Up to date on the use of triptans for child and adolescent migraine: “the state of the art”

The introduction of triptans, in the early 1990s, has improved the therapy for acute migraine attack, offering a new quality of life for those patients who suffer from this disabling neurological disorder. Epidemiological data point out that about 10% of school–age children suffer from migraine, with a progressive increase in incidence and prevalence up to the threshold of adulthood. The increase in extent and prevalence of migraine from the years of growth stresses the importance of the application and adjustment of ad hoc therapeutic (either pharmacological or not) and diagnostic measures. Indeed, the peculiar neurobiological and psychological aspects which are typical of an “evolving” organism preclude the use, by simple “transposition” or “proportion”, of the knowledge acquired from adult–targeted studies. That requires the implementation of studies to analyze the specific responses of children and adolescents to the triptans. To date, the studies on such issues are absolutely insufficient to draw definitive conclusions and indications for the use of triptans for child and adolescent migraineurs

The effect of placebo and neurophysiological involvements

Placebo and placebo effect are important issues related to the drug therapy for clinical and scientific meanings. The rates of placebo may get as many as 50% for analgesic drugs in headache. The high answer to placebo brings questions on pathophysiology of headache. Answers may offer a new strategy in the implementation of trials and new insight in neurophysiology of headache. Current knowledge on placebo and placebo effect will be analysed and dicussed looking for new direction in headache field

The relationship between difficulties in emotion regulation and dysfunctional technology use among adolescents

Objectives Since two decades scientific research is studying excessive and dysfunctional new technologies use and its influences on people’s lives, in terms of personal, relational, scholastic and work functioning impairment. The objectives of the present study are to investigate gender differences in problematic new technologies use as well as to examine the relationship between problematic new technologies use, emotional regulation and its specific dimensions. Methods 280 italian adolescents (51.1% males) aged 11 to 18 years (mean age = 13.31; SD = 2.33) were recruited from two italian secondary public schools and involved in this study. Data were collected using the Internet Addiction Test, the Video Game Dependency Scale, the Brief Multicultural Version of the Test of Mobile-Phone Dependence and the Difficulties in Emotion Regulation Scale. Results Results indicate significant association between emotion dysregulation and problematic internet (r = .504; p < .001), videogame (r = .372; p < .001), mobile-phone (r = .424; p < .001) use. These results support hypothesis that adolescents with greater emotion dysregulation are more likely to experience problematic new technologies use. Additionally, stepwise multiple regression analysis pointed out that the lack of effective emotion regulation strategies is a common risk factors between the problematic new technologies use, but regression analysis highlighted specific risk factors for some of the investigated dependent behaviors. Conclusions Findings of this study highlight a link between problematic new technologies use, emotion dysregulation and its specific dimensions. The results are discussed considering scientific advances and the role of emotional dysregulation in determining problematic new technologies use in adolescence. Further research with larger sample sizes is needed to confirm our data

The potential impact of internet and mobile use on headache and other somatic symptoms in adolescence. a population-based cross-sectional study

Objective.—The purpose of this cross-sectional study was to determine whether migraine or tension-type headaches are associated with abuse of the internet and/or mobile phones and to explore whether headache and the abuse of the two technologies are associated with sleep disturbances and other self-reported somatic symptoms. Background.—In the last several years, estimates indicate the increasing pervasiveness of the internet and other technologies in the lives of young people, highlighting the impact on well-being. Design.—A population-based cross-sectional study was conducted between February 2013 and June 2014. Method.—The initial sample was composed of 1004 Italian students (aged 10–16 years) recruited within public middle schools not randomly selected in central Italy. The final convenience sample consisted of 841 students (Males551.1%; Females548.9%) who were included in the analysis. Data were collected using self-reported measures. Results.—Headache was reported by 28.0% of the total sample. A significant relationship was determined with gender (v2(1)57.78, P < .01), with female students being overrepresented in the headache group. Approximately 39.6% of subjects were non-abusers of both technologies, internet and mobile. Mobile only abusers were approximately 26.0% of the study population; internet only abusers were approximately 14.9%; and abusers of both media were 19.5%. No significant relationship was found between students with and without headache with respect to the abuse of internet and mobile phone categories (headache was, respectively, the 26% in no abusers, the 30% in internet abusers, the 29% in mobile abusers, and the 29% in internet and mobile abusers, P5.86). Additionally, also by excluding the no headache group, the relationship between the two groups of headache (migraine and tension type headache) and the abuse of media (tension type headache was the 31% in no abusers, the 43% in internet abusers, the 49% in mobile abusers, and the 29% in internet and mobile abusers) is not statistically significant (P5.06). No significant relationship emerged between headache and the internet and mobile phone addiction groups (headache was the 28% in no addiction group, the 35% in mobile addiction group, the 25% of internet addiction group, and the 28% in mobile and internet addiction group, P5.57) as well as no significant relationship was found when only the different headache types were considered (tension type headache was the 39% in no addiction group, the 40% in mobile addiction group, the 32% in internet addiction group, and the 31% in mobile and internet addiction group,P5.71). Daily internet users reported higher median scores for somatic symptoms than the occasional internet users in the no-headache group (Kruskal-Wallis v2 (1)55.44, P5.02) and in the migraine group (Kruskal-Wallis v2 (1)56.54, P5.01

Behavioral management of headache in children and adolescents

Headache is the most frequent neurological symptom and the most prevalent pain in children and adolescents, and constitutes a serious health problem that may lead to impairment in several areas. Psychosocial factors, social environment, life events, school and family stressors are all closely related to headaches. A multidisciplinary strategy is fundamental in addressing headache in children and adolescents. Applying such a strategy can lead to reductions in frequency and severity of the pain, improving significantly the quality of life of these children.It has been demonstrated that behavioral intervention is highly effective, especially in the treatment of paediatric headache, and can enhance or replace pharmacotherapy, with the advantage of eliminating dangerous side effects and or reducing costs. Behavioral interventions appear to maximize long-term therapeutic benefits and improve compliance with pharmacological treatment, which has proven a significant problem with child and adolescent with headache.The goal of this review is to examine the existing literature on behavioral therapies used to treat headache in children and adolescents, and so provide an up-to-date picture of what behavioral therapy is and what its effectiveness is

The Wocah Project. A innovative Web-based System for the Study of Headache in Children and Adolescents. A Preliminary Study of Methodological Issues.

Our aim is to take account of the methodogical opportunities offered by a web-based model for of the study of epidemiology features of headache in a large population of children and adolescents from multiple countries all over the world, taking into account the co-occurring comorbid conditions and the correlations with disability

Headache disorders as risk factors for sleep disturbances in school aged children.

Several epidemiological studies have shown the presence of comorbidity between various types of sleep disorders and different headache subtypes. Migraine without aura is a sensitive risk factor for disorders of initiating and maintaining sleep (odds ratio (OR) 8.2500), and chronic tension-type headache for sleep breathing disorders (OR 15.231), but headache disorder is a cumulative risk factor for disorders of excessive somnolence (OR 15.061). This result has not been reported in the clinical literature. © Springer-Verlag Italia 2005

Alexithymia and psychopathological symptoms in adolescent outpatients and mothers suffering from migraines. A case control study

Background: Headache is a common disorder affecting a growing number of children and adolescents. In recent years, there has been an increase in scientific interest in exploring the relationship between migraine and emotional regulation, and in particular, the impact of emotional dysregulation on mental and physical health. The present study aims to explore the relationship between migraine and alexithymia among adolescents and their mothers as well as the impact of this association on mental health. An additional aim is to verify whether alexithymia may be a predictor of psychopathological symptoms in adolescents and mothers with migraines. Methods: A total of 212 subjects were involved in this study. The sample was divided into (a) Experimental Group (EG) consisting of 106 subjects (53 adolescents and 53 mothers) with a diagnosis of migraine according to International Classification of Headache Disorders (ICHD-3) and (b) Control Group (CG) including 106 subjects (53 adolescents and 53 mothers) without a diagnosis of migraine. All participants completed the Toronto Alexithymia Scale to assess alexithymia and the Symptom Checklist-90-R to assess psychopathological symptoms. Results: Higher rates of alexithymia were found in the adolescents and mothers of the EG in comparison to the adolescents and mothers of the CG. Furthermore, adolescents and mothers experiencing both migraine and alexithymia, demonstrated a higher risk of psychopathology. Conclusions: Findings from this study provide evidence that the co-occurrence of migraine and alexithymia increases the risk of psychopathology for both adolescents and their mother

Prenatal exposure to tobacco and alcohol are associated with chronic daily headaches at childhood: a population-based study

The influence of prenatal events on the development of headaches at childhood has not been investigated and is the scope of our study. Of 2,173 children identified as the target sample, consents and analyzable data were provided by 1,440 (77%). Parents responded to a standardized questionnaire with a validated headache module and specific questions about prenatal exposures. Odds of chronic daily headache (CDH) were significantly higher when maternal tabagism was reported. When active and passive smoking were reported, odds ratio (OR) of CDH were 2.29 [95% confidence intervals (CI)=1.6 vs. 3.6)]; for active tabagism, OR=4.2 (95% CI=2.1-8.5). Alcohol use more than doubled the chance of CDH (24% vs. 11%, OR=2.3, 95% CI=1.2-4.7). In multivariate analyses, adjustments did not substantially change the smoking/CDH association. Prenatal exposure to tobacco and alcohol are associated with increased rates of CDH onset in preadolescent children