Onset Of Chronic Daily Headache Research Articles

Rates of Stressful Life Events in Chronic and Episodic Migraine: Results of the American Migraine Prevalence and Prevention (AMPP) Study (P04.240)

Objective: To assess the occurrence of stressful life events (SLEs) in a population-based sample of adults with chronic and episodic migraine. Background SLEs have been associated with many medical conditions, including the onset of chronic daily headache. Design/Methods: The American Migraine Prevalence and Prevention (AMPP) study is a longitudinal, US population-based study with annual questionnaires mailed to 24,000 severe headache sufferers identified in 2004 and followed between 2005-2009. Respondents to the 2007 survey who met ICHD-2 criteria for migraine were divided into CM (≥15 HA days/month) or EM ( Results: In 2007, 14,069 responded, of which 557 had CM and 7,748 had EM. 5,858 migraineurs reported ≥1 SLE. In the CM group, 100(18.2%) reported no SLEs, 145(26.3%) reported 1, 153(27.8%) reported 2, and 153(27.8%) reported ≥3. Similarly, 1,639(21.4%) respondents with EM reported no SLEs, 2,098(27.5%) reported 1, 1,987(26%) reported 2, and 1,920(25.1%) reported ≥3. The unadjusted cumulative odds ratio indicated that the odds of experiencing SLEs were approximately 19% greater for persons with CM than EM. Adjusting for age, gender, race and BMI increased the trend (22% greater for CM than EM). Conclusions: It is unknown why SLEs are more common among persons with CM and the directionality of occurrence. Future work will examine the temporal sequencing of SLEs related to new-onset CM. Supported by: AMPP study funded through research grant to the National Headache Foundation from Ortho-McNeil Neurologics, Titusville, NJ. Additional analyses and abstract preparation supported by a grant from Allergan, Irvine, CA, to the National Headache Foundation. Disclosure: Dr. Manack has received personal compensation for activities with Allergan, Inc. Dr. Serrano has received personal compensation for activities as an employee of a pharmaceutical company. Dr. Turkel has received personal compensation for activities with Allergan, Inc. as an employee. Dr. Turkel holds stock and/or stock options in Allergan, Inc. Dr. Lipton has received personal compensation for activities with Advanced Bionics, Allergan, Inc., AstraZeneca Pharmaceuticals, Boehringer Ingelheim Pharmaceuticals, Bristol-Myers Squibb Company, Cierra, Endo, GlaxoSmithKline, Inc., Minster, Merck & Co., Inc., Neuralieve, Novartis, and OrthoMcNeil Pharmaceuticals. Dr. Lipton holds stock and/or stock options in Minster Pharma. Dr. Lipton9s institution has received research support from Allergan, Inc., OrthoMcNeil Pharmaceuticals, Minster, Endo, GlaxoSmithKline, Inc., Merck & Co., Inc., Neuralieve, and ProEthics. Dr. Buse has received personal compensation for activities with Allergan, Inc., MAP Pharmaceuticals, Nupathe, and Merck & Co., Inc. Dr. Buse has received research support from Allergan, Inc., Endo Pharmaceuticals Inc., MAP Pharmaceuticals, Nupathe, and Merck & Co., Inc.

Chronic Daily Headache in Children and Adolescents

Chronic daily headache (CDH) may be primary or secondary. Secondary causes can be suspected through "red flags" in the history and examination. With a prevalence of at least 1% and several associations, primary CDH is a common, often complex, chronic pain syndrome in children and adolescents. The intricate associations between stressors, psychiatric disorders (especially anxiety and depression), and CDH can be explained by "the limbically augmented pain syndrome" proposed by Rome and Rome. Disorders of sleep and other pain syndromes also may co-occur. For these reasons, a multiaxial classification is ideal. Many with primary CDH have features of both chronic migraine and chronic tension-type headache, contributing to confusion in subtyping. Primary CDH is often transformed from a primary episodic headache type, stressors being most responsible. Genetic factors also may facilitate chronification. Management should be biopsychosocial, family-centered, and often multidisciplinary, drugs being only one component. Treatment is still based on consensus, not evidence. Girls, migraineurs, and those with psychiatric comorbidity, medication overuse, and CDH onset before the age of 13years and lasting for 2years or longer, are at high risk for persistence; hence, such patients should be followed up into adult life. A classification for CDH should be included in the third edition of the International Classification of Headache Disorders.

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.

CHRONIC DAILY HEADACHE IN ADOLESCENTS: AN 8-YEAR FOLLOW-UP STUDY

Objective: To assess the long-term outcome of a community-based adolescent cohort with chronic daily headache (CDH). Methods: A field sample of 122 adolescents aged 12–14 years with CDH was established in 2000 (baseline) with short-term follow-up studies in 2001 and 2002. In 2008, the cohort was re-interviewed by physicians via telephone to determine the headache profile for the past year, including Migraine Disability Assessment (MIDAS), a headache disability questionnaire. Presence of CDH was defined as ≥15 headache days/month, average ≥4 hours/day for >3 months. Outcome measures included headache frequency, MIDAS score, and presence of CDH in 2008. Results: A total of 103 subjects (26 male/77 female, mean age 21.6 ± 0.9 years) completed the study (response rate 84.4%). The average monthly headache frequency was 4.7 ± 6.0 (0–30) days. Twenty-eight (27.2%) subjects had moderate or severe headache disability (MIDAS ≥11). Twelve (12%) subjects met CDH criteria, with chronic migraine (n = 10, 83%) as the most common subtype. Two (2%) subjects overused medications. From 2000 to 2008, the frequencies of migraine diagnoses were fairly consistent in this cohort. Presence of migraine at baseline predicted poorer outcome of all 3 measures. Additionally, CDH onset Conclusions: This long-term follow-up study revealed a marked decline in the frequency of chronic daily headache (CDH). However, one fourth of patients still had significant headache disability. Migraine history was a major factor in evolution of CDH into young adulthood. Early onset and longer duration of CDH implied a protracted disease course.

This week in Neurology ®

### Chronic daily headache in adolescents: An 8-year follow-up study This long-term study investigates the outcomes of adolescents with chronic daily headache (CDH) when they grow to young adulthood. The frequency of CDH markedly declines to 12%, but one fourth of them still suffer significant headache disability. Poor outcome predictors include medication overuse, migraine history, and early onset of CDH. See p. 416; Editorial, p. 412 ### Decreased GABA-A binding on FMZ-PET in succinic semialdehyde dehydrogenase deficiency This study presents groundbreaking research in succinic semialdehyde …

Chronic daily headache in adolescents

To assess the long-term outcome of a community-based adolescent cohort with chronic daily headache (CDH). A field sample of 122 adolescents aged 12-14 years with CDH was established in 2000 (baseline) with short-term follow-up studies in 2001 and 2002. In 2008, the cohort was re-interviewed by physicians via telephone to determine the headache profile for the past year, including Migraine Disability Assessment (MIDAS), a headache disability questionnaire. Presence of CDH was defined as >or=15 headache days/month, average >or=4 hours/day for >3 months. Outcome measures included headache frequency, MIDAS score, and presence of CDH in 2008. A total of 103 subjects (26 male/77 female, mean age 21.6 +/- 0.9 years) completed the study (response rate 84.4%). The average monthly headache frequency was 4.7 +/- 6.0 (0-30) days. Twenty-eight (27.2%) subjects had moderate or severe headache disability (MIDAS >or=11). Twelve (12%) subjects met CDH criteria, with chronic migraine (n = 10, 83%) as the most common subtype. Two (2%) subjects overused medications. From 2000 to 2008, the frequencies of migraine diagnoses were fairly consistent in this cohort. Presence of migraine at baseline predicted poorer outcome of all 3 measures. Additionally, CDH onset <13 years old, duration >or=2 years, and medication overuse predicted either higher headache frequencies or presence of CDH in 2008. This long-term follow-up study revealed a marked decline in the frequency of chronic daily headache (CDH). However, one fourth of patients still had significant headache disability. Migraine history was a major factor in evolution of CDH into young adulthood. Early onset and longer duration of CDH implied a protracted disease course.

Major Life Changes Before and After the Onset of Chronic Daily Headache: A Population-Based Study

Chronic daily headache (CDH), when defined as > or = 15 headache days per month, affects 3-5% of the adult population. Major life changes are putative precipitating events for onset of chronic pain, including chronic headache. This study compared the occurrence of specific life events between CDH cases and episodic headache controls in a community sample. CDH cases (180+ headache days per year: n = 206) and episodic headache controls (2-104 headache days per year: n = 507) were identified from a randomly selected adult US population. Subjects were interviewed about the occurrence of certain major life changes or events (change of residence, employment status, marital status, related to their children, deaths of relatives or close friends, and 'extremely stressful' ongoing situations) occurring in a defined time period. Events that occurred during the same year or year before frequent headache onset in cases or in an equivalent time period in controls were considered to be antecedent events. Those that occurred after this time were considered subsequent events. Compared with episodic headache controls, CDH cases had more major life changes in the year before or same year as CDH onset. After adjusting for age, gender, headache type and year of event, the odds of CDH increased additionally with each antecedent event [odds ratio (OR) 1.20 (1.1, 1.3), P < 0.001], but not with subsequent events [OR 0.94 (0.8, 1.1), P < 0.4]. In secondary analyses, the association between antecedent events and CDH was significant only for the approximately half of CDH cases who were aged >/= 40 years [OR 1.33 (1.2, 1.50) vs. OR 1.04 (0.9, 1.2), P < 0.05 for interaction by age]. These results suggest that major life changes are associated with the onset of chronic daily headache, particularly in middle age.

Head or neck injury increases the risk of chronic daily headache

To evaluate the extent to which head and neck injury (HANI) contributes to chronic daily headache (CDH). In prospective studies, head injury is associated with headache (HA) that remains a problem at 12 to 24 months post-head injury in 20 to 30% of patients. Of these, up to 30 to 50% manifest CDH. The degree to which head injury contributes to CDH has not been evaluated in a non-clinical population. We evaluate the relationship between lifetime occurrence of HANI and CDH in a randomly chosen population sample. Study participants are from the Frequent Headache Epidemiology Study. Cases with CDH (> or =180 HA/year) and a comparison group with episodic headache (EH, 2 to 102 HA/year) were identified from the general population. Subjects were asked about lifetime occurrence of HANI. HANI were further classified as potentially precipitating injuries (PPI) if they occurred within 2 years of CDH onset for cases or in an equivalent 2-year period for EH controls. Lifetime occurrence of HANI was more frequent in cases than controls for men (adjusted OR = 3.1 [1.3 to 7.2]), women (OR = 1.5 [0.97 to 2.3]), and overall (OR = 1.7 [1.1 to 2.4]). The attributable risk was 15% (36% men, 11% women). Results were similar for PPI. The odds of CDH increased with the number of lifetime HANI in all groups (p < 0.05 trend). Results suggest that head and neck injury (HANI) accounts for approximately 15% of chronic daily headache (CDH) cases in this non-clinical population. The relationship between HANI and CDH was not limited to injuries proximate to CDH onset. The lifetime risk of CDH increases with increasing number of HANI.

Outcome of Chronic Daily Headache in Adolescents

Neurology| June 01 2007 Outcome of Chronic Daily Headache in Adolescents AAP Grand Rounds (2007) 17 (6): 68. https://doi.org/10.1542/gr.17-6-68 Views Icon Views Article contents Figures & tables Video Audio Supplementary Data Peer Review Share Icon Share Twitter LinkedIn Tools Icon Tools Get Permissions Cite Icon Cite Search Site Citation Outcome of Chronic Daily Headache in Adolescents. AAP Grand Rounds June 2007; 17 (6): 68. https://doi.org/10.1542/gr.17-6-68 Download citation file: Ris (Zotero) Reference Manager EasyBib Bookends Mendeley Papers EndNote RefWorks BibTex toolbar search nav search search input Search input auto suggest search filter All PublicationsAll JournalsAAP Grand RoundsPediatricsHospital PediatricsPediatrics In ReviewNeoReviewsAAP NewsAll AAP Sites Search Advanced Search Topics: chronic daily headache, headache Source: Wang S-J, Fuh J-L, Lu S-R, et al. Outcomes and predictors of chronic daily headache in adolescents: a 2-year longitudinal study. Neurology. 2007;68:591–596; doi:10.1212/01. wnl.0000252800.82704.62 Outcomes and predictors of chronic daily headache (CDH) were determined in a two-year longitudinal study of a sample of 122 adolescents (32 male/90 female; ages 12–14) based on annual telephone follow-up by neurologists at Taipei Veterans General Hospital, Taiwan. CDH was defined as ≥15 headache days/month, average of two hours/day or more, for more than three months. All study patients met criteria for CDH at enrollment in 2000. Follow-up response rates were 92% in 2001 and 84% in 2002. Average monthly headache frequency for study patients was 11.0 ± 9.7 days during the first year of follow-up and 7.7 ± 6.5 days in the subsequent year. At the one-year follow-up, symptoms in 40% of study patients met criteria for CDH; by the year two follow-up the persistence rate was 25%. A gender difference was observed: only 4% of boys vs 32% of girls had persistent CDH at two-year follow-up. At baseline, 20% of patients met criteria for medication overuse; this decreased to 6% at two years. Based on the International Classification of Headache Disorders (ICHD-2)1 the prevalence of chronic migraine was not significantly changed during follow-up (67% at baseline and 60% at two years), whereas chronic tension-type headache (CTTH) decreased from 86% to 46% in the same time interval (P<.001). However, because the ICHD-2 criteria for diagnosing chronic migraine were felt to be too restrictive, they were revised in 2006.2 Based on the revised criteria, migraine prevalence increased three to four times when compared with the original ICDH-2 criteria, and chronic migraine became more common than CTTH in patients with persistent CDH in 2001 and 2002. Headaches were found to adversely affect learning at school in 56% of patients at the one-year follow-up and in 57% at the second follow-up; seven (6%) dropped out of school during the two-year study period. Poor outcome predictors included female gender, chronic migraine, medication overuse, major depression, anxiety disorders, school phobia, and obsessive compulsive disorder. Independent predictors for CDH persistence were medication overuse (P<.05) and major depression (P<.01). In contrast, migraine, age at CDH onset, and CDH duration were not significant predictors of the persistence of CDH. Dr. Millichap has disclosed no financial relationship relevant to this commentary. This commentary does not contain a discussion of a commercial product/device. This commentary does not contain a discussion of an unapproved/ investigative use of a commercial product/device. This report is an extension of a Taiwan study of the prevalence of headache and medication overuse in adolescents with chronic daily headache (CDH).3 The prevalence was 2.4% in girls and 0.8% in boys. CDH was subtyped as CTTH in 65.6% and chronic migraine in 6.6%; medication overuse CDH occurred in 20% of cases. Whereas the incidence of CDH in adolescents declined over a two-year follow-up, the relative prevalence... You do not currently have access to this content.

Migraine Days Decline with Duration of Illness in Adolescents with Transformed Migraine

The aim of this study was to assess the proportion of subjects with transformed migraine (TM) who have 15 or more migraine days per month as a function of duration of chronic daily headache (CDH) in an adolescent sample. CDH is a syndrome characterized by 15 or more headache days per month. In specialty care, TM is the most common type of CDH. Most adults who meet criteria for TM do not meet the International Headache Society (IHS) criteria for chronic migraine (CM). TM criteria require 15 or more headache days per month (not necessarily migraine), with a current or past history of migraine. CM requires 15 or more migraine days per month. As TM develops, attack frequency increases and the number of migraine features diminishes. If this observation is correct, individuals who meet criteria for TM but not CM may be at a later stage in the evolution of the disease, compared with those who meet criteria for CM. We reviewed charts of 267 adolescents (13-17 years) seen in a headache centre, to identify 117 with TM. We divide subjects with TM into those with recent onset (</=1 year) vs. longer duration (>1 year) and examined the number of migraine days per month and demographic features. We modelled predictors of CM (>15 migraine days per month) using logistic regression. Of 117 adolescents with TM, 55 (47%) had recent-onset (<1 year) and 62 (53%) had long-duration TM. Those with recent-onset TM were much more likely also to meet criteria for CM (74.5% vs. 25.8%, P < 0.001). This was verified in the TM with medication overuse subgroup (recent onset 66.7%, vs. long duration 37%, P = 0.01) and in the TM without medication overuse subgroup (62.2% vs. 19.2%, P = 0.001). Modelling the dichotomous outcome of CM (>15 days of migraine/month) in logistic regression, CM was predicted by recent onset of CDH, recent onset of migraine (<36 months), and younger ages (</=15 years), but not gender or use of migraine preventive drugs or medication overuse. Among adolescents with TM, CM is more likely in individuals who are young, whose episodic headache began recently, and with CDH of recent onset. These findings suggest that early in the process of transformation, migraine is more frequent, and that as CDH evolves, fewer typical attacks of IHS migraine occur.

Caffeine as a risk factor for chronic daily headache

To investigate the possible association of dietary caffeine consumption and medicinal caffeine use with chronic daily headache (CDH). Population-based cases and controls were recruited from the Baltimore, MD, Philadelphia, PA, and Atlanta, GA, metropolitan areas. Controls (n = 507) reported 2 to 104 headache days/year, and cases (n = 206) reported > or =180 headache days/year. Current and past dietary caffeine consumption and medication use for headache were based on detailed self-report. High caffeine exposure was defined as being in the upper quartile of dietary consumption or using a caffeine-containing over-the-counter analgesic as the preferred headache treatment. In comparison with episodic headache controls, CDH cases were more likely overall to have been high caffeine consumers before onset of CDH (odds ratio [OR] = 1.50, p = 0.05). No association was found for current caffeine consumption (i.e., post CDH) (OR = 1.36, p = 0.12). In secondary analyses, associations were confined to younger (age <40) women (OR = 2.0, p = 0.02) and those with chronic episodic (as opposed to chronic continuous) headaches (OR = 1.69, p = 0.01), without physician consultation (OR = 1.67, p = 0.04) and of recent (<2 years) onset (OR = 1.67, p = 0.03). Dietary and medicinal caffeine consumption appears to be a modest risk factor for chronic daily headache onset, regardless of headache type.

Chronic daily headache with analgesic overuse

To analyze the prevalence and demography of chronic daily headache (CDH) with analgesic overuse. A population of 9,984 inhabitants aged 14 or older living in Santoña, Spain, was studied. The authors personally interviewed 4,855 subjects, using a quota sampling approach. Those with headache for > or = 10 days/month and some analgesic use were asked to fill in a diary over the course of 1 month. Then, subjects were classified into CDH with or without analgesic overuse subtypes. Quality of life (Short Form-36 Health Survey [SF-36]) was also assessed in this second interview. Headache for > or = 10 days/month with analgesic consumption was reported by 332 subjects. Seven had secondary headache. Seventy-four (standardized prevalence 1.41%, 95% CI 1.1 to 1.8) fulfilled criteria for CDH with analgesic overuse. Prevalence in women (2.6%, 2.0 to 3.3) was much higher than in men (0.19%, 0.006 to 0.52). Mean age was 56 years (range 19 to 82 years). As recalled by the subjects, the mean age at onset of CDH was 38 years (range 9 to 82 years), whereas the mean age at onset of CDH with frequent analgesic consumption was 45 years (range 19 to 80 years) and that of primary headache was 22 years (range 5 to 60 years). CDH subjects showed a significant decrease in each SF-36 health-related score as compared with healthy control subjects. Transformed migraine was diagnosed in 49 (prevalence 0.9%), chronic tension-type headache in 20 (0.4%), and new daily persistent headache in 5 (0.1%). Thirty-five percent of patients overused simple analgesics, 22% ergotics, 12.5% opioids, and 2.7% triptans; the remaining 27.8% were overusing different combinations. CDH with analgesic overuse is a common disorder in the general population, mainly in women in their fifties, in whom 5% meet its diagnostic criteria.

Factors associated with the onset and remission of chronic daily headache in a population-based study

The etiology and prognosis of chronic daily headache (CDH) are not well understood. The aim of this study is to describe factors that predict CDH onset or remission in an adult population. Potential cases (180+ headaches per year, n=1134) and controls (two to 104 headaches per year, n=798) were interviewed two times over an average 11 months of follow-up. Factors associated with CDH prevalence at baseline were evaluated. The incidence of CDH and risk factors for onset were assessed in controls whose headache frequency increased to 180+ per year at follow-up. Prognostic factors were assessed in CDH cases whose headache frequency fell at follow-up. CDH was more common in women, in whites, and those of less education. CDH cases were more likely to be previously married (divorced, widowed, separated), obese, and report a physician diagnosis of diabetes or arthritis. At follow-up, 3% of the controls reported 180 or more headaches per year. Obesity and baseline headache frequency were significantly associated with new onset CDH. In CDH cases, the projected 1-year remission rate to less than one headache per week was 14% and to less than 180 headaches per year was 57%. A better prognosis was associated with higher education, non-white race, being married, and with diagnosed diabetes. Individuals with less than a high-school education, whites, and those who were previously married had a higher risk of CDH at baseline and reduced likelihood of remission at follow-up. New onset CDH was associated with baseline headache frequency and obesity.

Chronic daily headache in Taipei, Taiwan: prevalence, follow-up and outcome predictors.

We conducted a two-stage population-based headache survey among subjects aged > or = 15 in Taipei, Taiwan. Subjects with chronic daily headache (CDH) in the past year were identified, interviewed and followed-up. CDH was defined as a headache frequency > 15 days/month, with a duration > 4 h/day. Of the 3377 participants, 108 (3.2%) fulfilled the criteria for CDH, with a higher prevalence in women (4.3%) than men (1.9%). TM was the most common subtype (55%), followed by CTTH (44%). Thirty-four per cent of the CDH subjects overused analgesics. At the 2-year follow-up, 35% of the CDH subjects still had CDH. The significant predictors for persistent CDH at follow-up included: older age ( > or = 40 years) (RR = 2.4), CDH onset after 32 years (RR = 1.8), CDH duration > or = 6 years (RR = 2.0), medication overuse (RR = 1.8), and "daily" headache (RR = 2.1). We found that CDH is not uncommon in the community and its prevalence is similar among different populations. Older subjects and those with medication overuse may have a more protracted course of illness.