Children and adolescents with primary headaches exhibit altered sensory profiles - a multi-modal investigation.

IF 7.3 1区医学 Q1 CLINICAL NEUROLOGY Journal of Headache and Pain Pub Date : 2024-07-09 DOI:10.1186/s10194-024-01819-x

Michal Pieniak, Berit Höfer, Jenny Knipping, Vanda Faria, Matthias Richter, Valentin A Schriever, Antje Haehner, Gudrun Gossrau

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Abstract

Background: Pediatric headache is an increasing medical problem that has adverse effects on children's quality of life, academic performance, and social functioning. Children with primary headaches exhibit enhanced sensory sensitivity compared to their healthy peers. However, comprehensive investigations including multimodal sensory sensitivity assessment are lacking. This study aimed to compare sensory sensitivity of children with primary headaches with their healthy peers across multiple sensory domains.

Methods: The study included 172 participants aged 6 to 17 years (M = 13.09, SD = 3.02 years; 120 girls). Of these 80 participants were patients with migraine, 23 were patients with tension-type headache, and 69 were healthy controls. The following sensory measures were obtained: Mechanical Detection Threshold (MDT), Mechanical Pain Threshold (MPT), Mechanical Pain Sensitivity (MPS), detection and pain threshold for Transcutaneous Electrical Nerve Stimulation (TENS), olfactory and intranasal trigeminal detection threshold, and odor identification ability. Sensory sensitivity was compared between groups with a series of Kruskal-Wallis tests. Binomial regression models were used to compare the relative utility of sensory sensitivity measures in classifying participants into patients and healthy controls, as well as into patients with migraine and tension-type headache.

Results: Patients with migraine had lower MPT measured at the forearm than patients with tension-type headaches and healthy controls. MPS was higher in patients with migraine than in healthy controls. All patients with headaches had lower detection threshold of TENS and higher olfactory sensitivity. Healthy controls showed increased intranasal trigeminal sensitivity. Scores in MPS, TENS, and olfactory and trigeminal thresholds were significantly predicting presence of primary headaches. Additionally, scores in MPT, olfactory and trigeminal threshold were positive predictors of type of headache.

Conclusions: Children with primary headaches exhibit different sensory profiles than healthy controls. The obtained results suggest presence of increased overall, multimodal sensitivity in children with primary headaches, what may negatively impact daily functioning and contribute to further pain chronification.

Trial registration: The study was registered in the German Registry of Clinical Trials (DRKS) DRKS00021062.

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患有原发性头痛的儿童和青少年的感觉特征发生了改变--一项多模式调查。

背景：小儿头痛是一个日益严重的医学问题，对儿童的生活质量、学习成绩和社会功能都有不利影响。与健康儿童相比，患有原发性头痛的儿童表现出更强的感觉敏感性。然而，目前还缺乏包括多模态感觉灵敏度评估在内的全面调查。本研究旨在比较原发性头痛儿童与健康儿童在多个感官领域的感官敏感性：研究包括 172 名年龄在 6 至 17 岁之间的参与者（中位数 = 13.09，标准差 = 3.02 岁；120 名女孩）。其中80人为偏头痛患者，23人为紧张型头痛患者，69人为健康对照组。他们进行了以下感官测量机械检测阈值（MDT）、机械疼痛阈值（MPT）、机械疼痛敏感度（MPS）、经皮神经电刺激（TENS）的检测和疼痛阈值、嗅觉和鼻内三叉神经检测阈值以及气味识别能力。通过一系列 Kruskal-Wallis 检验比较了各组之间的感觉灵敏度。使用二项式回归模型比较了感觉灵敏度测量在将参与者分为患者和健康对照组以及偏头痛患者和紧张型头痛患者时的相对效用：与紧张型头痛患者和健康对照组相比，偏头痛患者在前臂测量的MPT较低。偏头痛患者的MPS高于健康对照组。所有头痛患者的 TENS 检测阈值都较低，嗅觉灵敏度较高。健康对照组则显示鼻内三叉神经敏感性增高。MPS、TENS、嗅觉阈值和三叉神经阈值的得分可显著预测是否存在原发性头痛。此外，MPT、嗅觉和三叉神经阈值的得分对头痛类型有积极的预测作用：结论：与健康对照组相比，患有原发性头痛的儿童表现出不同的感觉特征。研究结果表明，原发性头痛患儿的整体多模态敏感性增加，这可能会对日常功能产生负面影响，并导致疼痛进一步慢性化：该研究已在德国临床试验注册中心（DRKS）DRKS00021062注册。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Headache and Pain 医学-临床神经学

CiteScore

11.80

自引率

13.50%

发文量

143

审稿时长

6-12 weeks

期刊介绍： The Journal of Headache and Pain, a peer-reviewed open-access journal published under the BMC brand, a part of Springer Nature, is dedicated to researchers engaged in all facets of headache and related pain syndromes. It encompasses epidemiology, public health, basic science, translational medicine, clinical trials, and real-world data. With a multidisciplinary approach, The Journal of Headache and Pain addresses headache medicine and related pain syndromes across all medical disciplines. It particularly encourages submissions in clinical, translational, and basic science fields, focusing on pain management, genetics, neurology, and internal medicine. The journal publishes research articles, reviews, letters to the Editor, as well as consensus articles and guidelines, aimed at promoting best practices in managing patients with headaches and related pain.