Metacognition and headache: which Is the role in childhood and adolescence?

Headache, in particular migraine, is one of the most frequent neurological symptoms in children and adolescents and it affects about 60% of children and adolescents all over the world. Headache can affect several areas of child’s functioning, such as school, physical activities, peer, and family relationship. The global and severe burden of this disease requires a multidisciplinary strategy and an effective treatment addressed all of the patient’s needs and based on cutting-edge scientific research. In recent years, research has focused on cognitive factors specifically in functions called metacognitive processes. Metacognition can be defined as the knowledge, beliefs, and cognitive processes involved in monitoring, control, and assessment of cognition. Metacognition seems to be closely related to the ability of theory of mind, the ability to infer, and reason about the mental states of other people in order to predict and explain own behavior. Recent studies found a relationship between metacognitive skills and anxiety, depression, motivation, academic performance, human social interactions, and stress symptoms. This relationship is very interesting for headache treatment, because these factors are the most commonly reported triggers in this disorder and there is a high comorbidity with anxiety and depression in children and adolescents with headache. So, headache and these comorbidities, in particular anxiety and depression, may have in common persistent and maladaptive patterns of thinking which are related to maladaptive metacognitive beliefs. Further research should assess metacognitive processes of children and adolescents with headache in order to increase their ability to control their own cognitive processes and consequently monitor factors which may trigger the attacks

Headache and alexithymia in children and adolescents: what Is the connection?

Background: Headache is one of the most common complaints in children and adolescents and comorbidity rates are very high and the major associated diseases are depression, anxiety, atopic disorders, sleep, and behavioral disorders. In recent years, it has been highlighted that difficulties regulating emotions such as alexithymia have also been associated with diagnosis of somatization. Methods: We carried out a mini review analyzing the relation between alexithymia and primary headache (e.g., migraine and tension type headache) in children and adolescents by synthesizing the relevant studies in the literature on PubMed, PsycINFO, and Google Scholar. Search terms were "alexithymia" combined with the "primary headache," "migraine," "tension type headache," "children," and "adolescents." Results: All analyzed studies found higher levels of alexithymia in children and adolescents with headache than control groups but there are different opinions about the relationship between headache and alexithymia. For example, some studies suggest that the association between headache and alexithymia in children may be due to an incomplete development of emotive competency or a general immature cognitive development, instead other studies found a correlation between headache symptoms, insecure attachment, and alexithymia. There seems to be also differences between children with migraine compared to those with tension type headache (TTH). Conclusion: There are some studies on adults suffering from headache or migraine and alexithymia, but there is only a moderate amount of research on pediatric age with different opinions and theories about this relationship. Further studies on children and adolescents are necessary to effectively understand this relationship and to help children to reduce headache and improve emotional consciousness

Don't judge a book by its cover. factitious disorder imposed on children-report on 2 cases

Factitious Disorder Imposed on Another (FDIA), also known as Munchausen Syndrome by Proxy (MSbP) is a very serious form of child abuse. The perpetrator, usually the mother, invents symptoms or causes real ones in order to make her child appear sick. Usually this is due to a maladaptive disorder or to an excessive of attention-seeking on her part. We report here two new cases of FDIA. The first one is a 9-year-old boy with a history of convulsive episodes, reduced verbal production, mild psychomotor disorder and urological problems who underwent several invasive procedures and hospitalizations before a diagnosis of FDIA was made. The second is a 12 year-old girl with headache, abdominal pain, lipothymic episodes, seizures and a gait impairment, who was hospitalized in several hospitals before an FDIA was diagnosed

Effects of add-on ultramicronized n-palmitol ethanol amide in patients suffering of migraine with aura. a pilot study

Background: Palmitoyl ethanol amide (PEA) is an endogenously produced substance showing anti-nociceptive effect through both receptor and non-receptor mediated effects at the level of different cellular and tissue sites. This study showed the results of a single blind study that was conducted to evaluate both the safety and the efficacy of ultramicronized PEA (umPEA; 1,200 mg/day) for up 90 days in patients suffering of Migraine with Aura (MA) treated with NSAIDs. Methods: A total of 20 patients, 8 male (33-56-years, average 41.4 ± 7.8) and 12 female (19-61-years, average 38.5 ± 11.9) with MA were admitted to our observation and diagnosed according to ICHD-3 criteria, they received umPEA (1,200 mg/day) in combination with NSAIDs for up to 90 days. They were revaluated at 30, 60, and 90 days after treatment. Results: umPEA administration induced a statistically significant and time dependent pain relief. In particular, these effects were evident at 60 days (male P = 0.01189; female P = < 0.01) and they lasted until the end of the study (male P = 0.0066; female P = 0.01473). Conclusion: Although further studies are needed, our findings indicate that in patients suffering of MA treatment with umPEA had good efficacy and safety which candidate this compound as a therapeutic tool in pain migraine management

First Report of Root and Basal Stem Rot Caused by Phytophthora cryptogea and P. inundata on Dwarf Banana in Italy

In Sicily (southern Italy) local cultivars of dwarf banana (Musa acuminata) are cultivated for edible fruit and as ornamental plants. During the summer of 2015, in an ornamental nursery of Aci San Filippo (Catania province), eastern Sicily, ten out of forty mature plants of dwarf banana grown in the field showed leaf chlorosis, wilt and sudden collapse of the entire plant associated with root and basal stem rot. Two Phytophthora species (overall 24 and 22 isolates, respectively) were consistently recovered directly from rotted roots and stems on BNPRA-HMI selective medium (Masago et al. 1977). Pure cultures of both species were obtained by single-hypha isolations. The first species formed slight petaloid colonies on potato dextrose agar (PDA) and slightly fluffy colonies on V-8 juice agar (V8A). It grew between 2 and 30°C, with an optimum of 25°C. On V8A discs flooded with non-sterile soil extract this species produced persistent, ovoid to obpyriform, non-papillate, internally proliferating sporangia (35 ..

Phytophthora root and collar rot of Paulownia, a new disease for Europe

Paulownia species are fast growing trees native to China, which are being grown in managed plantings in several European countries for the production of wood and biomasses. In 2018, wilting, stunting, leaf yellowing, and collapse, as a consequence of root and crown rot, were observed in around 40% of trees of a 2-year-old planting of Paulownia elongata × P. fortunei in Calabria (Southern Italy). Two species of Phytophthora were consistently recovered from roots, basal stem bark, and rhizosphere soil of symptomatic trees and were identified as Ph. nicotianae and Ph. palmivora on the basis of both morphological characteristics and phylogenetic analysis of rDNA ITS sequences. Koch’s postulates were fulfilled by reproducing the symptoms on potted paulownia saplings transplanted into infested soil or stem-inoculated by wounding. Both Phytophthora species were pathogenic and caused root rot and stem cankers. Even though P. palmivora was the only species recovered from roots of naturally infected plants, in pathogenicity tests through infested soil P. nicotianae was more virulent. This is the first report of Phytophthora root and crown rot of a Paulownia species in Europe. Strategies to prevent this emerging disease include the use of healthy nursery plants, choice of well-drained soils for new plantations, and proper irrigation management

A new approach in the monitoring of the phytosanitary conditions of forests: the case of oak and beech stands in the Sicilian Regional Parks

L'obiettivo del presente studio è stato quello di esaminare lo stato fitosanitario delle quercete e faggete dei tre Parchi Regionali Siciliani (Parco dell'Etna, Parco delle Madonie, Parco dei Nebrodi). Lo studio è stato condotto individuando delle aree di saggio, popolamenti forestali omogenei sotto l'aspetto floristico, ecologico e fitosanitario. Complessivamente sono state delimitate 81 aree di saggio, di cui 54 quercete e 27 faggete. La condizione fitosanitaria di ogni essenza arborea all'interno della rispettiva area di saggio è stata espressa con un indice numerico denominato “classe fitosanitaria” (PC). I popolamenti di quercia hanno mostrato un elevato grado di sofferenza, con alberi sintomatici nell’85% delle aree di saggio. I popolamenti di faggio hanno mostrato una situazione di maggiore stabilità, ad eccezione delle faggete del parco dei Nebrodi che apparivano molto degradate. Sul genere Quercus, sono stati osservati sintomi di infezioni di patogeni fungini comuni nelle foreste delle aree temperate e Mediterranee, quali Biscogniauxia mediterranea, Polyporus sp., Fistulina hepatica, Mycrosphaera alphitoides ed Armillaria sp., mentre su faggio sono state osservate infezioni di Biscogniauxia nummularia, Fomes fomentarius e Neonectria radicicola. Sono state altresì individuate 22 aree che vengono proposte come aree di saggio permanenti dello stato fitosanitario delle foreste nei tre parchi.The objective of this study was to investigate the health conditions of oak and beech stands in the three Regional Parks of Sicily (Etna, Madonie and Nebrodi). A total of 81 sampling areas were investigated, 54 in oak stands and 27 in beech stands. The phytosanitary conditions of each tree within the respective sampling area was expressed with a synthetic index namely phytosanitary class (PC). Oak stands showed severe symptoms of decline, with 85% of the sampling areas including symptomatic trees. In general, beech stands were in better condition, with the exception of Nebrodi Park, where trees showed severe symptoms of decline. On oak trees, infections of fungal pathogens were also observed, including Biscogniauxia mediterranea, Polyporus sp., Fistulina hepatica, Mycrosphaera alphitoides and Armillaria sp. By contrast, on beech trees Biscogniauxia nummularia, Fomes fomentarius and Neonectria radicicola were recognized. Furthermore, twenty-two permanent sampling areas were delimited with the aim of monitoring regularly the health conditions of forests in these three parks

Repeated Assessment of Exploration and Novelty Seeking in the Human Behavioral Pattern Monitor in Bipolar Disorder Patients and Healthy Individuals

Exploration and novelty seeking are cross-species adaptive behaviors that are dysregulated in bipolar disorder (BD) and are critical features of the illness. While these behaviors have been extensively quantified in animals, multivariate human paradigms of exploration are lacking. The human Behavioral Pattern Monitor (hBPM), a human version of the animal open field, identified a signature pattern of hyper-exploration in manic BD patients, but whether exploratory behavior changes with treatment is unknown. The objective of this study was to assess the sensitivity of the hBPM to changes in manic symptoms, a necessary step towards elucidating the neurobiology underlying BD.Twelve acutely hospitalized manic BD subjects and 21 healthy volunteers were tested in the hBPM over three sessions; all subjects were retested one week after their first session and two weeks after their second session. Motor activity, spatial and entropic (degree of unpredictability) patterns of exploration, and interactions with novel objects were quantified. Manic BD patients demonstrated greater motor activity, extensive and more unpredictable patterns of exploration, and more object interactions than healthy volunteers during all three sessions. Exploration and novelty-seeking slightly decreased in manic BD subjects over the three sessions as their symptoms responded to treatment, but never to the level of healthy volunteers. Among healthy volunteers, exploration did not significantly decrease over time, and hBPM measures were highly correlated between sessions.Manic BD patients showed a modest reduction in symptoms yet still demonstrated hyper-exploration and novelty seeking in the hBPM, suggesting that these illness features may be enduring characteristics of BD. Furthermore, behavior in the hBPM is not subject to marked habituation effects. The hBPM can be reliably used in a repeated-measures design to characterize exploration and novelty seeking and, in parallel with animal studies, can contribute to developing treatments that target neuropsychiatric disease