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Children and adolescents with chronic daily headache (defined as 15 or more headache days per month) are frequently seen in tertiary headache clinics. Chronic daily headache 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 daily headache.
Study Status: Open to enrollmentSponsored by the Migraine Research Foundation, this is a longitudinal study to better understand the experience and impact of migraine (e.g., emotional, physical, school, social, family functioning) on 100 adolescents presenting to the Cincinnati Children’s Headache Center. A random sample of participants will also be 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.
Study Status: In preparationThe 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.
Study Status: Closed to enrollmentThe 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 headache.
Patients involved in this trial progress through screening phase where they keep a daily headache calendar for 28 days, followed by a study screening visit. Next during the treatment phase patients attend weekly skills training sessions for eight weeks, followed by two monthly booster sessions. Patients keep track of their headaches on daily headache diaries and practice acquired skills while taking amitriptyline (the study medication). During the follow-up phase, patients have visits every three months for one year to review monthly headache calendars, headache skills learned during the treatment phase and healthy habits along with their neurological check-up. They often continue on a preventative medication as well.
The trial is testing the impact of combined drug and nondrug treatment on a primary end point of reduction in headache frequency and a secondary end point of reduction in headache disability (PedMIDAS).
Funded by: National Institutes of Health, R01NS050536.
Dr. Powers, his lab, and colleagues have submitted a grant to the NIH/NINDS with the plan to conduct a multi-site clinical trial to determine the optimal medication for the prevention of migraines 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, ages 8 to 17 years old, inclusive, and to conduct a comparative effectiveness study of the two therapies.
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. Mar 22, 2011.
Hershey AD, Burdine D, Kabbouche MA, Powers SW. Genomic expression patterns in medication overuse headaches. Cephalalgia. 31(2):161-71. Jan, 2011.
Hershey AD, Kabbouche MA, Powers SW. Treatment of pediatric and adolescent migraine. Pediatr Ann. 39(7):416-423. Jul, 2010.
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. 50(6):1005-16. Jun, 2010.
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. 49, 341-347. 2009.
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. 49(2), 170-177. Feb, 2009.
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. 49(1):106-9. Jan, 2009.
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. 48, 994-1004. Jul, 2008.
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. 28, 734-743. Jul, 2008.
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. Journal of Pain. 11(9):885-93. Sep, 2010.
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 Pediatri Psychol. 35(9):996-1004. Oct, 2010.
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. Journal of Pediatric Psychology. 35(1):32-41. Jan-Feb, 2010.
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