Psychopathology in children and adolescents with primary headaches: Categorical and dimensional approaches

Background Recurrent headache is common in childhood, but there is not a great amount of data on the associations between headaches and psychopathology in children. Objective The aim of this study is to examine the relationships between primary headaches and psychopathology in children, using both the categorical and dimensional assessment. Methods The sample consisted of 70 patients with primary headache compared to a matched sample of 50 healthy children. Psychiatric comorbidity was defined according to the diagnostic criteria of the Diagnostic and Statistical Manual of Disorders. Child psychopathology outcomes were assessed using child- and parent-reported standardized instruments. Results Internalizing and externalizing problems were significantly represented among children with headaches compared to the control group, respectively 63% and 27%, without significant differences between migraine and tension-type headache children. Moreover, a total of 26% of the children with a headache reported psychiatric comorbidity such as anxiety and mood disorders. Conclusion The dimensional approach improves accuracy in the recognition of emotional and behavioral problems compared to the categorical approach; however, the use of both of these approaches could be useful for clinical practice, treatment and research.

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Is There a Relation Between Vitamin B₁₂ Levels and Headaches in Children and Adolescents?

Journal of Dr Behcet Uz Children s Hospital ◽

10.5222/buchd.2021.32767 ◽

2021 ◽

Author(s):

Müge Ayanoğlu ◽

Hale Tuhan ◽

Ayça Kömüroğlu ◽

Ayşe Tosun

Keyword(s):

Vitamin B12 ◽

Children And Adolescents ◽

Tension Type Headache ◽

Control Group ◽

Vitamin B ◽

Primary Headaches ◽

Healthy Children ◽

Significant Difference ◽

Type Headache ◽

Lower Vitamin

Objective: Primary headaches are common and benign discomforts both in children and adolescents. However, they have a negative influence on the quality of life. This retrospective study aimed to determine the relationship between vitamin B12 results and primary headaches in Turkish children. Methods: Demographical features, headache types, laboratory results, including vitamin B12, were assessed retrospectively. Headache types were categorized as tension-type headache, migraine, and unclassified headache according to the International Classification of Headache Disorders-beta version (ICD-3 beta). Patients with seconder headaches, anemia, and macrocytosis were excluded. Results: The study group consisted of 133 (86 female, 47 male) patients with headache and a control group of 103 (57 female, 46 male) healthy children. There was no significant difference in terms of age and gender between groups (p>0.05). Vitamin B₁₂ levels in tension-type headache, migraine, and unclassified headache groups were significantly lower (p<0.0001) than in the control group. Logistic regression has identified lower vitamin B12 levels than 400 pg/ml as an independent risk factor for headache (OR: 3.212, 95% CI: 1.850-5.576). Conclusion: We conclude that lower vitamin B12 levels than 400 pg/mL may be associated with tension-type headache, migraine, and unclassified headache.

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Genetic aspects of primary headaches in Siberia (Russia)

Personalized Psychiatry and Neurology ◽

10.52667/2712-9179-2021-1-1-54-63 ◽

2021 ◽

Vol 1 (1) ◽

pp. 54-63

Author(s):

A. V. Kondratiev ◽

N. A. Shnayder ◽

A. Shulmin ◽

D. V. Dmitrenko ◽

V. V. Trefilova ◽

...

Keyword(s):

Risk Factor ◽

Primary Headache ◽

European Population ◽

Mthfr Gene ◽

Tension Type Headache ◽

Control Group ◽

Primary Headaches ◽

Single Nucleotide Variants ◽

Allelic Discrimination ◽

Type Headache

Primary headaches are common neurological problem in the world. Migraine (M) and tension type headache (TTH) are the leaders in the structure of primary headaches in the population; (1) Background: The study of the association of single nucleotide variants (SNVs) of MTHFR (meth-ylenetetrahydrofolate reductase) and HTR2C (5-Hydroxytryptamine Receptor 2C) genes with M and TTH development in the European population in Siberia (Russia); (2) Methods: 192 adults were examined: 82 (42.7%) males and 110 (57.3%) females. Control group: 81 healthy adults, median age 49.5 [36; 59] years; 53 (66.7%) males and 27 (33.3%) females. Headache group consisted of 111 patients with primary headache, median age 54 [45; 64] years, including two subgroups: subgroup 1 (M) of 39 patients; subgroup 2 (TTH) of 72 patients. Carriage of alleles and genotypes rs1801133 and rs1801131 of the MTHFR gene and rs6318 of the HTR2C gene was determined using PCR-RT by TaqMan allelic discrimination technology; (3) Results: A statistically significant association of the carriage of the A allele rs1801133 of the MTHFR gene with the formation of M (p = 0.025) and TTH (p = 0.022), as well as the GA genotype with the development of TTH (p = 0.024) was revealed. Carriage of the G allele and the TG and GG genotypes of the MTHFR gene, associated with a decreased activity of the MTHFR enzyme, does not affect the development of primary headache. A statistically significant association was revealed between the carriage of the heterozygous GC genotype (rs6318) of the HTR2C gene and the formation of M (p = 0.013); (4) Conclusions: Carriage of the A allele (OR 1.77; 95% CI 1.09-2.89) and the GA genotype (OR 2.24; 95% CI 1.17-4.29) rs1801133 of the MTHFR gene is a risk factor for the development of TTH (p <0.05). Carriage of the A allele rs1801133 of the MTHFR gene is a risk factor for the development of M (OR 1.97; 95% CI 1.08-3.57; p <0.05). Carriage of the variant G allele and rs1801131 GT and GG genotypes associated with reduced activity of the MTHFR enzyme does not affect the development of primary headache. In the control group, the prevalence of the T allele associated with normal enzymatic activity was noted (p = 0.024). Carriage of the heterozygous genotype CG SNV rs6318 of the HTR2C gene increases the risk of developing migraine by 3.6 times.

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The need for preventive therapy in primary headaches

Headache Medicine ◽

10.48208/headachemed.2011.10 ◽

2011 ◽

pp. 46-49

Author(s):

Mario Fernando Prieto Peres ◽

Daniel Krempel Amado ◽

André Leite Gonçalves ◽

Reinaldo Ribeiro ◽

Jorge Roberto Pagura ◽

...

Keyword(s):

Preventive Treatment ◽

Primary Headache ◽

Preventive Therapy ◽

Tension Type Headache ◽

Primary Headaches ◽

Correct Treatment ◽

Treatment Type ◽

Geographical Regions ◽

Probable Migraine ◽

Type Headache

Introduction: Primary headaches are common conditions. In Brazil, the prevalence of migraine is 15.2%, tension-type headache 13% and chronic daily headache (CDH) 6.9%. Although frequent disorders a proportion of patients are undertreated. Patients patterns of headache care can trend toward acute medication only and those in need of prevention may not receive it. Objective: To estimate the rates of preventive treatment in primary headache sufferers. Methods: A telephone interview containing questions about headache and socio-demographic characteristics was applied to 3,848 people from 27 States of Brazil, in its five geographical regions. We considered MIDAS > 10 points as a marker for the need of preventive treatment. Patients were asked if they were taking any medication on a daily basis or any treatment to prevent headaches from happening. Subjects were divided into: 1. Those who responded positively for the question regarding preventive treatment regardless of the treatment type. 2. Those who responded positively for the question, but only medications or treatments studied for migraine prevention, labeled as "Correct treatment" 3. Those who responded positively for the question, but only medications or treatments from the prevention consensus (Brazilian Headache Society), labeled as "Consensus treatment" Results: In total, 12.8% of primary headache sufferers had MIDAS higher than 10, meeting criteria for prophylactic treatment, but only 8.4% of them reported it, 3.9% were using a right preventive treatment. The percentage of patients in need for prevention was 24.7% in migraine, 15.6 % in probable migraine, 5 % for tension-type headache (TTH) and 4% for probable TTH. Only 2.6% of migraineurs, 7.5% of probable migraine patients, 4.3% of tension-type headache and 0% of probable TTH received proper preventive treatment Conclusion: Primary headaches are common, debilitating conditions but a substantial proportion of those who might need prevention do not receive it. Patient education, public health initiatives in order to deliver migraine and other primary headaches treatment for the general population should be considered not only in Brazil, but worldwide.

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Prevalence and characteristics of headache attributed to ingestion or inhalation of a cold stimulus (HICS): A cross-sectional study

Cephalalgia ◽

10.1177/0333102419884938 ◽

2019 ◽

Vol 40 (3) ◽

pp. 299-306

Author(s):

Torsten Kraya ◽

Malte Schulz-Ehlbeck ◽

Philipp Burow ◽

Stefan Watzke ◽

Stephan Zierz

Keyword(s):

Rating Scale ◽

Primary Headache ◽

Tension Type Headache ◽

Primary Headaches ◽

Cross Sectional ◽

Cold Stimulus ◽

Clinical Criteria ◽

Number Of Patients ◽

Accompanying Symptoms ◽

Type Headache

Background Headache attributed to ingestion or inhalation of a cold stimulus (HICS), colloquially called ice-cream headache, is a common form of a primary headache in adults and children. However, previous studies on adults are limited due to the small number of patients. Furthermore, most of the subjects in previous studies had a history of other primary headaches. Methods Biographic data, clinical criteria of HICS and prevalence of primary headache were collected by a standardized questionnaire. A total of 1213 questionnaires were distributed; the return rate was 51.9% (n = 629); 618 questionnaires could be analyzed. Results In a cohort of 618 people aged between 17–63 years (females: n = 426, 68.9%), the prevalence of HICS was 51.3% (317 out of 618). There was no difference between men and women (51.3% vs. 51.6%). The duration of HICS was shorter than 30 sec in 92.7%. In the HICS group, localization of the pain was occipital in 17%. Trigemino-autonomic symptoms occurred in 22%, and visual phenomena (e.g. flickering lights, spots or lines) were reported by 18% of the HICS group. The pain intensity, but not the prevalence of HICS, was higher when tension-type headache and migraine or both were present as co-morbid primary headaches (Numeric Rating Scale (NRS) 4.58 and 6.54, p = 0.006). There was no higher risk of participants with migraine getting HICS than for those who did not have migraine (odds ratio = 1.17, 95% confidence interval (CI) 0.75–1.83; p = 0.496). Conclusion The results of this study modified the current criteria for HICS in the ICHD-3 regarding duration and localization. In addition, accompanying symptoms in about one fifth of the participants are not mentioned in the ICHD-3. Neither migraine nor tension-type headache seems to be a risk factor for HICS. However, accompanying symptoms in HICS are more frequent in subjects with another primary headache than in those without such a headache.

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Clinical features, diagnosis and treatment of acute primary headaches at an emergency center: why are we still neglecting the evidence?

Arquivos de Neuro-Psiquiatria ◽

10.1590/s0004-282x2007000700007 ◽

2007 ◽

Vol 65 (4b) ◽

pp. 1130-1133 ◽

Cited By ~ 6

Author(s):

Facundo Burgos Ruiz Jr ◽

Márcia Silva Santos ◽

Helen Souto Siqueira ◽

Ulisses Correa Cotta

Keyword(s):

Clinical Features ◽

Primary Headache ◽

Tension Type Headache ◽

Primary Headaches ◽

Main Diagnosis ◽

Management Protocol ◽

Headache Management ◽

Probable Migraine ◽

Type Headache ◽

Acute Headache

In order to analyze the clinical features, approach and treatment of patients with acute primary headaches seen at the Clinics Hospital of the Federal University of Uberlândia (HC-UFU) throughout 2005, the medical charts of 109 patients were evaluated through a standardized questionnaire as to age, gender, main diagnosis, characteristics of the headache attacks, diagnostic tests and treatment. Probable migraine was the most common type of primary headache (47.7%), followed by probable tension-type headache (37.6%), unspecified headache (11.9%), and headache not elsewhere classified (2.8%). As to characteristics of the crisis, the location of the pain was described in 86.2% of the patients. The most commonly used drugs for treatment of acute headache attacks were dipyrone (74.5%), tenoxicam (31.8%), diazepam (20.9%), dimenhydrate (10.9%), and metochlopramide (9.9%). The data collected are in agreement with those reported in literature. In most cases, treatment was not what is recommended by consensus or clinical studies with appropriate methodology. Therefore, we suggest the introduction of a specific acute headache management protocol which could facilitate the diagnosis, treatment and management of these patients.

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Primary Headache in Yemen: Prevalence and Common Medications Used

Neurology Research International ◽

10.1155/2014/808126 ◽

2014 ◽

Vol 2014 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Salah A. Abdo ◽

Mohammed Amood AL-Kamarany ◽

Karem H. Alzoubi ◽

Mohamed T. Al-Maktari ◽

Abdulrhman H. Al-Baidani

Keyword(s):

Diclofenac Sodium ◽

Case Series ◽

Primary Headache ◽

Tension Type Headache ◽

Primary Headaches ◽

Simple Explanation ◽

Cross Sectional ◽

High Prevalence ◽

Type Headache ◽

The Relationship

Background and Objective. Primary headaches is a major medical concern in certain Arabic countries, for example Oman, Jordan, and Qatar. This study was aimed at increasing understanding of the prevalence of headache in Arabic countries and identifying common medications used for treatment because of the lack of research done in this field in Yemen.Methods. This is a cross-sectional observational study conducted by recruiting case-series of adults and elderly who have primary headache within the age group from 18 to 85 years. 12640 subjects received a simple explanation for the aim of the study as ethical issue. The subjects were allowed to complete a self-conducted screening questionnaire. The data were diagnosed according to the International Headache Society’s diagnostic criteria (2004).Results. The results showed that 76.5% of the primary headache is prevalent at least once per year, 27.1% of the tension type headache (TTH) was the maximum percentage of type of headache, and 14.48% of the migraine headache (MH) was the minimum percentage. On the other hand, the relationship between the primary headache and age of subjects was statistically significant (P<0.05), while between primary headache and sex was not (P>0.05). In addition, 70.15% of the subjects said that headache attacks affected their activity of daily livings (ADL). 62.26% of the subjects used the medications without medical advice regarding their headache. 37.73% of the subjects relied on medical professionals (physicians and pharmacist) regarding analgesics use. The most common agent used among the medications was paracetamol (38.4%). Others included ibuprofen, aspirin, diclofenac sodium, naproxen, mefenamic acid, ergotamine and (11.45%) were unknown agents.Conclusion. We concluded that absence of health attention from the Yemeni Community and education from the health system in the country regarding analgesics use and their potential risk led to abuse of such medications and could be a reason beyond high prevalence of headache in Yemen.

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Estimation of Antiphospholipid Antibodies in a Prospective Longitudinal Study of Children with Migraine

Cephalalgia ◽

10.1111/j.1468-2982.2004.00752.x ◽

2004 ◽

Vol 24 (10) ◽

pp. 831-837 ◽

Cited By ~ 23

Author(s):

T Avcin ◽

G Markelj ◽

V Niksic ◽

Z Rener-Primec ◽

S Cucnik ◽

...

Keyword(s):

Antiphospholipid Antibodies ◽

Tension Type Headache ◽

Control Group ◽

Healthy Children ◽

Prospective Longitudinal Study ◽

Glycoprotein I ◽

Patient Groups ◽

Unselected Group ◽

Type Headache ◽

Prospective Longitudinal

The aim of this study was to determine the prevalence and clinical significance of antiphospholipid antibodies (aPL) in children with migraine. The values of anti-cardiolipin (aCL) and antiβ2 glycoprotein I (antiβ2GPI) antibodies were assayed by an ELISA method in 52 children with migraine and 22 children with tension-type headache. The control group consisted of 61 apparently healthy children at regular preventive visits. Two monoclonal β2GPI dependent aCL (HCAL and EY2C9) were used as calibrators. Lupus anticoagulant (LA) was determined by a modified dilute Russell viper venom time test. Persistently positive aPL were observed during the follow-up in 16.3% of children with migraine (9.3% for aCL, 7.0% for antiβ2GPI and 0% for LA) and in 16.7% of children with tension-type headache (11.1% for aCL, 5.6% for antiβ2GPI and 0% for LA). The prevalence of aPL did not differ significantly between patient groups and healthy children. The prevalence of aPL does not appear to be increased in an unselected group of children with migraine, however, the possible role of aPL in individual cases of paediatric migraine can not be excluded.

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Diagnosis of primary headache in children younger than 6 years: A clinical challenge

Cephalalgia ◽

10.1177/0333102416660533 ◽

2016 ◽

Vol 37 (10) ◽

pp. 947-954 ◽

Cited By ~ 13

Author(s):

Roberto Torriero ◽

Alessandro Capuano ◽

Rosanna Mariani ◽

Roberto Frusciante ◽

Samuela Tarantino ◽

...

Keyword(s):

International Headache Society ◽

Primary Headache ◽

Tension Type Headache ◽

Preschool Age ◽

Clinical Feature ◽

Primary Headaches ◽

Clinical Challenge ◽

Adults And Children ◽

Type Headache

Background Criteria defined by the International headache Society are commonly used for the diagnosis of the different headache types in both adults and children. However, some authors have stressed some limits of these criteria when applied to preschool age. Objective Our study aimed to describe the characteristics of primary headaches in children younger than 6 years and investigate how often the International Classification of Headache Disorders (ICHD) criteria allow a definitive diagnosis. Methods This retrospective study analysed the clinical feature of 368 children younger than 6 years with primary headache. Results We found that in our patients the percentage of undefined diagnosis was high when either the ICHD-II or the ICHD-III criteria were used. More than 70% of our children showed a duration of their attacks shorter than 1 hour. The absence of photophobia/phonophobia and nausea/vomiting significantly correlate with tension-type headache (TTH) and probable TTH. The number of first-degree relatives with migraine was positively correlated to the diagnosis of migraine in the patients ( p < 0.001). Conclusions Our study showed that the ICHD-III criteria are difficult to use in children younger than 6 years. The problem is not solved by the reduction of the lowest duration limit for the diagnosis of migraine to 1 hour, as was done in the ICHD-II.

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POTENTIAL GENDER DIFFERENCES IN PATHOPHYSIOLOGY OF MIGRAINE AND TENSION TYPE HEADACHE

Human Care Journal ◽

10.32883/hcj.v5i2.749 ◽

2020 ◽

Vol 5 (2) ◽

pp. 539

Author(s):

Restu Susanti

Keyword(s):

Gender Differences ◽

Sex Differences ◽

Psychosocial Factors ◽

Primary Headache ◽

Tension Type Headache ◽

Primary Headaches ◽

Trigeminal Autonomic Cephalalgias ◽

Migraine Headaches ◽

Type Headache ◽

Underlying Diseases

Headache is one of the most common symtomps which cause patients consult a neurologist. Primary headache is headache without other underlying diseases. Primary headaches can be divided into migraine headaches, tension types-headache, trigeminal autonomic cephalalgias, and other types of headaches. Sex differences play a role in the perception of headache. Theories regarding hormonal, the number of pain-sensitive points, subjectivity, and psychosocial factors are mostly related to the differences of migraine and TTH pathophysiology between women and men.

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Primary headaches and cognitive disorders — pathophysiologically associated and comorbidity conditions.

V M BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY ◽

10.31363/2313-7053-2018-2-97-103 ◽

2018 ◽

pp. 97-103

Author(s):

D. A. Iskra ◽

V. Yu. Lobzin ◽

S. A. Kalygin

Keyword(s):

Cognitive Impairment ◽

Nmda Receptors ◽

Central Sensitization ◽

Adult Population ◽

Primary Headache ◽

Tension Type Headache ◽

Glutamate Excitotoxicity ◽

Primary Headaches ◽

Cognitive Symptoms ◽

Type Headache

Primary headaches (migraine, tension-type headache and other primary headaches) cause 3% of all disability cases in adult population, fully decrease possibilities of social functioning. Te phenomenon of the central sensitization is one of the fundamental pathophysiological units of primary headaches. NMDA receptors are involved both in initiation and in maintaining of mechanisms of a long-term central sensitization. NMDA activation by glutamate play important role in the initiation of primary headaches. Cognitive impairment development also conducted with NMDA-excitotoxicity due to hyper excitability of NMDA receptors. Tus, it is evident that mechanisms of antinociceptive changes in primary headaches and development of a glutamate excitotoxicity are strongly interdependent. Relationship between somatic symptoms, such as headache in dementia and cognitive symptoms now is represented more widely than just a comorbidity. Te gravity of migraine, tension-type headache and severity of cognitive impairment are strongly connected. Tus, the reliable interrelation between development of primary headache and cognitive decrease is traced, considering a community of pathophysiological mechanisms that has important practical value due to possible correction by NMDA-antagonists. Memantine not only slows the progression of cognitive symptoms in dementia, but also signifcantly inﬂuences the frequency and expressiveness of primary headache.

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