarely seek professional help for treatment of headache. Health promotion in adolescents should increase awareness for evidence-based treatment options for headache. Electronic supplementary material The online version of this article (doi:10.1186/s10194-015-0534-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Lucia Albers
- Institute of Social Paediatrics and Adolescents Medicine, Division of Epidemiology, Ludwig-Maximilians-University Munich, 80337, Munich, Germany,
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Alterations in the trapezius muscle in young patients with migraine--a pilot case series with MRI. Eur J Paediatr Neurol 2015; 19:372-6. [PMID: 25596902 DOI: 10.1016/j.ejpn.2014.12.021] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2014] [Accepted: 12/30/2014] [Indexed: 01/13/2023]
Abstract
BACKGROUND/PURPOSE Migraine is frequent in young adults and adolescents and often associated with neck muscle tension and pain. Common pathophysiological pathways, such as reciprocal cervico-trigeminal activation, are assumed. Tense areas within the neck muscles can be clinically observed many patients with migraine. The aim of this pilot case study was to visualize these tense areas via magnet resonance imaging (MRI). METHODS Three young patients with migraine were examined by an experienced investigator. In all three patients tense areas in the trapezius muscles were palpated. These areas were marked by nitroglycerin capsules on the adjacent skin surface. RESULTS The MRI showed focal signal alterations at the marked locations within the trapezius muscles. CONCLUSION Visualization of palpable tense areas by MRI may be usefully applied in the future to help elucidate the underlying pathophysiological processes of migraine.
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Straube A, Heinen F, Ebinger F, von Kries R. Headache in school children: prevalence and risk factors. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 110:811-8. [PMID: 24333367 DOI: 10.3238/arztebl.2013.0811] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2012] [Revised: 08/13/2013] [Accepted: 08/13/2013] [Indexed: 01/03/2023]
Abstract
BACKGROUND Recurrent headache is a common problem in school children. Evaluation generally leads to the diagnosis of a primary headache syndrome (migraine or tension-type headache). This review is addressed to the question whether headaches in school children are becoming more common and, if so, what risk factors are associated with the rise in frequency. METHOD We selectively searched the PubMed database for pertinent publications that contained the terms "primary headache AND children/adolescent AND risk factors/prevalence." Articles published in either English or German up to April 2013 were considered. Articles on secondary types of headache were excluded. RESULTS Headaches are becoming more common among school children. At present, 66% to 71% of 12- to 15- year-olds have at least one headache every three months, and 33% to 40% have at least one per week. Headache is often accompanied by other physical and/or emotional manifestations. Studies from Scandinavia reveal increasing prevalence in age groups from 8 years of age and upward. Various studies have identified the following risk factors for headache or for its chronification (up to 5.8-fold elevation of risk): a dysfunctional family situation, the regular consumption of alcohol, caffeine ingestion, smoking, a low level of physical activity, physical or emotional abuse, bullying by peers, unfair treatment in school, and insufficient leisure time. CONCLUSION Headaches are becoming more common among children and adolescents. They are often associated with other physical and emotional complaints.
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Affiliation(s)
- Andreas Straube
- Department of Neurology, University of Munich, Campus Grosshadern, Department of Pediatric Neurology, University of Munich, Campus Innenstadt, Dr. von Haunersches Kinderspital, Clinic for Child and Adolescent Medicine, St. Vincent Hospital, Paderborn, and Center for Child and Adolescent Medicine, University of Heidelberg, Institute of Social Paediatrics and Adolescent Medicine, University of Munich
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Abstract
Concussion is one of the most hotly debated topics in sports medicine today. Research surrounding concussion has experienced significant growth recently, especially in the areas of incidence, assessment, and recovery. However, there is limited research on the most effective rehabilitation approaches for this injury. This review evaluates the current literature for evidence for and against physical and cognitive rest and the emerging areas targeting vestibular, oculomotor, and pharmacologic interventions for the rehabilitation of sport-related concussion.
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Sacco S, Pistoia F, Degan D, Carolei A. Conventional vascular risk factors: their role in the association between migraine and cardiovascular diseases. Cephalalgia 2014; 35:146-64. [PMID: 25505017 DOI: 10.1177/0333102414559551] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Migraine, in particular migraine with aura, has been found to be associated with cardiovascular disease. However, the role of conventional vascular risk factors in the association is still debated. The aim of the present review is to address the association between migraine and conventional cardiovascular risk factors as well as to address their possible role in the association between migraine and cardiovascular disease. METHODS Data for this review were obtained through searches in multiple sources up to May 2014 using the terms "migraine" OR "headache" in combination with all the vascular risk factors of interest. RESULTS Data about the possible association between migraine and high blood pressure values are heterogeneous, hindering any final conclusion. Data addressing the possible association between migraine and diabetes mellitus indicate the lack of any association or in some cases a negative association between the two conditions. The body of evidence on the role of dyslipidemia in migraineurs is relatively homogeneous and, with few exceptions, reports an association between migraine and an unfavorable lipid profile; however, the difference in lipid levels between migraineurs and non-migraineurs is small and its clinical implication unclear. Regarding obesity, a trend has been observed of increased risk of migraine with increasing obesity, especially in young patients, albeit in the midst of conflicting data. Evidence about the association between cigarette smoking and migraine mostly indicates that migraineurs are more commonly smokers than non-migraineurs. On the other hand, the majority of the available studies report less alcohol use in migraineurs than in non-migraineurs. Finally, many of the available studies suggest a more frequent family history of cardiovascular disease in migraineurs as compared to non-migraineurs. Since most of the studies that supported the association between migraine and cardiovascular disease adjusted the analyses for the presence of several vascular risk factors, they cannot entirely explain this association. CONCLUSIONS Based on the available reported data, it seems unlikely that the higher risk of cardiovascular disease in migraineurs is mediated by any single vascular risk factor. For this reason the role of specific interactions among risk factors with the contribution of genetic, environmental, personality and psychological factors should be appropriately investigated.
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Affiliation(s)
- Simona Sacco
- Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy
| | - Francesca Pistoia
- Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy
| | - Diana Degan
- Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy
| | - Antonio Carolei
- Institute of Neurology, Department of Applied Clinical Sciences and Biotechnology, University of L'Aquila, Italy
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Abstract
Childhood obesity and headache are both significant health concerns that often have a marked impact both personally and socially, that if not addressed can carry over into adulthood. For many individuals, these effects may be magnified when obesity and headache are seen in conjunction. It is this overlap between obesity and headache in children, as well as similarities in the known mechanism of action for feeding and headache, which led to a suspected association between the two. Unfortunately, although recent studies have supported this association, only a limited number have been conducted to directly address this. Furthermore, despite rising rates of childhood obesity and headache, the associated medical comorbidities, and the significant financial cost for these conditions, there is a relative void in studies investigating treatment options that address both underlying conditions of obesity and headache in children.
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Albers L, Heinen F, Landgraf M, Straube A, Blum B, Filippopulos F, Lehmann S, Mansmann U, Berger U, Akboga Y, von Kries R. Headache cessation by an educational intervention in grammar schools: a cluster randomized trial. Eur J Neurol 2014; 22:270-6, e22. [PMID: 25244562 DOI: 10.1111/ene.12558] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2014] [Accepted: 07/25/2014] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND PURPOSE Headache is a common health problem in adolescents. There are a number of risk factors for headache in adolescents that are amenable to intervention. The aim of the study was to assess the effectiveness of a low-level headache prevention programme in the classroom setting to prevent these risk factors. METHODS In all, 1674 students in 8th-10th grade at 12 grammar schools in greater Munich, Germany, were cluster randomized into intervention and control groups. A standardized 60-min prevention lesson focusing on preventable risk factors for headache (physical inactivity, coffee consumption, alcohol consumption and smoking) and providing instructions on stress management and neck and shoulder muscle relaxation exercises was given in a classroom setting. Seven months later, students were reassessed. The main outcome parameter was headache cessation. Logistic regression models with random effects for cluster and adjustment for baseline risk factors were calculated. RESULTS Nine hundred students (intervention group N = 450, control group N = 450) with headache at baseline and complete data for headache and confounders were included in the analysis. Headache cessation was observed in 9.78% of the control group compared with 16.22% in the intervention group (number needed to treat = 16). Accounting for cluster effects and confounders, the probability of headache cessation in the intervention group was 1.77 (95% confidence interval = [1.08; 2.90]) higher than in the control group. The effect was most pronounced in adolescents with tension-type headache: odds ratio = 2.11 (95% confidence interval = [1.15; 3.80]). CONCLUSION Our study demonstrates the effectiveness of a one-time, classroom-based headache prevention programme.
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Affiliation(s)
- L Albers
- Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University Munich, Munich, Germany
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Bektaş Ö, Uğur C, Gençtürk ZB, Aysev A, Sireli Ö, Deda G. Relationship of childhood headaches with preferences in leisure time activities, depression, anxiety and eating habits: A population-based, cross-sectional study. Cephalalgia 2014; 35:527-37. [PMID: 25149505 DOI: 10.1177/0333102414547134] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 07/06/2014] [Indexed: 11/15/2022]
Abstract
OBJECTIVES The objective of this article is to determine the relationship between headache frequency and socio-demographic data, personal characteristics, habits, daily activities, daily loss of ability, depression and anxiety in the headache subtypes in the pediatric population. PATIENTS AND METHODS Our sample group was composed of approximately 5355 children aged between 9 and 18 years. An eight-stage questionnaire was administered to the children. In the second stage of the study, headache subtypes were created according to the ICHD-II criteria. The resulting data were compared according to the results of the headache subtypes. RESULTS In school-age children, the prevalence of recurrent headaches was 39.4%, and the prevalence of migraine was 10.3%. The subjects with migraine mostly preferred sedentary activities in their leisure time, and preferred less exercise than the subjects with the other headache types. The PedMIDAS score of the children who preferred to play sports was significantly lower than those who did not prefer to play sports. In the group that preferred reading books, an opposite relationship was found. In overweight and obese migraine sufferers, other types of headache were found to be significantly higher. CONCLUSIONS In the management of treating childhood headaches, the association of psychiatric comorbidities should be considered. To minimize disability, children should be directed to more useful physical activities.
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Affiliation(s)
- Ömer Bektaş
- Department of Pediatric Neurology, Ankara University Medical School, Turkey
| | - Cağatay Uğur
- Department of Child and Adolescent Psychiatry, Ankara University Medical School, Turkey
| | | | - Ayla Aysev
- Department of Child and Adolescent Psychiatry, Ankara University Medical School, Turkey
| | - Özlem Sireli
- Department of Child and Adolescent Psychiatry, Ankara University Medical School, Turkey
| | - Gülhis Deda
- Department of Pediatric Neurology, Ankara University Medical School, Turkey
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Albers L, Straube A, Landgraf MN, Heinen F, von Kries R. High diagnostic stability of confirmed migraine and confirmed tension-type headache according to the ICHD-3 beta in adolescents. J Headache Pain 2014; 15:36. [PMID: 24916858 PMCID: PMC4075938 DOI: 10.1186/1129-2377-15-36] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2014] [Accepted: 04/30/2014] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Stable headache diagnosis classification is a prerequisite for identification of headache type specific risk factors. Does the stability of a headache diagnosis over time vary between migraine and tension-type headache (TTH)? Are there differences in diagnosis stability between a probable and a definite headache diagnosis? FINDINGS In a sample of 783 students (ages 12 to 18 years) participating in a headache intervention study in greater Munich, the stability of headache classification according to the International Classification of Headache Disorder - third edition (beta version) (ICHD-3 beta) after a follow-up of 7 months was examined. Differences in stability of probable or definite migraine and probable or definite TTH were assessed. The stability of the headache diagnosis was assessed as predictive value of headache diagnosis with regard to confirmation of the headache type using the same diagnostic instrument 7 months later. Predictive values with 95% confidence intervals (CI) are reported.Of students with initial migraine, a diagnosis of migraine was confirmed in 65.71% of students after 7 months (95%-CI [59.40-71.64]). A clear distinction between probable (44.71%, 95%-CI [33.91-53.89]) and confirmed diagnosis (76.88% 95%-CI [69.56-83.17]) of migraine was observed. For TTH the predictive value was 62.66% (95%-CI [57.07-68.01]) overall with a lower stability for probable (46.10%, 95%-CI [37.68-54.69]) compared to the confirmed diagnosis (69.71%, 95%-CI [23.58-37.67]). CONCLUSION While confirmed migraine and confirmed TTH diagnoses seem stable over time, stability of a probable diagnosis for either headache type was lower. TRIAL REGISTRATION The trial was registered at the German Clinical Trial Register with the ID DRKS00003308.
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Affiliation(s)
- Lucia Albers
- Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University Munich, Haydnstr. 5, 80337 Munich, Germany
| | - Andreas Straube
- Department of Neurology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Mirjam N Landgraf
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Rüdiger von Kries
- Division of Epidemiology, Institute of Social Paediatrics and Adolescent Medicine, Ludwig-Maximilians-University Munich, Haydnstr. 5, 80337 Munich, Germany
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Blaschek A, Decke S, Albers L, Schroeder AS, Lehmann S, Straube A, Landgraf MN, Heinen F, von Kries R. Self-reported neck pain is associated with migraine but not with tension-type headache in adolescents. Cephalalgia 2014; 34:895-903. [DOI: 10.1177/0333102414523338] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Aim The aim of the present analysis is to confirm or refute the association of neck pain to migraine or tension-type headache and to assess whether this association is independent of other risk factors for headache. Methods Secondary school students were invited to complete a questionnaire on headache and lifestyle factors in a cross-sectional study. Neck pain was assessed via (a) a screening question concerning neck pain and (b) denoting affected areas in schematic drawings of the human body. Results Absolute increment in prevalence of headache with pain in the shoulder-neck region was between 7.5% and 9.6%. Gender, grade, stress and lifestyle factors were assessed as potential confounding factors. Nearly all factors were associated with shoulder-neck pain and most with headache. After adjustment for confounders, the association of neck pain with headache was almost completely confined to migraine (OR 2.39; 95% CI 1.48–3.85) and migraine + tension-type headache (OR 2.12; 95% CI 1.50–2.99), whereas the association with isolated tension-type headache was negligible (OR 1.22, 95% CI 0.87–1.69). Conclusion Neck pain is associated with migraine but not with tension-type headache. A possible link between migraine and neck pain may be the cervico-trigeminal convergence of neck and meningeal sensory afferents or a disturbed descending inhibition in migraine.
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Affiliation(s)
- Astrid Blaschek
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, LMU Munich, Germany
| | - Siona Decke
- Institute of Social Paediatrics and Adolescent Medicine, LMU Munich, Germany
| | - Lucia Albers
- Institute of Social Paediatrics and Adolescent Medicine, LMU Munich, Germany
| | - Andreas Sebastian Schroeder
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, LMU Munich, Germany
- German Center for Vertigo and Balance Disorders, Munich University Hospital, Germany
| | - Steffi Lehmann
- Institute of Social Paediatrics and Adolescent Medicine, LMU Munich, Germany
| | - Andreas Straube
- German Center for Vertigo and Balance Disorders, Munich University Hospital, Germany
- Department of Neurology, Klinikum Großhadern, LMU Munich, Germany
| | - Mirjam N Landgraf
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, LMU Munich, Germany
- German Center for Vertigo and Balance Disorders, Munich University Hospital, Germany
| | - Florian Heinen
- Department of Paediatric Neurology and Developmental Medicine, Dr. von Hauner Children's Hospital, LMU Munich, Germany
- German Center for Vertigo and Balance Disorders, Munich University Hospital, Germany
| | - Rüdiger von Kries
- Institute of Social Paediatrics and Adolescent Medicine, LMU Munich, Germany
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Abstract
Several dietary habits and lifestyles can be associated with different headache types or with their progression to chronic forms. Different population-based studies have tried to investigate this relationship with poor or contradictory results. We shortly reported the current knowledges available in literature in this regard, paying particular attention to the role that certain factors play in modifying frequency and intensity of headache in adults and in adolescents. Future studies are necessary to clarify the real weight which the different factors have in natural history and in clinic evolution of headache, especially in adolescence, but the already known data suggest an important modulating action. If they will be confirmed, these results will be likely to influence clinical practice as well to address educational programs in preadolescents and adolescents.
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Bonfert M, Heinen F. [Migraine in adolescence]. MMW Fortschr Med 2013; 155:56-60. [PMID: 24288926 DOI: 10.1007/s15006-013-2283-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
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