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Children and adolescents with chronic migraine (defined as 15 or more headache days per month) are frequently seen in tertiary headache clinics. Chronic migraine is associated with significant disability, including difficulty with daily functioning, frequent school absences, and emotional distress. It is known that children who experience recurrent headaches often continue to have them into adulthood. No evidence-based interventions exist for youth with chronic migraine.
Study Status: Open to enrollment
Dr. Powers, his lab, and colleagues received funding from the NIH/NINDS through a U01 grant in September 2011. Powers and his staff (Clinical Coordinating Center) are working cooperatively with the Data Coordinating Center (Clinical Trials Statistical & Data Management Center, University of Iowa, Iowa City, Iowa) to conduct this multi-site clinical trial. Across 40 sites in the U.S., they aim to determine the optimal medication to prevent migraine in children and adolescents. Specifically, this trial will test if amitriptyline and topiramate are superior to placebo in reducing migraine frequency in children and adolescents, 8 to 17 years of age, inclusive, and to conduct a comparative effectiveness study of the two therapies.
The scope of this study and the national sites involved can be reviewed at ClinicalTrials.gov.
This study will be in progress through 2016. Funded by the National Institutes of Health, U01NS076788.
The purpose of this investigation is to examine treatment adherence to biobehavioral recommendations (i.e., sleep, exercise, dietary, and fluid intake) for the purpose of improving health outcomes in pediatric migraine. We are conducting a longitudinal study of adherence to preventative medication and lifestyle recommendations with 30 adolescents presenting to a headache specialty care center. Adolescents will be asked to report daily assessments of lifestyle behaviors, using a mobile electronic device, and consent to using an electronic monitoring bottle (i.e., MEMS) to track daily medication usage and wireless technology system to track sleep. Funded in part by the Society for Developmental & Behavioral Pediatrics Research Grant.
Study Status: Closed to enrollment
Sponsored by the Migraine Research Foundation, this was a longitudinal study to better understand the experience and impact of migraine (e.g., emotional, physical, school, social, family functioning) in 115 adolescents presenting to the Cincinnati Children’s Headache Center. A random sample of 40 participants were asked to provide daily ratings of migraine pain and functioning using an iPod Touch device to understand the dynamic relationship between migraine pain, behavior, and various psychological states.
The Chronic Headache Study is a randomized, controlled, clinical trial incorporating the use of educational or behavioral treatment with medication to treat children with chronic daily migraine.
Patients involved in this trial progressed through a screening phase where they kept a daily headache calendar for 28 days, followed by a study screening visit. During the treatment phase, patients attended weekly skills training sessions for eight weeks, followed by two monthly booster sessions. Patients kept track of their headaches on a daily headache diary and practiced acquired skills while taking amitriptyline (the study medication). Throughout the follow-up phase, patients attended visits every three months over the course of a year to review monthly headache calendars, headache skills learned during the treatment phase, and healthy habits during a neurological check-up. They often continued on a preventative medication as well. This trial is testing the impact of combined drug and nondrug treatment on a primary end point of reduction in headache days and a secondary end point of reduction in headache disability (PedMIDAS). Funded by the National Institutes of Health, R01NS050536.
Ramsey RR, Ryan JL, Hershey AD, Powers SW, Aylward BS, Hommel KA. Treatment adherence in patients with headache: a systematic review. Headache. 2014 May;54(5):795-816.
Rapoff MA, Connelly M, Bickel JL, Powers SW, Hershey AD, Allen JR, Karlson CW, Litzenburg CC, Belmont JM. Headstrong intervention for pediatric migraine headache: A randomized clinical trial. J Headache Pain. 2014 Feb 28;15:12.
Kedia S, Ginde AA, Grubenhoff JA, Kempe A, Hershey AD, Powers SW. Monthly variation of United States pediatric headache emergency department visits. Cephalalgia. 2014 May;34(6):473-8.
Xiang J, Degrauw X, Korman AM, Allen JR, O'Brien HL, Kabbouche MA, Powers SW, Hershey AD. Neuromagnetic abnormality of motor cortical activation and phases of headache attacks in childhood migraine. PLoS One. 2013 Dec 27; 8(12):e83669.
Powers SW, Kashikar-Zuck SM, Allen JR, LeCates SL, Slater SK, Zafar M, Kabbouche MA, O'Brien HL, Shenk CE, Rausch JR, Hershey AD. Cognitive behavioral therapy plus amitriptyline for chronic migraine in children and adolescents: a randomized clinical trial. JAMA. 2013 Dec 25; 310(24):2622-30.
Karlson CW, Litzenburg CC, Sampilo ML, Rapoff MA, Connelly M, Bickel JL, Hershey AD, Powers SW. Relationship between daily mood and migraine in children. Headache. 2013 Nov-Dec;53(10):1624-34.
Xiang J, deGrauw X, Korman AM, Allen JR, O’Brien MA, Powers SW, Hershey AD. Altered cortical activation in adolescents with acute migraine: a magnetoencephalography study. J Pain. 2013 Dec;14(12):1553-63.
Hershey AD, Powers SW, Coffey CS, Eklund DD, Chamberlin LA, Korbee LL, CHAMP Study Group. Childhood and Adolescent Migraine Prevention (CHAMP) study: a double-blinded, placebo-controlled, comparative effectiveness study of amitriptyline, topiramate, and placebo in the prevention of childhood and adolescent migraine. Headache. 2013 May;53(5):799-816.
Kashikar-Zuck S, Zafar M, Barnett KA, Aylward BS, Strotman D, Slater SK, Allen JR, LeCates SL, Kabbouche MA, Ting TV, Hershey AD, Powers SW. Quality of life and emotional functioning in youth with chronic migraine and juvenile fibromyalgia. Clin J Pain. 2013 Dec;29(12):1066-72.
Guo X, Xiang J, Wang Y, O'Brien H, Kabbouche M, Horn P, Powers SW, Hershey AD Aberrant neuromagnetic activation in the motor cortex in children with acute migraine: a magnetoencephalography study. PLoS One, 7(11):e50095.2012.
Slater SK, Kashikar-Zuck SM, Allen JR, Lecates SL, Kabbouche MA, O'Brien HL, Hershey AD, Powers SW. Psychiatric comorbidity in pediatric chronic daily headache. Cephalalgia, 32(15): 1116-22. Nov, 2012.
Slater SK, Powers SW. Editorial on "Behavioral and emotional symptoms and primary headaches in children: A population-based study" by Arruda and Bigal. Cephalalgia,32(15): 1091-2. Nov, 2012.
Zafar M, Kashikar-Zuck SM, Slater SK, Allen JR, Barnett KA, Lecates SL, Kabbouche MA, Hershey AD, Powers SW. Childhood Abuse in Pediatric Patients with Chronic Daily Headache. Clin Pediatr (Phila). 2012 Jun;51(6):590-3.
Korostenskaja M, Pardos M, Kujala T, Rose DF, Brown D, Horn P, Wang Y, Fujiwara H, Xiang J, Kabbouche MA, Powers SW, Hershey AD. Impaired Auditory Information Processing During Acute Migraine: A Magnetoencephalography Study. Int J Neurosci. 2011 Jul;121(7):355-65.
Slater SK, Nelson TD, Kabbouche M, Lecates SL, Horn P, Segers A, Manning P, Powers SW, Hershey AD. A randomized, double-blinded, placebeo-controlled, crossover, add-on study of CoEnzyme Q10 in the prevention of pediatric and adolescent migraine. Cephalalgia. 2011 Jun;31(8):897-905.
Hershey AD, Burdine D, Kabbouche MA, Powers SW. Genomic expression patterns in medication overuse headaches. Cephalalgia. 2011 Jan;31(2):161-71.
Hershey AD, Kabbouche MA, Powers SW. Treatment of pediatric and adolescent migraine. Pediatr Ann. 2010 Jul;39(7):416-23.
Wang X, Xiang J, Wang Y, Pardos M, Meng L, Huo X, Korostenskaja M, Powers SW, Kabbouche MA, Hershey AD. Identification of Abnormal Neuromagnetic Signatures in the Motor Cortex of Adolescent Migraine. Headache. 2010 Jun;50(6):1005-16.
Slater S, Crawford MJ, Kabbouche MA, LeCates SL, Cherney S, Vaughan P, Segera A, Manning P, Burdine D, Powers SW, Hershey AD. Effects of gender and age on paediatric headache. Cephalalgia. 29(9): 969-973. Sep, 2009.
Crawford MJ, Lehman L, Slater S, Powers SW, Kabbouche MA, LeCates SL, Segers A, Manning P, Hershey AD. Menstrual migraine in adolescents. Headache. 2009 Mar;49(3):341-7.
Hershey AD, Powers SW, Nelson TD, Kabbouche MA, Yonker M, Linder SL, Bicknese A, Sowell MK, McClintock W, the American Headache Society Pediatric Adolescent Section. Obesity in the pediatric headache population: a multicenter study. Headache. 2009 Feb;49(2):170-7.
Kabbouche MA, Powers SW, Segers A, LeCates S, Manning P, Biederman S, Vaughan P, Burdine D, Hershey AD. Inpatient treatment of status migraine with dihydroergotamine in children and adolescents. Headache. 2009 Jan;49(1):106-9.
Allen JR, Crawford MJ, Sullivan SM, Powers SW, Hershey AD. Coenzyme Q10 deficiency in adolescent migraine. AgroFood Industry Hi-Tech.19, 14-15. 2008.
Vannatta KV, Getzhoff EA, Powers SW, Noll RB, Gerhardt CA, Hershey AD. Multiple perspectives on the psychological functioning of children with and without migraine. Headache. 2008 Jul;48(7):994-1004.
Vannatta K, Getzoff EA, Gilman DK, Noll RB, Gerhardt CA, Powers SW, Hershey AD. Friendships and social interactions of school-aged children with migraine. Cephalalgia. 2008 Jul;28(7):734-43.
Sil S, Arnold LM, Lynch-Jordan A, Ting TV, Peugh J, Cunningham N, Powers SW, Lovell DJ, Hashkes PJ, Passo M, Schikler KN, Kashikar-Zuck S. Identifying treatment responders and predictors of improvement after cognitive-behavioral therapy for juvenile fibromyalgia. Pain. 2014 Jul;155(7):1206-12.
Kashikar-Zuck SM, Cunningham N, Sil S, Bromberg MH, Lynch-Jordan AB, Strotman D, Peugh J, Noll J, Ting TV, Powers SW, Lovell DJ, Arnold LM. Long-term outcomes of adolescents with juvenile-onset fibromyalgia in early adulthood. Pediatrics. 2014 Mar;133(3):e592-600.
Joffe NE, Lynch-Jordan AM, Ting TV, Arnold LM, Hashkes PJ, Lovell DJ, Passo MH, Powers SW, Schikler KN, Kashikar-Zuck S. Utility of the PedsQL rheumatology module as an outcome measure in juvenile fibromyalgia. Arthritis Care Res (Hoboken). 2013 Nov;65(11):1820-7.
Kashikar-Zuck S, Sil S, Lynch-Jordan AM, Ting TV, Peugh J, Schikler KR, Hashkes PJ, Arnold LM, Passo MH, Richards MM, Powers SW, Lovell D. Changes in pain coping, catastrophizing and coping efficacy after cognitive-behavioral therapy in children and adolescents with juvenile fibromyalgia. J Pain. 2013 May;14(5):492-501.
Kashikar-Zuck S, Flowers SR, Verkamp E, Ting T, Lynch-Jordan A, Graham TB, Passo M, Schikler KN, Hashkes PJ, Spalding S, Banez G, Richards MM, Powers SW, Arnold LM, Lovell D. Actigraphy-based physical activity monitoring in adolescents with juvenile primary fibromyalgia syndrome. J Pain. 2010 Sep;11(9):885-93.
Kashikar-Zuck S, Johnston M, Ting TV, Graham BT, Lynch-Jordan AM, Verkamp E, Passo M, Schikler KN, Hashkes PJ, Spalding S, Banez G, Richards MM, Powers SW, Arnold LM, Lovell D. Relationship between school absenteeism and depressive symptoms among adolescents with juvenile fibromyalgia. J Pediatr Psychol. 2010 Oct;35(9):996-1004.
Lynch-Jordan AM, Kashikar-Zuck S, Crosby LE, Lopez WL, Smolyansky BH, Parkins IS, Luzader CP, Hartman A, Guilfoyle SM, Powers SW. Applying quality improvement methods to implement a measurement system for chronic pain-related disability. J Pediatr Psychol. 2010 Jan-Feb;35(1):32-41.
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