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Jusienė R, Lisauskienė L, Baukienė E, Laurinaitytė I, Praninskienė R, Urbonas V. Predictors of children's headaches during the second COVID-19 pandemic wave in the country with long-lasting lockdown. Cent Eur J Public Health 2024; 32:95-100. [PMID: 39069312 DOI: 10.21101/cejph.a8007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2023] [Accepted: 06/28/2024] [Indexed: 07/30/2024]
Abstract
OBJECTIVES The current study examined the links and interactions among headaches, screen-based media use, physical activity, sleep, and the family environment in Lithuanian school-aged children during the second COVID-19 lockdown. METHODS The study comprised data of 541 children aged 7-14 years from different Lithuania regions, and without chronic health conditions or developmental disorders. Information about the child was provided by their parents or caregivers who filled questionnaire on child's screen time, sleep duration and quality, physical activity, parental distress, parent-child relationship, history of child's headaches and infectious diseases. RESULTS During the study period, 54% of the children had headaches, and the frequency was positively associated with child's age, screen time and parental distress, as well as negatively related to physical activity (PA), sleep quality, and the parent-child relationship. Parental education was related to child's PA, screen time and sleep quality. The results of binary logistic regression analysis and path analysis revealed that sleep quality and parental distress were significant predictors of headaches in children. CONCLUSIONS Family and child or adolescent education and lifestyle modification aiming to improve sleep hygiene and PA, and to reduce screen-based sedentary behaviour should be provided. Family centred approach for more effective coping with distress and improvement of parent-child relationship is also important in treating child and adolescent headache.
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Affiliation(s)
- Roma Jusienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Lina Lisauskienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
- Centre for Obstetrics and Gynaecology, Hospital of Vilnius University Clinics of Santaros, Vilnius, Lithuania
| | - Edita Baukienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Ilona Laurinaitytė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
| | - Rūta Praninskienė
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
| | - Vaidotas Urbonas
- Institute of Psychology, Faculty of Philosophy, Vilnius University, Vilnius, Lithuania
- Clinic of Children's Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, Vilnius, Lithuania
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Kozlowska K, Scher S. Recent advances in understanding the neurobiology of pediatric functional neurological disorder. Expert Rev Neurother 2024; 24:497-516. [PMID: 38591353 DOI: 10.1080/14737175.2024.2333390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024]
Abstract
INTRODUCTION Functional neurological disorder (FND) is a neuropsychiatric disorder that manifests in a broad array of functional motor, sensory, or cognitive symptoms, which arise from complex interactions between brain, mind, body, and context. Children with FND make up 10%-20% of presentations to neurology services in children's hospitals and up to 20% of adolescents admitted to hospital for the management of intractable seizures. AREAS COVERED The current review focuses on the neurobiology of pediatric FND. The authors present an overview of the small but growing body of research pertaining to the biological, emotion-processing, cognitive, mental health, physical health, and social system levels. EXPERT OPINION Emerging research suggests that pediatric FND is underpinned by aberrant changes within and between neuron-glial (brain) networks, with a variety of factors - on multiple system levels - contributing to brain network changes. In pediatric practice, adverse childhood experiences (ACEs) are commonly reported, and activation or dysregulation of stress-system components is a frequent finding. Our growing understanding of the neurobiology of pediatric FND has yielded important flow-on effects for assessing and diagnosing FND, for developing targeted treatment interventions, and for improving the treatment outcomes of children and adolescents with FND.
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Affiliation(s)
- Kasia Kozlowska
- The Children's Hospital at Westmead, Westmead, NSW, Australia
- Brain Dynamics Centre, Westmead Institute of Medical Research, Westmead, NSW, Australia
- University of Sydney Medical School, Camperdown, NSW, Australia
| | - Stephen Scher
- University of Sydney Medical School, Camperdown, NSW, Australia
- Department of Psychiatry, Harvard Medical School, Belmont, MA, USA
- McLean Hospital, Belmont, MA, USA
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3
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Kapos FP, Vandeleur DM, Tham SW, Palermo TM, Groenewald CB. Comparing the prevalence of chronic pain in school-aged children in the United States from 2019 to 2020: a nationally representative study examining differences associated with the COVID-19 pandemic. Pain 2024; 165:233-242. [PMID: 37556380 PMCID: PMC10841312 DOI: 10.1097/j.pain.0000000000003020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 06/15/2023] [Indexed: 08/11/2023]
Abstract
ABSTRACT The coronavirus disease 19 (COVID-19) pandemic negatively affected children's health in the United States (US), with more severe disruption for marginalized groups. However, potential impact on pediatric chronic pain has not been assessed at the population level. This study aimed to (1) estimate differences in the US national prevalence of pediatric chronic pain during the first year of the COVID-19 pandemic (2020), relative to one year earlier (2019); (2) determine whether differences in prevalence varied across sociodemographic groups; and (3) explore changes in child, caregiver, and family factors associated with chronic pain prevalence. Using data of children 6 to 17 years from the National Survey of Children's Health 2019 and 2020 (n = 50,518), we compared weighted percentages of sample characteristics by year and conducted a series of directed-acyclic graph-informed survey-weighted Poisson regressions. The estimated national prevalence (95% CI) of pediatric chronic pain was 10.8% (9.9, 11.9%) in 2019, decreasing to 7.6% (6.9, 8.3%) in 2020. Contrary to hypotheses, the adjusted prevalence of chronic pain was 31% lower in 2020 than in 2019 (aPR = 0.69, 95% CI: 0.61, 0.79), adjusting for child age, sex, race or ethnicity, caregiver education, neighborhood park or playground, and census region. The 2019 to 2020 change in chronic pain prevalence was similar by age ( P = 0.34), sex ( P = 0.94), race or ethnicity ( P = 0.41), caregiver education ( P = 0.49), neighborhood park or playground ( P = 0.22), and census region ( P = 0.20). Exploratory analyses identified 3 potential contributors to the unexpected decrease in the national prevalence of pediatric chronic pain: lower prevalence of bullying, more frequent family meals, and higher family resilience.
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Affiliation(s)
- Flavia P. Kapos
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
| | - Daron M. Vandeleur
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - See Wan Tham
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - Tonya M. Palermo
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
| | - Cornelius B. Groenewald
- Center for Child Health, Behavior & Development, Seattle Children’s Research Institute, Seattle, WA
- Department of Anesthesiology & Pain Medicine, University of Washington, Seattle, WA
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Ferretti A, Parisi P, Striano P, Spalice A, Iannetti P. Editorial: Stress neurobiology in COVID-19: diagnosis, neuroimaging and therapeutic tools. Front Neurol 2023; 14:1309043. [PMID: 38020589 PMCID: PMC10643119 DOI: 10.3389/fneur.2023.1309043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 10/18/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Alessandro Ferretti
- Pediatrics Unit, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pasquale Parisi
- Pediatrics Unit, Department of Neuroscience, Mental Health and Sense Organs (NESMOS), Faculty of Medicine and Psychology, Sapienza University of Rome, Rome, Italy
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
| | - Alberto Spalice
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Paola Iannetti
- Department of Maternal, Infantile, and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
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Aluko B, Mitchell AN, Tumin D, Zeldin E. Nation-wide decrease in the prevalence of pediatric chronic pain during the COVID-19 pandemic. Scand J Pain 2023; 23:608-612. [PMID: 36450241 DOI: 10.1515/sjpain-2022-0102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Accepted: 11/10/2022] [Indexed: 07/21/2023]
Abstract
OBJECTIVES The COVID-19 pandemic was expected to increase prevalence and severity of chronic pain. We compared pandemic-era and pre-pandemic prevalence of chronic pain among children in the US. METHODS Data were obtained from the 2019 and 2020 National Survey of Children's Health, a web-or mail-based survey representative of children living in the US (n=20,359 in 2019; 29,159 in 2020). Caregiver-reported prevalence of chronic pain was compared between survey years using bivariate and multivariable methods. RESULTS The prevalence of chronic pain among US children decreased from 11 to 8% in the first year of the pandemic. Multivariable analysis adjusting for children's and caregivers' demographics and socioeconomic characteristics confirmed that in 2020, odds of caregiver-reported chronic pain declined by 33% (95% confidence interval: 23%, 42%; p<0.001). CONCLUSIONS The encouraging finding of a nationwide decrease in the prevalence of chronic pain calls into question initial predictions anticipating the pandemic to contribute to onset or persistence of chronic pain among children.
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Affiliation(s)
- Boluwatife Aluko
- Brody School of Medicine at East Carolina University, Greenville, USA
| | | | - Dmitry Tumin
- Department of Pediatrics, Brody School of Medicine at East Carolina University, Greenville, USA
| | - Evan Zeldin
- Department of Physical Medicine & Rehabilitation, Brody School of Medicine at East Carolina University, Greenville, USA
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Bonuccelli A, Depietri G, Baldaccini T, Ricciutelli I, Peroni D, Spalice A, Massimetti G, Morganti R, Orsini A, Striano P. Essential headaches in developmental age: What is changed before, during and after the lockdown for COVID-19 pandemic. Clinical study. Front Pediatr 2023; 11:1166984. [PMID: 37181428 PMCID: PMC10168180 DOI: 10.3389/fped.2023.1166984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Accepted: 03/31/2023] [Indexed: 05/16/2023] Open
Abstract
Introduction Essential headache is one of the main causes of pain in children, and has an important impact on their quality of life. In children with essential headaches play an important role in both triggers like stress, excessive use of video terminals, or physical fatigue but also comorbidities like anxiety, depression, and sleep disturbances. CoViD-19 Pandemic was very stressful, especially for children, and amplified all headache triggers and comorbidities. Study objective In this work, we studied the aspects concerning the headache,lifestyle, habits, and mental health of children before, during, and after the lockdown and the differences between some categories (selected by age, gender, and headache status before the lockdown). Methods This study was conducted on 90 patients with primary headaches followed at the AOUP Neuropediatrics Clinic from January 2018 to March 2022. Participants answered a questionnaire of 21 questions. For every question, the answer was divided into three periods: before, during, or after the lockdown. All dates have been converted and inserted into a database and we used SPSS technology for statistical analysis. Results In our study, 51,1% were females and 48,9% were males and there was a prevalence of adolescents (56,7%) compared to children from 5 to 11 years (43,3%). Regarding the headache onset, 77,7% of patients started to suffer from headaches before 10 years, moreover, 68,9% had familiarity with the headache. Using Cohen's K- Concordance Test, we performed a Concordance Analysis, studying the questions in the three periods above mentioned: considering headache characteristics there is poor concordance about the trend of headache; modest concordance (K: 0,2-0,4) about the frequency and the type (migraine or tension headache); moderate concordance (K: 0,41-0,61) about the acute use of analgesic. Analyzing lifestyle the lockdown had a significant impact on sports (practiced much less) and on the use of video terminals (used much more). Conclusion The pandemic and lockdown aren't events that led to strong and unidirectional responses in patients, there is great variability in the answers about headache, lifestyle, and psychology, and each patient had individualized reactions. However, these considerations are not applied to physical activity and the use of video terminals, because both have been inevitably modified by the pandemic situations and so were not affected by subjective influence.
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Affiliation(s)
- Alice Bonuccelli
- PediatricNeurology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Greta Depietri
- Pediatric Clinic, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Tommaso Baldaccini
- Pediatric Clinic, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Irene Ricciutelli
- Pediatric Clinic, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Diego Peroni
- PediatricNeurology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
- Pediatric Clinic, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Alberto Spalice
- Department of Pediatrics, Child Neurology Division, Sapienza University Rome, Roma, Italy
| | - Gabriele Massimetti
- Psychiatric Clinic, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Riccardo Morganti
- Division of Statistical Support to Clinical Studies, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Alessandro Orsini
- PediatricNeurology, Pediatric University Department, Azienda Ospedaliero Universitaria Pisana, University of Pisa, Pisa, Italy
| | - Pasquale Striano
- “IRCCS Istituto Giannina Gaslini” member of ERN-Epicare, Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
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Tamulevicius N, Save R, Gandhi N, Lubiak S, Sharma S, Aguado Loi CX, Paneru K, Martinasek MP. Perceived Stress and Impact on Role Functioning in University Students with Migraine-Like Headaches during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:ijerph20085499. [PMID: 37107781 PMCID: PMC10138729 DOI: 10.3390/ijerph20085499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 03/01/2023] [Accepted: 04/03/2023] [Indexed: 05/11/2023]
Abstract
Migraines, a chronic disease, can be debilitating in university students, affecting their academic performance, attendance, and social interactions. The purpose of this study was to identify the impact of COVID-19 on the role functioning and perceived stress levels of students suffering from migraine-like headaches. METHODS Two identical cross-sectional surveys were sent to students in Fall 2019 and Spring 2021 at a mid-sized university in the U.S. The students were queried on the headache impact scale (HIT-6) and perceived stress scale (PSS-10). Associations between the migraine-like headaches, severity of the headaches, stress levels, and headache impacts on the individuals' role functioning were analyzed. RESULTS The average age of the respondents (n = 721) was 20.81 ± 4.32 years in 2019 and (n = 520) 20.95 ± 3.19 years in 2021. A difference (p = 0.044) was found in the HIT-6 score <49 category. The other categories of the HIT-6 and the PSS-10 were not significant. CONCLUSIONS During COVID-19, more students answered that their migraine-like headaches had lower impacts on their role functioning, thus suggesting that the students were having less severe migraines. A trend was seen for student's stress levels, indicating a decrease from 2019 to 2021. Furthermore, our results showed that the impact of headaches and stress levels slightly declined throughout the pandemic.
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Affiliation(s)
- Nauris Tamulevicius
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
- Correspondence:
| | - Ritika Save
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
| | - Nishita Gandhi
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
| | - Sean Lubiak
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
| | - Siddhi Sharma
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
| | - Claudia X. Aguado Loi
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
| | - Khyam Paneru
- Department of Mathematics, The University of Tampa, Tampa, FL 33606, USA
| | - Mary P. Martinasek
- Department of Health Sciences and Human Performance, The University of Tampa, Tampa, FL 33606, USA
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Checchi MP, Tarantino S, Ursitti F, Monte G, Moavero R, Sforza G, Ferilli MAN, Grimaldi Capitello T, Vigevano F, Valeriani M, Papetti L. Long-Term Effects of COVID-19 Pandemic on Migraine in Adolescents. A Retrospective Analysis of the Population Attending the Headache Center in Different Phases of the Pandemic. Brain Sci 2023; 13:brainsci13020273. [PMID: 36831817 PMCID: PMC9953965 DOI: 10.3390/brainsci13020273] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
BACKGROUND Literature data report that the first COVID-19 pandemic had an impact on the progression of migraine both in adults and children. The present study aimed to verify how the migraine course and psychological aspects varied in adolescent patients in relation to some of the different phases of the COVID-19 pandemic and compared with the months before COVID-19. In addition, the relationship between the characteristics of headache episodes and psychological and school-related aspects were analyzed. METHODS The study included 418 adolescents. Based on the timing of the evaluation, they were categorized into patients observed before the COVID-19 pandemic (pre COVID) or during the first (COVID 1) or second (COVID 2) wave of the pandemic. Subjects were also categorized into three further groups: those who had high or low frequency of migraine attacks during the month, those who had mild or severe pain during the attack, and those who were taking prophylactic drugs. The Patient Health Questionnaire-9 (PHQ-9) and General Anxiety Disorder-7 (GAD-7) scales were utilized to assess depression and anxiety. RESULTS We observed a significant increase in the frequency of attacks and the use of prophylactic drugs during the COVID 2 period compared to the COVID 1 and pre-COVID periods (p < 0.05). Patients showed higher levels of anxiety and depression during each of the two COVID periods compared with the pre-COVID months (p < 0.05), especially during the COVID 2 period (p < 0.05). CONCLUSION Our results show long-term negative impacts of the COVID-19 pandemic on clinical parameters and psychological symptoms in adolescents with migraine.
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Affiliation(s)
| | - Samuela Tarantino
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Fabiana Ursitti
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Gabriele Monte
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Romina Moavero
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, 9220 Rome, Italy
| | - Giorgia Sforza
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | | | | | - Federico Vigevano
- Neurological Sciences and Rehabilitation Medicine, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
| | - Massimiliano Valeriani
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, 9220 Aalborg, Denmark
| | - Laura Papetti
- Developmental Neurology, Bambino Gesù Children Hospital, IRCCS, 00165 Rome, Italy
- Correspondence: ; Tel.: +39-0668592865
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Aktan Ç, Toptan T, Utku Ç, Bolay H. Female migraine patients had lower COVID-19 phobia and PCL-5 scores during the lockdown period. Acta Neurol Belg 2023:10.1007/s13760-023-02175-4. [PMID: 36658450 PMCID: PMC9867834 DOI: 10.1007/s13760-023-02175-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND To examine the impact of the lockdown period of the pandemic on COVID-19 phobia and post-traumatic stress disorder (PTSD) in migraine patients. METHODS A total of 73 patients, including 39 migraine and 34 controls, completed the study during the lockdown period. The patients were evaluated using the Structured Headache Questionnaire, PTSD Checklist for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders) (PCL-5) and COVID-19 Phobia Scale via the telephone-based telemedicine method. RESULTS Migraine patients had significantly lower scores in all subgroups of the COVID-19 Phobia Scale (mean = 42.33 ± 12.67) than those in the healthy control group (mean = 52.88 ± 13.18). PCL-5 scale scores in migraine patients were significantly lower (mean = 27.18 ± 14.34) compared to the healthy controls (Mean = 34.03 ± 14.36). Migraine attack frequency decreased or did not change in 67% of the patients during the lockdown period. CONCLUSION Acute stress response to an extraordinary situation such as a pandemic may be more controlled in migraine patients, yet specific phobia and post-traumatic stress disorder have been reported more frequently in patients with migraine under normal living conditions. We interpreted that the life-long headache-associated stress may generate a tendency to resilience and resistance to extraordinary traumatic events in migraine patients.
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Affiliation(s)
- Çile Aktan
- Department of Neurology and Algology, Gazi University Hospital, Ankara, Turkey
| | - Tuğçe Toptan
- Department of Neurology and Algology, Gazi University Hospital, Ankara, Turkey
| | - Çisem Utku
- Department of Psychiatry, Gazi University Hospital, Ankara, Turkey
| | - Hayrunnisa Bolay
- Department of Neurology and Algology, Gazi University Hospital, Ankara, Turkey ,Gazi University Neuropsychiatry Center, Gazi University NÖROM Center, Ankara, Turkey
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Connelly M, Dilts J, Boorigie M, Gerson T. A Prospective Evaluation of the Effects of the COVID-19 Pandemic on Youth with Primary Headache Disorders. CHILDREN (BASEL, SWITZERLAND) 2023; 10:children10020184. [PMID: 36832313 PMCID: PMC9954271 DOI: 10.3390/children10020184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2022] [Revised: 12/22/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = -2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = -2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic.
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Affiliation(s)
- Mark Connelly
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
- Correspondence:
| | - Jennifer Dilts
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
| | | | - Trevor Gerson
- Children’s Mercy Kansas City, Kansas City, MO 64108, USA
- School of Medicine, University of Missouri-Kansas City, Kansas City, MO 64108, USA
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Triggers and clinical changes of childhood primary headache characteristics during COVID-19 pandemic lockdown. Acta Neurol Belg 2023; 123:215-220. [PMID: 36478546 PMCID: PMC9734329 DOI: 10.1007/s13760-022-02150-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Accepted: 11/28/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE Children with primary headache are particularly vulnerable to the negative impacts of the pandemic due to factors like increased social isolation, disruption of sleep and impairment of healthy diet. We aimed to investigate the clinical changes and triggering factors for childhood primary headaches to demonstrate the impact of the pandemic lockdown. METHOD Children aged between 60 months and 18 years with headache complaint attending the general outpatient clinic between December 2019 and December 2020 were included in the study. Patients were classified according to ICHD-3 regarding clinical and laboratory data. Primary headaches diagnosed before (December 2019-March 2020) and during the pandemic lockdown (April 2020-December 2020) were divided into two groups as migraine and tension-type headache (TTH). Clinical picture and triggering factors were compared between groups to illustrate the effect of the lockdown. RESULTS The study included 612 subjects, with 463 patients (76%) classified in the primary headache group and 149 (24%) in the secondary headache group. Among the first group, 267 patients (58%) had migraine and 196 patients (42%) had TTH. Comparisons between before and during the pandemic lockdown showed significant increased frequency of TTH, but no difference in the frequency and duration of migraine. Both screen exposure and sleep pattern changes were found to be significantly increased in the TTH group during the pandemic lockdown. DISCUSSION We found a significant increase in the attack frequency for TTH patients during the pandemic lockdown. Reduction in screen time is an important strategy in preventing primary headache attacks in children.
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Caronna E, van den Hoek TC, Bolay H, Garcia-Azorin D, Gago-Veiga AB, Valeriani M, Takizawa T, Messlinger K, Shapiro RE, Goadsby PJ, Ashina M, Tassorelli C, Diener HC, Terwindt GM, Pozo-Rosich P. Headache attributed to SARS-CoV-2 infection, vaccination and the impact on primary headache disorders of the COVID-19 pandemic: A comprehensive review. Cephalalgia 2023; 43:3331024221131337. [PMID: 36606562 DOI: 10.1177/03331024221131337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
OBJECTIVE The objective is to summarize the knowledge on the epidemiology, pathophysiology and management of secondary headache attributed to SARS-CoV-2 infection and vaccination; as well as to delineate their impact on primary headache disorders. METHODS This is a narrative review of the literature regarding primary and secondary headache disorders in the setting of COVID-19 pandemic. We conducted a literature search in 2022 on PubMed, with the keywords "COVID 19" or "vaccine" and "headache" to assess the appropriateness of all published articles for their inclusion in the review. RESULTS Headache is a common and sometimes difficult-to-treat symptom of both the acute and post-acute phase of SARS-CoV-2 infection. Different pathophysiological mechanisms may be involved, with the trigeminovascular system as a plausible target. Specific evidence-based effective therapeutic options are lacking at present. Headache attributed to SARS-CoV-2 vaccinations is also common, its pathophysiology being unclear. People with primary headache disorders experience headache in the acute phase of COVID-19 and after vaccination more commonly than the general population. Pandemic measures, forcing lifestyle changes, seemed to have had a positive impact on migraine, and changes in headache care (telemedicine) have been effectively introduced. CONCLUSIONS The ongoing COVID-19 pandemic is a global challenge, having an impact on the development of secondary headaches, both in people with or without primary headaches. This has created opportunities to better understand and treat headache and to potentiate strategies to manage patients and ensure care.
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Affiliation(s)
- Edoardo Caronna
- Neurology Department, Hospital Universitari Vall d'Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Hayrunnisa Bolay
- Department of Neurology and Algology, NÖROM, Gazi University Hospital, Ankara, Turkey
| | - David Garcia-Azorin
- Headache Unit, Department of Neurology, Hospital Clínico Universitario de Valladolid, Valladolid, Spain.,Department of Medicine, Universidad de Valladolid, Valladolid, Spain
| | - Ana Beatriz Gago-Veiga
- Headache Unit, Department of Neurology, Hospital Universitario de La Princesa and Instituto de Investigación Sanitaria de La Princesa, Madrid, Spain.,Department of Neurology, Universidad Autónoma de Madrid, Madrid, Spain
| | - Massimiliano Valeriani
- Headache Center, Department of Neuroscience, Bambino Gesù Children's Hospital, Rome, Italy
| | - Tsubasa Takizawa
- Department of Neurology, Keio University School of Medicine, Tokyo, Japan
| | - Karl Messlinger
- Institute of Physiology and Pathophysiology, Friedrich-Alexander-University, Erlangen-Nuernberg, Germany
| | - Robert E Shapiro
- Department of Neurological Sciences, Larner College of Medicine, University of Vermont, Burlington, USA
| | - Peter J Goadsby
- NIHR-Wellcome Trust King's Clinical Research Facility, SLaM Biomedical Research Centre, King's College London, London, UK.,Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Messoud Ashina
- Danish Headache Center, Department of Neurology, Faculty of Health and Medical Sciences, Rigshospitalet Glostrup, University of Copenhagen, Glostrup, Denmark
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Hans-Christoph Diener
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE) Faculty of Medicine, University Duisburg-Essen, Essen, Germany
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Patricia Pozo-Rosich
- Neurology Department, Hospital Universitari Vall d'Hebron, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.,Headache and Neurological Pain Research Group, Vall d'Hebron Research Institute, Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
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13
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Pedrosa Luna Oliveira J, Zangirolami-Raimundo J, Evaristo de Andrade P, Louise Pereira Lima S, Cavalcante Lima AR, de Abreu LC, Raimundo RD. Relationship between musculoskeletal pain, sleep quality and migraine with level of physical activity in college students during the COVID-19 pandemic. Heliyon 2022; 8:e10821. [PMID: 36193233 PMCID: PMC9519513 DOI: 10.1016/j.heliyon.2022.e10821] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 02/17/2022] [Accepted: 09/23/2022] [Indexed: 11/05/2022] Open
Abstract
Background The COVID-19 pandemic has negative impacts on general health of the population, social isolation can contribute to the emergence of various dysfunctions. Objective To investigate the association musculoskeletal pain, sleep quality and migraine with the level of physical activity during the COVID-19 pandemic in college students. Method Data were collected through a sociodemographic questionnaire containing questions regarding sample characterization, the Nordic Musculoskeletal Questionnaire (NMQ), Pittsburgh Sleep Quality Index (PSQI), Migraine Disability Assessment (MIDAS) and the International Physical Activity Questionnaire (IPAQ). Results In the correlation made between the data at the beginning of the pandemic, there was a direct relationship between PSQI and the number of days with pain (p < 0.001), the Initial MIDAS score (p < 0.001) and the initial pain intensity (p < 0.001). There was a direct relationship between PSQI scores and age (p = 0.044), MIDAS (p < 0.001) and pain intensity (p < 0.001). We identified a direct relationship between MIDAS and the number of days with pain (p < 0.001) and pain intensity (p < 0.001). Conclusion Social isolation, during the COVID-19 pandemic, probably potentiated painful symptoms in various parts of the body, worsening sleep quality and migraine. In addition, there is a strong evidence that the decrease in physical activity during the pandemic is associated with sleep quality, with the number of days with musculoskeletal pain and migraine.
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Affiliation(s)
| | - Juliana Zangirolami-Raimundo
- Gynecology Discipline, Department of Obstetrics and Gynecology, Faculty of Medicine FMUSP, University of São Paulo, São Paulo, SP, Brazil.,Laboratory of Study Design and Scientific Writing, Faculdade de Medicina da ABC, Santo André, SP, Brazil
| | - Paulo Evaristo de Andrade
- Laboratory of Study Design and Scientific Writing, Faculdade de Medicina da ABC, Santo André, SP, Brazil
| | | | | | | | - Rodrigo Daminello Raimundo
- Laboratory of Study Design and Scientific Writing, Faculdade de Medicina da ABC, Santo André, SP, Brazil
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14
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Feasibility and effect of mindfulness approach by web for chronic migraine and high-frequency episodic migraine without aura at in adolescents during and after COVID emergency: preliminary findings. Neurol Sci 2022; 43:5741-5744. [PMID: 35788839 PMCID: PMC9252540 DOI: 10.1007/s10072-022-06225-2] [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: 04/22/2022] [Accepted: 06/15/2022] [Indexed: 11/17/2022]
Abstract
Background Migraine disorders are common among adolescents: however, the efficacy of medical prophylaxis is limited in this population. This study reports preliminary findings on the feasibility and effect of a mindfulness-based intervention delivered via web for adolescents with chronic migraine (CM) and high-frequency episodic migraine (HFEM) without aura. Methods Patients with CM or HFEM received six session of a mindfulness-based treatment and were followed-up for 6 months as part of a larger study. Repeated measure analyses were carried out to test the effect of this behavioral intervention. Results A total of 12 patients were included in this analysis. A significant improvement was observed up to 6 months for headache frequency, symptoms of depression, and catastrophizing, and up to 3 months for patients’ disability. No change was detected for patients’ anxiety level. Conclusions The results of our study provides initial support to the hypothesis that patients’ education and mindfulness-based programs can be very useful in populations of adolescents with CM or HFEM.
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15
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Polese D, Belli A, Esposito D, Evangelisti M, Luchetti A, Di Nardo G, Parisi P, Bruni O. Psychological Disorders, Adverse Childhood Experiences and Parental Psychiatric Disorders in Children Affected by Headache: A Systematic Review. Neurosci Biobehav Rev 2022; 140:104798. [PMID: 35907492 DOI: 10.1016/j.neubiorev.2022.104798] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Revised: 07/23/2022] [Accepted: 07/24/2022] [Indexed: 10/16/2022]
Abstract
BACKGROUND Pediatric headaches have been linked to adverse life events or psychological factors in children and their families, with a complex and bidirectional association. Moreover, it is well-known that psychological stress can trigger headaches. METHODS We searched three databases for studies focusing on headaches and adverse events or psychological factors in children up to 12 years old or in their caregivers. RESULTS We included 28 studies. Child psychological factors, including internal and external symptoms, were commonly associated with all types of headaches. Sleep disturbances showed a positive association with headaches in 3 out of 5 studies. Family conflict and unhappiness were frequently found in children suffering with headaches, while single-parent families and divorce were not associated. Stressful environments and adverse life events, particularly bullying, were also found to be linked with headaches. CONCLUSIONS Childhood headaches represent an alarm bell for clinicians to investigate and treat psychological or psychiatric disorders in children and their family. Further studies are needed to elucidate the role of early-life adverse events in children and their families.
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Affiliation(s)
- Daniela Polese
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Arianna Belli
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108 - 00185 Rome, Italy
| | - Dario Esposito
- Child Neurology and Psychiatry Unit, Department of Human Neurosciences, Sapienza University of Rome, Via dei Sabelli 108 - 00185 Rome, Italy
| | - Melania Evangelisti
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Anna Luchetti
- "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Giovanni Di Nardo
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Pasquale Parisi
- Chair of Pediatrics, NESMOS Department, Faculty of Medicine & Psychology, Sapienza University c/o Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy
| | - Oliviero Bruni
- Department of Neuroscience, Mental Health and Sensory Organs (NESMOS), "Sapienza" University of Rome, Sant'Andrea Hospital Via di Grottarossa, 1035-1039, 00189, Rome, Italy; Department of Social and Developmental Psychology, Sapienza University, Via dei Marsi 78 - 00185 Rome, Italy.
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16
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Börner C, Staisch J, Lang M, Hauser A, Hannibal I, Huß K, Klose B, Lechner MF, Sollmann N, Heinen F, Landgraf MN, Bonfert MV. Repetitive Neuromuscular Magnetic Stimulation for Pediatric Headache Disorders: Muscular Effects and Factors Affecting Level of Response. Brain Sci 2022; 12:brainsci12070932. [PMID: 35884738 PMCID: PMC9320292 DOI: 10.3390/brainsci12070932] [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: 06/09/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
Repetitive neuromuscular magnetic stimulation (rNMS) for pediatric headache disorders is feasible, safe, and alleviates headache symptoms. This study assesses muscular effects and factors affecting response to rNMS. A retrospective chart review included children with headaches receiving six rNMS sessions targeting the upper trapezius muscles. Pressure pain thresholds (PPT) were measured before and after rNMS, and at 3-month follow-up (FU). Mean headache frequency, duration, and intensity within the last 3 months were documented. In 20 patients (14.1 ± 2.7 years), PPT significantly increased from pre- to post-treatment (p < 0.001) sustaining until FU. PPT changes significantly differed between primary headache and post-traumatic headache (PTH) (p = 0.019−0.026). Change in headache frequency was significantly higher in patients with than without neck pain (p = 0.032). A total of 60% of patients with neck pain responded to rNMS (≥25%), while 20% of patients without neck pain responded (p = 0.048). 60% of patients receiving rNMS twice a week were responders, while 33% of patients receiving rNMS less or more frequently responded to treatment, respectively. Alleviation of muscular hyperalgesia was demonstrated sustaining for 3 months, which was emphasized in PTH. The rNMS sessions may positively modulate headache symptoms regardless of headache diagnosis. Patients with neck pain profit explicitly well. Two rNMS sessions per week led to the highest reduction in headache frequency.
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Affiliation(s)
- Corinna Börner
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany;
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
| | - Jacob Staisch
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Magdalena Lang
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Ari Hauser
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Iris Hannibal
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Kristina Huß
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Birgit Klose
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Matthias F. Lechner
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany;
- TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Ismaninger Str. 22, 81675 Munich, Germany
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Albert-Einstein-Allee 23, 89081 Ulm, Germany
| | - Florian Heinen
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Mirjam N. Landgraf
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
| | - Michaela V. Bonfert
- LMU Hospital, Department of Pediatrics—Dr. von Hauner Children’s Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany; (C.B.); (J.S.); (M.L.); (A.H.); (I.H.); (K.H.); (B.K.); (M.F.L.); (F.H.); (M.N.L.)
- LMU Center for Children with Medical Complexity, Dr. von Hauner Children’s Hospital, Ludwig-Maximilians Universität, Lindwurm Str. 4, 80337 Munich, Germany
- Correspondence:
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Papetti L, Tarantino S, Ursitti F, Moavero R, Proietti MC, Sforza G, Monte G, Ferilli MAN, Balestri M, Vigevano F, Valeriani M. From the New Diagnostic Criteria to COVID-19 Pandemic Passing Through the Placebo Effect. What Have We Learned in the Management of Pediatric Migrane Over the Past 5 Years? Front Neurol 2022; 13:935803. [PMID: 35911893 PMCID: PMC9326104 DOI: 10.3389/fneur.2022.935803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 06/14/2022] [Indexed: 11/13/2022] Open
Abstract
In 2018, the Food and Drug Administration (FDA) approval of anti-calcitonin gene-related peptide (CGRP) therapies for the treatment of migraine represented a milestone for the management of the disease in adults. On the contrary, the novelties in the field of pediatric migraine are inserted in a different scenario and still concern: (1) diagnostic criteria of the international classification of headache disorders-3 (ICHD-3) that show numerous limits of applicability in the developmental age; (2) the release of the results of the Childhood and Adolescent Migraine Prevention (CHAMP) study that raised doubts about the usefulness of traditional drugs for the treatment of pediatric migraine; (3) the Coronavirus disease 2019 (COVID-19) pandemic has put the spotlight on the importance of managing the psychological factors associated with the disease. In this mini review we discuss the most relevant news in pediatric migraine over the last 5 years.
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Affiliation(s)
- Laura Papetti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Samuela Tarantino
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Fabiana Ursitti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Romina Moavero
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
- Child Neurology and Psychiatry Unit, Tor Vergata University of Rome, Rome, Italy
| | - Martina Checchi Proietti
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Giorgia Sforza
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Gabriele Monte
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Michela Ada Noris Ferilli
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
| | - Martina Balestri
- Child Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Federico Vigevano
- Child Neurology Unit, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico, Rome, Italy
| | - Massimiliano Valeriani
- Pediatric Headache Center, Department of Neuroscience, Bambino Gesù Children Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRRCS), Rome, Italy
- Center for Sensory-Motor Interaction, Aalborg University, Aalborg, Denmark
- *Correspondence: Massimiliano Valeriani
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18
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Togha M, Hashemi SM, Yamani N, Martami F, Salami Z. A Review on Headaches Due to COVID-19 Infection. Front Neurol 2022; 13:942956. [PMID: 35911910 PMCID: PMC9327440 DOI: 10.3389/fneur.2022.942956] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 06/20/2022] [Indexed: 11/13/2022] Open
Abstract
Since December 2019, the time when the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was spotted, numerous review studies have been published on COVID-19 and its neuro invasion. A growing number of studies have reported headaches as a common neurological manifestation of COVID-19. Although several hypotheses have been proposed regarding the association between headache and the coronavirus, no solid evidence has been presented for the mechanism and features of headache in COVID-19. Headache also is a common complaint with the omicron variant of the virus. COVID-19 vaccination also is a cause of new-onset headaches or aggravation of the previous headache in migraine or tension headache sufferers. In this review study, the types of headaches reported in previous studies and their possible pathogenic mechanisms are outlined. To accomplish this objective, various types of headaches are classified and their patterns are discussed according to ICHD-3 diagnostic criteria, including, headaches attributed to systemic viral infection, viral meningitis or encephalitis, non-infectious inflammatory intracranial disease, hypoxia and/or hypercapnia, cranial or cervical vascular disorder, increased cerebrospinal fluid (CSF) pressure, refractive error, external-compression headache, and cough headache. Then, their pathogeneses are categorized into three main categories, direct trigeminal involvement, vascular invasion, and inflammatory mediators. Furthermore, persistent headache after recovery and the predictors of intensity is further investigated. Post-vaccination headache is also discussed in this review.
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Affiliation(s)
- Mansoureh Togha
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
- Headache Department, Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyedeh Melika Hashemi
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Nooshin Yamani
- Neurology Department, Zanjan University of Medical Sciences, Zanjan, Iran
| | - Fahimeh Martami
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
| | - Zhale Salami
- Headache Department, Iranian Center of Neurological Researches, Institute of Neuroscience, Tehran University of Medical Sciences, Tehran, Iran
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19
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Staisch J, Börner C, Lang M, Hauser A, Hannibal I, Huß K, Klose B, Lechner MF, Sollmann N, Heinen F, Landgraf MN, Bonfert MV. Repetitive neuromuscular magnetic stimulation in children with headache. Eur J Paediatr Neurol 2022; 39:40-48. [PMID: 35660103 DOI: 10.1016/j.ejpn.2022.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 03/20/2022] [Accepted: 04/27/2022] [Indexed: 12/25/2022]
Abstract
INTRODUCTION Repetitive neuromuscular magnetic stimulation (rNMS) was previously applied in adult patients with episodic migraine, showing beneficial effects on headache characteristics, high safety, and convincing satisfaction. This study aims to assess rNMS as a personalized intervention in pediatric headache. METHODS Retrospective chart review including patients with migraine, TTH, mixed type headache, or PTH, who had received at least one test rNMS session targeting the upper trapezius muscles (UTM). RESULTS 33 patients (13.9 ± 2.5 years; 61% females) were included in the primary analysis, resulting in a total of 182 rNMS sessions. 43 adverse events were documented for 40 of those sessions (22%). Most common side effects were tingling (32.6%), muscle sore (25.5%), shoulder (9.3%) and back pain (9.3%). Secondly, in patients (n = 20) undergoing the intervention, headache frequency (p = 0.017) and minimum and maximum intensities (p = 0.017; p = 0.023) significantly decreased from baseline to 3-month after intervention. 11 patients (44%) were classified as ≥25% responders, with 7 patients (28%) experiencing a ≥75% reduction of headache days. After 73% of interventions, patients reported rNMS helped very well or well. A majority of patients would repeat (88.5%) and recommend rNMS (96.2%) to other patients. CONCLUSION rNMS seems to meet the criteria of safety, feasibility, and acceptance among children and adolescents with three age-typical headache disorders. A significant reduction in headache frequency and intensity during a 3 months follow-up was documented. Larger, prospective, randomized, sham-controlled studies are urgently needed to confirm if rNMS may become a new valuable non-invasive, non-pharmacological treatment option for pediatric headache disorders.
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Affiliation(s)
- Jacob Staisch
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Corinna Börner
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany; Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Magdalena Lang
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Ari Hauser
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Iris Hannibal
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Kristina Huß
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Birgit Klose
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Matthias F Lechner
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany; Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Florian Heinen
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Mirjam N Landgraf
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany
| | - Michaela V Bonfert
- LMU Hospital, Department of Pediatrics - Dr. von Hauner Children's Hospital, Division of Pediatric Neurology and Developmental Medicine, Ludwig-Maximilians University, Munich, Germany; LMU Center for Children with Medical Complexity - iSPZ Hauner, Ludwig-Maximilians University, Munich, Germany.
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20
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Valença MM, Andrade JRD. Migraine in Covid-19 lockdown. HEADACHE MEDICINE 2022. [DOI: 10.48208/headachemed.2022.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
Migraine in Covid-19 lockdown
Editorial v.13 n.2
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21
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Jörgensen E, Koller D, Raman S, Olatunya O, Asemota O, Ekpenyong BN, Gunnlaugsson G, Okolo A. The voices of children and young people during COVID-19: A critical review of methods. Acta Paediatr 2022; 111:1670-1681. [PMID: 35608994 PMCID: PMC9348412 DOI: 10.1111/apa.16422] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 01/22/2023]
Abstract
AIM Critically review research methods used to elicit children and young people's views and experiences in the first year of COVID-19, using an ethical and child rights lens. METHODS A systematic search of peer-reviewed literature on children and young people's perspectives and experiences of COVID-19. LEGEND (Let Evidence Guide Every New Decision) tools were applied to assess the quality of included studies. The critical review methodology addressed four ethical parameters: (1) Duty of care; (2) Children and young people's consent; (3) Communication of findings; and (4) Reflexivity. RESULTS Two phases of searches identified 8131 studies; 27 studies were included for final analysis, representing 43,877 children and young people's views. Most studies were from high-income countries. Three major themes emerged: (a) Whose voices are heard; (b) How are children and young people heard; and (c) How do researchers engage in reflexivity and ethical practice? Online surveys of children and young people from middle-class backgrounds dominated the research during COVID-19. Three studies actively involved children and young people in the research process; two documented a rights-based framework. There was limited attention paid to some ethical issues, particularly the lack of inclusion of children and young people in research processes. CONCLUSION There are equity gaps in accessing the experiences of children and young people from disadvantaged settings. Most children and young people were not involved in shaping research methods by soliciting their voices.
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Affiliation(s)
- Eva Jörgensen
- Faculty of Sociology, Anthropology and Folkloristics University of Iceland Reykjavik Iceland
| | - Donna Koller
- Early Childhood Studies Toronto Metropolitan University Toronto Canada
| | - Shanti Raman
- Department of Community Paediatrics South Western Sydney Local Health District Liverpool New South Wales Australia
| | - Oladele Olatunya
- Department of Paediatrics Ekiti State University Ado Ekiti Nigeria
| | - Osamagbe Asemota
- Department of Paediatrics University of Calabar Teaching Hospital Calabar Cross River State Nigeria
| | - Bernadine N. Ekpenyong
- Department of Public Health College of Medical Sciences, University of Calabar Calabar Nigeria
| | - Geir Gunnlaugsson
- Faculty of Sociology, Anthropology and Folkloristics University of Iceland Reykjavik Iceland
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22
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Quality of Life and Mental Health in Children and Adolescents after the First Year of the COVID-19 Pandemic: A Large Population-Based Survey in South Tyrol, Italy. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095220. [PMID: 35564614 PMCID: PMC9101425 DOI: 10.3390/ijerph19095220] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 02/04/2023]
Abstract
Background: Methodological heterogeneity of studies and geographical variation limit conclusions about the impact of the COVID-19 pandemic on the mental health of youth. This study aimed to explore the health-related quality of life and mental health of children and adolescents in the second year of the pandemic in South Tyrol, Italy. Methods: An online survey representative for the age and gender of the children and adolescents in South Tyrol was conducted among 5159 families with children and adolescents aged 7–19 years, between 28 May and 16 June 2021. The survey collecting parental ratings and self-rated questionnaires from children and adolescents aged 11–19 years included instruments to measure health-related quality of life (KIDSCREEN-10), mental health problems (SDQ), anxiety (SCARED), and depression (CES-DC). The results were compared with data from corresponding studies conducted in Germany. Results: Decreased health-related quality of life and increased conduct problems, peer-related mental health problems, anxiety, and depressive and psychosomatic symptoms in children and adolescents observed in the second year of the pandemic in Germany were confirmed in the second year in South Tyrol. Children and adolescents with low socioeconomic status, a migration background, and limited living space were significantly affected. Female sex and older age were associated with increased psychosocial problems and a positive family climate supported the mental health of children and adolescents during the pandemic. Conclusions: Confirmation of findings of decreased health-related quality of life and increased emotional problems after the first year of the pandemic supports the ongoing call for low-threshold health promotion, prevention, and early intervention programs to support children and adolescents who have been severely affected by the pandemic.
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Kaczynski KJ, Chang CYH, Chimoff J, Koike C, Berde CB, Logan DE, Nelson S, Kossowsky J. Initial Adjustment to the COVID-19 Pandemic and the Associated Shutdown in Children and Adolescents With Chronic Pain and Their Families. FRONTIERS IN PAIN RESEARCH 2022; 2:713430. [PMID: 35295442 PMCID: PMC8915775 DOI: 10.3389/fpain.2021.713430] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2021] [Accepted: 09/01/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: Youth with chronic pain often struggle to function in multiple domains due to pain and associated psychosocial distress. In 2020, schools and businesses shut down and people were encouraged to remain at home due to the COVID-19 pandemic, eliminating or reducing stress due to functional difficulties. This study assessed whether pain and associated psychosocial outcomes improved in youth with chronic pain during the shutdown, compared with before the pandemic. Methods: Patients who completed clinical outcome measures during a multidisciplinary evaluation before the pandemic were readministered the same measures (PROMIS Anxiety, Depression, Sleep Disturbance, PCS, PedsQL) during the shutdown. At follow-up, patients also completed measures of adjustment to COVID-19 and their parents completed a measure of pandemic effects. Results: Participants included 47 patients ages 8–18 and a parent/guardian. The pandemic impacted families in both positive (e.g., more quality time with family) and negative ways (e.g., social isolation, disruption in care). Pain intensity and pain catastrophizing significantly decreased during the shutdown (ps <0.01). Change in pain catastrophizing was correlated positively with change in psychological stress (p = 0.004) and anxiety (p = 0.005) and negatively with change in quality of life (p = 0.024). Discussion: Pain and pain catastrophizing decreased initially during the shutdown related to the COVID-19 pandemic. Change in catastrophizing was associated with change in stress and anxiety. It may be that the reduction in functional demands contributed to this change. Functional difficulties should be addressed in treatment, including pain coping and also environmental modification to support optimal functioning in youth with chronic pain.
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Affiliation(s)
- Karen J Kaczynski
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Cindy Yu Hsing Chang
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Justin Chimoff
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Camila Koike
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Charles B Berde
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
| | - Deirdre E Logan
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Sarah Nelson
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard Medical School, Boston, MA, United States
| | - Joe Kossowsky
- Department of Anesthesiology, Critical Care and Pain Medicine, Harvard Medical School, Boston Children's Hospital, Boston, MA, United States
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Cerami C, Crespi C, Bottiroli S, Santi GC, Sances G, Allena M, Vecchi T, Tassorelli C. High perceived isolation and reduced social support affect headache impact levels in migraine after the Covid-19 outbreak: A cross sectional survey on chronic and episodic patients. Cephalalgia 2021; 41:1437-1446. [PMID: 34256651 PMCID: PMC8619713 DOI: 10.1177/03331024211027568] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 05/14/2021] [Accepted: 06/01/2021] [Indexed: 12/23/2022]
Abstract
BACKGROUND Psychosocial variables are key factors influencing psycho-physical equilibrium in migraine patients. Social isolation and vulnerability to stressors may prevent efficient psychological adjustment negatively affecting adaptation to life changes, as that imposed during Covid-19 lockdown. Here, we explored psychosocial dimensions and changes in clinical condition during Covid-19 lockdown in migraine patients, with regard to migraine type and headache impact. METHODS Sixty-four migraine patients (32 episodic and 32 chronic) and 64 healthy control subjects were included in a case-control cross-sectional study. A two-step clustering procedure split patients into two clusters, based on the Headache Impact Test. Perceived global distress, loneliness, empathy, and coping levels were compared in groups, as well as changes in clinical condition. RESULTS Migraine patients reported higher general loneliness and lower social support compared to healthy control subjects. Emotional loneliness was more marked in patients with higher headache impact. This subgroup of patients more frequently reported changes in the therapeutic and care paths as the perceived cause of the occurrence of motor or extra-motor symptomatology. CONCLUSIONS Migraine patients, especially those more severely affected, proved more vulnerable than healthy control subjects to Covid-19 lockdown. Long-lasting interruption of social interactions may be detrimental in fragile patients that are in need of structured support interventions to maintain psycho-physical wellbeing.
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Affiliation(s)
- Chiara Cerami
- Scuola Universitaria Superiore IUSS Pavia, Pavia, Italy
- Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, Pavia, Italy
| | - Chiara Crespi
- Cognitive Computational Neuroscience Research Unit, IRCCS Mondino Foundation, Pavia, Italy
- Department of Brain and Behavioral Sciences, University of Pavia, University of Pavia, Pavia, Italy
| | - Sara Bottiroli
- Faculty of Law, Giustino Fortunato University, Benevento, Italy
- Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation, Pavia, Italy
| | | | - Grazia Sances
- Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Marta Allena
- Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation, Pavia, Italy
| | - Tomaso Vecchi
- Department of Brain and Behavioral Sciences, University of Pavia, University of Pavia, Pavia, Italy
- Cognitive Psychology Research Center, IRCCS Mondino Foundation, Pavia, Italy
| | - Cristina Tassorelli
- Department of Brain and Behavioral Sciences, University of Pavia, University of Pavia, Pavia, Italy
- Headache Science and Neurorehabilitation Centre, IRCCS Mondino Foundation, Pavia, Italy
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Mahmood MM, Jafarli I, Al-Barazanchi AF, Mosa NM, Al-Ameen ZGY, Alkhanchi T. What you need to know about children's COVID-19: a systematic review. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2021; 23:1080-1090. [PMID: 34753538 DOI: 10.7499/j.issn.1008-8830.2106122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The aim of the systematic review is to describe clinical features of coronavirus disease 2019 (COVID-19) in children with a focus on the possible reasons why children are less susceptible to COVID-19 and whether their immune response works better than adults. The three research questions below were determined. (1) Why do pediatric COVID-19 cases have milder clinical symptoms than adults? (2) What are clinical manifestations, diagnosis, and treatment of COVID-19 in children? (3) How long lasts viral shedding after recovery? We searched MEDLINE, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Abstracts of Reviews of Effects, as well as foreign literature with English translations. Extra information and data have been collected from Google Scholar and the American Society for Microbiology. Information on patients' age, comorbidities, methods of treatment, and effects on mortality and morbidity were extracted. It is concluded that children are less susceptible to COVID-19 than adults and that the symptoms in children are less severe than in adults. A low incidence of COVID-19 in children and milder disease than in adults might be attributed to many theories and reasons; however, the mechanisms involved are not fully understood.
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Affiliation(s)
- Majid Mohammed Mahmood
- Unit of Zoonotic Diseases, College of Veterinary Medicine, University of Baghdad, Iraq, Baghdad, Iraq
| | - Ilhama Jafarli
- Pediatric Surgery Department, Cardiff and Vale University Hospital, Heath Park. CF14 4XW, Cardiff, Wales, UK
| | - Aras Fathi Al-Barazanchi
- Department of Pediatrics, Pediatric Hospital, Halabja, Halabja Road, Sulimanyha, Postal code 46018, Kurdistan Region of Iraq
| | - Nadhim Mohammed Mosa
- Department of Radiology Techniques, Al-Qalam University College, Nawroz City, Erbil, Postal code 44001, Iraq
| | - Zenab Ghanim Younus Al-Ameen
- Division of Pharmaceuticals, Al-Adel Health Sector, Al-Kharkh Health Center, Ministry of Health, Baghdad, Postal code 10006, Iraq
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Grazzi L, Grignani E, Raggi A, Rizzoli P, Guastafierro E. Effect of a Mindfulness-Based Intervention for Chronic Migraine and High Frequency Episodic Migraine in Adolescents: A Pilot Single-Arm Open-Label Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182211739. [PMID: 34831494 PMCID: PMC8619568 DOI: 10.3390/ijerph182211739] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 11/04/2021] [Accepted: 11/06/2021] [Indexed: 01/03/2023]
Abstract
In this single-arm pilot open-label study we examined the effect of a mindfulness-based intervention on reduction of headache frequency after 12 months in adolescents aged 12-18 with chronic or high-frequency migraine without aura. Adolescents were recruited at the headache center of the C. Besta Neurological Institute and followed-up for 12 months. The mindfulness-based intervention was delivered in small groups and consisted of six weekly group sessions of guided meditation, and one booster session 15 days after. Patients filled in questionnaires assessing headache frequency (primary endpoint), medication intake, disability, anxiety, depression, catastrophizing, and caregivers' burden. Within-person ANOVA was used to address variation of endpoints over time. Thirty-five out of 37 patients completed the study for primary endpoints, and 33 for secondary endpoints. Headache frequency dropped from 21.3 (95% CI 18.5; 24.1) to 9.6 (95% CI 6.1; 13.1) days per month at 12 months (F = 30.5, p < 0.001); 23 patients out of 35 (65.7%) achieved a headache frequency reduction greater than or equal to 50%. Significant improvements were also reported for medication intake (F = 18.7, p < 0.001), disability (F = 3.8, p = 0.027), trait anxiety (F = 5.1, p = 0.009), symptoms of depression (F = 9.5, p < 0.001), and catastrophizing (F = 23.6, p < 0.001). In conclusions, our study shows a reduction of headache attacks in adolescents who follow a mindfulness-based program, suggesting benefit of this nonpharmacological approach.
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Affiliation(s)
- Licia Grazzi
- Dipartimento Neuroalgologia Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy;
- Correspondence: ; Tel.: +39-02-2394-2366
| | - Eleonora Grignani
- Dipartimento Neuroalgologia Centro Cefalee, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy;
| | - Alberto Raggi
- UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy; (A.R.); (E.G.)
| | - Paul Rizzoli
- John Graham Headache Center, Brigham and Women’s Faulkner Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - Erika Guastafierro
- UO Neurologia Salute Pubblica e Disabilità, Fondazione IRRCS Istituto Neurologico Carlo Besta, 20133 Milano, Italy; (A.R.); (E.G.)
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Chronic Pain in Schoolchildren and its Association With Psychological Wellbeing Before and During the COVID-19 Pandemic. J Adolesc Health 2021; 69:721-728. [PMID: 34521577 PMCID: PMC8492937 DOI: 10.1016/j.jadohealth.2021.07.027] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 06/23/2021] [Accepted: 07/21/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE The current longitudinal observational study aimed to explore how chronic pain among schoolchildren changed before and during the COVID-19 pandemic, and how changes in chronic pain were related to changes in psychological wellbeing and COVID-19-related experiences. METHODS Data were collected from N = 777 German schoolchildren (aged 9-17 years) at two assessments before and one assessment during the COVID-19 pandemic lockdown. Participants self-reported chronic pain experience, anxiety, depression, and quality of life across all assessments; and COVID-19-related experiences at the last assessment. Trajectories of anxiety, depression, and quality of life as well as COVID-19-related experiences were analyzed separately for groups of stable chronic pain trajectories compared to chronic pain trajectories that changed during the pandemic. RESULTS Chronic pain prevalence was lowest at the assessment during the COVID-19 pandemic (22.8% vs. 29.2% and 29.9% before the pandemic). However, 4.6% experienced new chronic pain onset during the COVID-19 pandemic. This was preceded by heightened depression and anxiety, as well as lowered quality of life scores. These students were also more likely to describe time with their family during the COVID-19 pandemic as tense compared to students who did not develop chronic pain. During the COVID-19 pandemic boys were more likely to recover from ongoing chronic pain than girls. CONCLUSIONS Overall, during the COVID-19 pandemic the prevalence of chronic pain decreased. However, stressful situations and pre-existing vulnerabilities in psychological wellbeing can facilitate the development of chronic pain during the pandemic.
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Grozeva V, Mínguez-Olaondo A, Vila-Pueyo M. Experiment in vivo: How COVID-19 Lifestyle Modifications Affect Migraine. Front Neurol 2021; 12:744796. [PMID: 34707560 PMCID: PMC8544242 DOI: 10.3389/fneur.2021.744796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 09/03/2021] [Indexed: 11/21/2022] Open
Abstract
Introduction: The coronavirus disease 2019 (COVID-19) pandemic represents a unified lifestyle modification model, which was developed by the globally applied measures. The lockdowns designed the perfect study settings for observing the interaction between migraine and the adopted changes in lifestyle. An experiment in vivo took place unexpectedly to determine how the lockdown lifestyle modifications can influence migraine. Subsection 1: Overall lifestyle modifications during the pandemic: People stay home, and outdoor activities and public contacts are restricted. Sleep is disturbed. Media exposure and prolonged screen use are increased. Working conditions change. In-person consultations and therapies are canceled. The beneficial effects of short-term stress, together with the harmful effects of chronic stress, were observed during the pandemic. Subsection 2: Short-term effects: Substantial lifestyle changes happened, and knowing how vulnerable migraine patients are, one could hypothesize that this would have resulted in severe worsening of headache. Surprisingly, even though the impacts of changing social conditions were significant, some patients (including children) experienced a reduction in their migraine during the first lockdown. Subsection 3: Long-term effects: Unfortunately, headache frequency returned to the basal state during the second pandemic wave. The risk factors that could have led to this worsening are the long-term disruption of sleep and dietary habits, stress, anxiety, depression, non-compliance to treatment, and working during the pandemic. Discussion: Sudden short-term lifestyle changes taking migraine patients out of their usual routine may be beneficial for headache management. It is not necessary to have a natural disaster in place for a drastic lifestyle modification with 6–8-week duration, if we know that this will improve migraine.
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Affiliation(s)
| | - Ane Mínguez-Olaondo
- Department of Neurology, Hospital Universitario Donostia, San Sebastián, Spain
| | - Marta Vila-Pueyo
- Headache Group, Wolfson Centre for Age Related Diseases, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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The impact of Coronavirus disease 2019 (COVID-19) pandemic on migraine disorder. J Neurol 2021; 268:4429-4435. [PMID: 33950336 PMCID: PMC8098636 DOI: 10.1007/s00415-021-10590-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Revised: 04/28/2021] [Accepted: 04/30/2021] [Indexed: 12/05/2022]
Abstract
Objective To evaluate the impact of the Coronavirus disease of 2019 (COVID‐19) pandemic on patients with migraine. Methods Self-reported data from a migraine tracking smartphone application, Migraine Buddy, were used. Data were collected from users who reported at least one attack in the Jan, Feb, Mar and Apr of 2018, 2019 and 2020. In addition, a survey was conducted to evaluate the impact of COVID‐19 on migraine management. Results On average, data from 124,717 users per month (mean age 36.3 ± 10.9 years and 89% female) were collected. Overall, the mean frequency of migraine headache was higher in 2020 than in 2019 and higher in 2019 than in 2018. The four commonest headache triggers in 2018, 2019 and 2020 were stress in 39.7, 38.4 and 36.1%, lack of sleep in 25, 25 and 22.8%, neck pain, 20, 20.4 and 19.3 and anxiety in 19, 18.4 and 18.4% of participants, respectively. 1689 users participated in the survey and they reported that they preferred face-to-face (54.29%) to telehealth (11.9%) consultations. Conclusion An increase in migraine frequency from 2018 to 2020 was reported by the users of the mobile phone. This could reflect a real increase or change in reporting habits. Stress, lack of sleep, neck pain and anxiety were the commonest attack triggers. The frequency of these triggers decreased slightly in 2020 compared to 2019 and 2018. An increase in telehealth consultations with specialists was reported in the survey but migraine patients preferred face-to-face consultations.
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Di Stefano V, Ornello R, Gagliardo A, Torrente A, Illuminato E, Caponnetto V, Frattale I, Golini R, Di Felice C, Graziano F, Caccamo M, Ventimiglia D, Iacono S, Matarazzo G, Armetta F, Battaglia G, Firenze A, Sacco S, Brighina F. Social Distancing in Chronic Migraine during the COVID-19 Outbreak: Results from a Multicenter Observational Study. Nutrients 2021; 13:1361. [PMID: 33921674 PMCID: PMC8074143 DOI: 10.3390/nu13041361] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 04/12/2021] [Accepted: 04/13/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The restrictions taken to control the rapid spread of COVID-19 resulted in a sudden, unprecedented change in people's lifestyle, leading to negative consequences on general health. This study aimed to estimate the impact of such changes on migraine severity during 2020 March-May lockdown. METHODS Patients affected by migraine with or without aura, diagnosed by expert physicians, completed a detailed interview comprehensive of: assessment of migraine characteristics; measure of physical activity (PA) levels; measure of the intake frequency of main Italian foods; the Insomnia Severity Index (ISI) questionnaire investigating sleep disorders. RESULTS We included 261 patients with a mean age of 44.5 ± 12.3 years. During social distancing, 72 patients (28%) reported a headache worsening, 86 (33%) an improvement, and 103 (39%) a stable headache frequency. A significant decrease of the PA levels during COVID-19 quarantine in the whole study sample was observed (median total metabolic equivalent task (METs) decreased from 1170 to 510; p < 0.001). Additionally, a significant difference was reported on median ISI scores (from 7 to 8; p < 0.001), which were increased in patients who presented a stable or worsening headache. CONCLUSIONS Our study confirmed that the restrictions taken during the pandemic have affected the practice of PA levels and sleep quality in migraine. Hence, PA and sleep quality should be assessed to find strategies for an improvement in quality of life.
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Affiliation(s)
- Vincenzo Di Stefano
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Raffaele Ornello
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (R.O.); (V.C.); (I.F.); (G.M.); (S.S.)
| | - Andrea Gagliardo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Angelo Torrente
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Elisa Illuminato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (E.I.); (F.A.); (A.F.)
| | - Valeria Caponnetto
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (R.O.); (V.C.); (I.F.); (G.M.); (S.S.)
| | - Ilaria Frattale
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (R.O.); (V.C.); (I.F.); (G.M.); (S.S.)
| | - Raffaella Golini
- Department of Internal Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (R.G.); (C.D.F.)
| | - Chiara Di Felice
- Department of Internal Medicine, Public Health, Life and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (R.G.); (C.D.F.)
| | - Fabiola Graziano
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Maria Caccamo
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Davide Ventimiglia
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Salvatore Iacono
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
| | - Gabriella Matarazzo
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (R.O.); (V.C.); (I.F.); (G.M.); (S.S.)
| | - Francesco Armetta
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (E.I.); (F.A.); (A.F.)
| | - Giuseppe Battaglia
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90127 Palermo, Italy;
| | - Alberto Firenze
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro”, University of Palermo, 90127 Palermo, Italy; (E.I.); (F.A.); (A.F.)
| | - Simona Sacco
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, 67100 L’Aquila, Italy; (R.O.); (V.C.); (I.F.); (G.M.); (S.S.)
| | - Filippo Brighina
- Department of Biomedicine, Neuroscience and Advanced Diagnostic (BIND), University of Palermo, 90127 Palermo, Italy; (A.G.); (A.T.); (F.G.); (M.C.); (D.V.); (S.I.); (F.B.)
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31
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Migraine during COVID-19: Data from Second Wave Pandemic in an Italian Cohort. Brain Sci 2021; 11:brainsci11040482. [PMID: 33920175 PMCID: PMC8070557 DOI: 10.3390/brainsci11040482] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/07/2021] [Accepted: 04/08/2021] [Indexed: 12/24/2022] Open
Abstract
Objectives: The study aims to assess the impact of the second COVID-19 pandemic wave on migraine characteristics. Methods: This is an observational cross-sectional study conducted on migraine patients previously interviewed during the first Italian pandemic outbreak. A second structured telephone interview was conducted between 20 November 2020 and 18 January 2021. We compared migraine characteristics among T0 (before pandemic), T1 (during the first pandemic phase), and T2 (during the second pandemic phase). Results: Among the 433 patients interviewed during the first pandemic phase, 304 cases were finally considered. One hundred forty-eight patients had a control visit between March 2020 and December 2020, 120 had an in-person visit, 14 by phone, the remainder used telemedicine software provided by the hospital. Frequency of headache, number of symptomatic drugs and headache intensity worsened during T2, compared to T0 and T1, especially in episodic migraine. Headache intensity increased relating to the negative emotional impact of the pandemic. Migraine management during the pandemic did not influence the clinical outcome. Conclusion: The prolongation of the pandemic seems to have a negative impact on migraine evolution. The arousal and negative psychological behavior toward the COVID-19 outbreak seem to worsen migraine.
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Okuyama J, Seto S, Fukuda Y, Funakoshi S, Amae S, Onobe J, Izumi S, Ito K, Imamura F. Mental Health and Physical Activity among Children and Adolescents during the COVID-19 Pandemic. TOHOKU J EXP MED 2021; 253:203-215. [PMID: 33775993 DOI: 10.1620/tjem.253.203] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is causing disruptions in the global social system. Japanese children and adolescents have had their schools closed, government-mandated activity restrictions imposed, and interactions outside the home reduced. These restrictions can have a considerable psychological impact on children and adolescents. This review aims to describe the impacts of COVID-19 pandemic on physical activity and psychological status of this population. The review was conducted by searching PubMed for information on the impact of COVID-19-related activity restrictions on children and adolescents. The search identified 11 articles, three of which contained data on anxiety and psychological problems due to physical inactivity. Next, a PubMed search was conducted about physical activity and psychological status in children and adolescents under psychological stress. The search identified 368 articles, 28 of which were included in the review. For children, data that revealed a correlation between physical activity and psychological health and sedentary time leading to mood disorders were included. For adolescents, there were nine studies that reported a correlation between physical activity and psychological health and four studies that reported no correlation between physical activity and psychological health. Of the studies that reported a correlation, seven reported that physical activity improves psychological health. The impact of psychologically stressful situations such as COVID-19 on children and adolescents has been experienced worldwide. Physical activity has been correlated with psychological health, and it may improve psychological status; physical activity should be recommended to better support the psychological health of children and adolescents under the influence of COVID-19.
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Affiliation(s)
- Junko Okuyama
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine.,Core Research Cluster of Disaster Science, Tohoku University
| | - Shuji Seto
- Core Research Cluster of Disaster Science, Tohoku University.,International Research Institute of Disaster Science (IRIDeS), Tohoku University
| | | | | | - Shintaro Amae
- Sendai Ekoh Medical and Rehabilitation Center for Persons with Severe Motor and Intellectual Disabilities
| | - Jun Onobe
- Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University
| | - Shinichi Izumi
- Department of Physical Medicine and Rehabilitation, Tohoku University Graduate School of Medicine
| | - Kiyoshi Ito
- Core Research Cluster of Disaster Science, Tohoku University.,International Research Institute of Disaster Science (IRIDeS), Tohoku University
| | - Fumihiko Imamura
- Core Research Cluster of Disaster Science, Tohoku University.,International Research Institute of Disaster Science (IRIDeS), Tohoku University
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Abstract
Most children with SARS-CoV-2 infection have relatively mild clinical symptoms without fever or pneumonia, although severe cases with multiple-organ failure have been reported. Neurological symptoms, which have been mainly reported in adults, are very rare in children. This article will review 2 different aspects of neurological involvement related to this infection in children. In the first part, we will review the neurological abnormalities reported in children caused by this viral infection. Adults frequently report muscle pain, headache, anosmia, dysgeusia, and occasionally more severe central or peripheral nervous system damage. Neurological involvement seems infrequent in children, although some cases have been reported. In the second part, we will discuss the COVID-19 pandemic impact on the healthcare system of some countries, causing collateral damage to general pediatric care and in particular to those children affected with chronic diseases, mainly neurological conditions, including autism, intellectual disability, attention deficit and hyperactivity disorder (ADHD), neuromuscular disorders, cerebral palsy, and epilepsy, and patients needing neurosurgical procedures.
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Affiliation(s)
- Susana Boronat
- Pediatric Neurology, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
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34
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Raucci U, Musolino AM, Di Lallo D, Piga S, Barbieri MA, Pisani M, Rossi FP, Reale A, Ciofi Degli Atti ML, Villani A, Raponi M. Impact of the COVID-19 pandemic on the Emergency Department of a tertiary children's hospital. Ital J Pediatr 2021; 47:21. [PMID: 33514391 PMCID: PMC7844808 DOI: 10.1186/s13052-021-00976-y] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 01/21/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Italy was the first country in Europe affected by COVID-19: the emergency started on February 20, 2020, culminating with national lockdown on March 11, which terminated on May 4, 2020. We describe how the pandemic affected Emergency Department (ED) accesses in a tertiary children's hospital, composed by two different pediatric centers, one located in Rome's city center and the second, Palidoro (regional COVID-19 center), in its surrounding metropolitan area, both in the Lazio region, analyzing the profile of admitted patients during the pandemic period in terms of their general characteristics (at presentation in the ED's) and urgent hospitalizations compared to prepandemic period. METHODS The study compare the period between the 21st of February and the 30th of April 2020, covering the three phases of the national responses (this period will be referred to as the pandemic period) with the same period of 2019 (prepandemic period). The study analyzes the number of ED visits and urgent hospitalizations and their distribution according to selected characteristics. RESULTS The reduction of ED visits was 56 and 62%, respectively in Rome and Palidoro centers. The higher relative decline was encountered for Diseases of Respiratory System, and for Diseases of the Nervous System and Sense Organs. A doubling of the relative frequency of hospitalizations was observed, going from 14.2 to 24.4% in Rome and from 6.4 to 10.3% in Palidoro. In terms of absolute daily numbers the decrease of urgent hospitalizations was less sharp than ED visits. For pathologies such as peritonitis, tumors or other possible life-treathening conditions we did not observe a significative increase due to delayed access. CONCLUSIONS In the pandemic period there was a general reduction in the number of children referred to ED, such reduction was greater in low-acuity levels. The reduction for respiratory tract infections and other communicable diseases during school closure and the national lockdown must make us reflect on the possible impact that these conditions may have on the health system, in particular the ED, at the reopening of schools. The major problem remains the fear for possible diagnostic delays in life-threatening or crippling diseases; our study doesn't demonstrate an increase in number or significant delay in some serious conditions such as tumors, peritonitis, diabetic ketoacidosis, ileo-colic intussusception and testis/ovary torsion. A continuous, deep re-organizational process step by step of the ED is nececessary in the present and upcoming pandemic situation.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
| | - Anna Maria Musolino
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Domenico Di Lallo
- Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Simone Piga
- Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Mara Pisani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Francesco Paolo Rossi
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marta Luisa Ciofi Degli Atti
- Clinical Pathways and Epidemiology Unit, Medical Direction, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Palidoro, Rome, Italy
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35
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Abstract
A recent study reports an improvement in migraine symptoms during a COVID-19 lockdown in the Netherlands. The findings suggest that lifestyle changes can substantially alter the course of migraine, opening the door for greater use of behavioural interventions alongside existing pharmacological therapies.
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Affiliation(s)
- Licia Grazzi
- grid.417894.70000 0001 0707 5492Headache and Neuroalgology Unit, Neurological Institute “C. Besta” IRCCS Foundation, Milan, Italy
| | - Paul Rizzoli
- grid.415122.10000 0004 0378 8518John R. Graham Headache Center, Brigham & Women’s/Faulkner Hospital, Department of Neurology, Boston, MA USA
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36
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Pohl H, Gantenbein AR. [COVID-19 and Headaches]. PRAXIS 2021; 110:201-206. [PMID: 33726510 DOI: 10.1024/1661-8157/a003661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
COVID-19 and Headaches Abstract. Headaches are a common symptom of COVID-19 infections. Patients generally describe them as bilateral, predominantly frontal, squeezing and of moderate or severe intensity. Searching for "Red Flags" often allows distinction from primary headaches - usually fever, cough, and elevated inflammatory markers accompany COVID-19-associated headaches. Prospective studies did not confirm caveats against the use of ibuprofen as symptomatic treatment. While carrying facial masks often caused headaches, probably by compressing sensory nerves, many patients' migraine frequencies dropped during lockdown. Treatment of patients with primary headaches was complicated by quarantine and many centres offered online consultations.
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Affiliation(s)
- Heiko Pohl
- Klinik für Neurologie, Universitätsspital Zürich
| | - Andreas R Gantenbein
- Klinik für Neurologie, Universitätsspital Zürich
- Neurologie & Neurorehabilitation, RehaClinic Bad Zurzach
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37
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Smirni D. Noli Timere: The Role of Reassuring Adults in Dealing with COVID-19 Anxiety in Pediatric Age. Pediatr Rep 2021; 13:15-30. [PMID: 33401500 PMCID: PMC7838802 DOI: 10.3390/pediatric13010003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Revised: 12/06/2020] [Accepted: 12/09/2020] [Indexed: 12/19/2022] Open
Abstract
Since the earliest stages of the Corona Virus Disease-19 (COVID-19) spread, the elderly has been identified as the most vulnerable and health authorities have rightly focused on that population. Minor attention was paid to pediatric populations and their emotional reactions. Actually, children and adolescents faced severe anxiety, fear and stress conditions. An efficient management of the pandemic, therefore, must take into account the pediatric population which cannot be neglected as a minor matter compared to the elderly, the economy and health care. Since the lockdown time is over, children and adolescents must recover sociality, return to living in the open air, rediscover playing, free time, aiming for the beauty of their everyday life. In order to mitigate the long-term impact of COVID-19, the key response is the reassuring presence of the adult as 'a secure base'. The current study aimed to collect an overview of the recent references that report evidence on the role of adults in containing pandemic anxiety COVID-19 in pediatric populations, suggesting the need to ensure a reassuring presence of the adult, an effective child-parent communication, a child-friendly day and a long-lasting shared time with parents.
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Affiliation(s)
- Daniela Smirni
- Department of Psychology, Educational Science and Human Movement, University of Palermo, 90128 Palermo, Italy
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38
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Peng KP. Association between COVID-19 and headache: What evidence and history tell us. Cephalalgia 2020; 40:1403-1405. [PMID: 33146041 DOI: 10.1177/0333102420965969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Kuan-Po Peng
- Department of Systems Neuroscience, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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