Migraine Briefs

Excitatory non-invasive brain stimulation (NIBS) of the excitatory primary motor cortex (M1) is likely to reduce headache intensity and the frequency of headache attacks in patients with migraine, a new study found. Researchers quantitatively reviewed the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in randomized controlled trials (RTCs) in modifying headache intensity and frequency of headache attacks in patients with migraine. A random meta-analysis was performed to pool effect sizes of outcomes. Among the findings:

• Nine RCTs with 276 participants were included.
• Meta-analysis of excitatory M1 stimulation demonstrated significant effects on reducing headache intensity in patients with migraine.
• Meta-analysis of excitatory M1 stimulation showed significant effects on reducing frequency of headache attacks in patients with migraine.

Feng Y, et al. Effects of non-invasive brain stimulation on headache intensity and frequency of headache attacks in patients with migraine: A systematic review and meta-analysis. [Published online ahead of print September 18, 2019]. Headache. doi: 10.1111/head.13645.

Excitatory non-invasive brain stimulation (NIBS) of the excitatory primary motor cortex (M1) is likely to reduce headache intensity and the frequency of headache attacks in patients with migraine, a new study found. Researchers quantitatively reviewed the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in randomized controlled trials (RTCs) in modifying headache intensity and frequency of headache attacks in patients with migraine. A random meta-analysis was performed to pool effect sizes of outcomes. Among the findings:

• Nine RCTs with 276 participants were included.
• Meta-analysis of excitatory M1 stimulation demonstrated significant effects on reducing headache intensity in patients with migraine.
• Meta-analysis of excitatory M1 stimulation showed significant effects on reducing frequency of headache attacks in patients with migraine.

Feng Y, et al. Effects of non-invasive brain stimulation on headache intensity and frequency of headache attacks in patients with migraine: A systematic review and meta-analysis. [Published online ahead of print September 18, 2019]. Headache. doi: 10.1111/head.13645.

Excitatory non-invasive brain stimulation (NIBS) of the excitatory primary motor cortex (M1) is likely to reduce headache intensity and the frequency of headache attacks in patients with migraine, a new study found. Researchers quantitatively reviewed the efficacy of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) in randomized controlled trials (RTCs) in modifying headache intensity and frequency of headache attacks in patients with migraine. A random meta-analysis was performed to pool effect sizes of outcomes. Among the findings:

• Nine RCTs with 276 participants were included.
• Meta-analysis of excitatory M1 stimulation demonstrated significant effects on reducing headache intensity in patients with migraine.
• Meta-analysis of excitatory M1 stimulation showed significant effects on reducing frequency of headache attacks in patients with migraine.

Feng Y, et al. Effects of non-invasive brain stimulation on headache intensity and frequency of headache attacks in patients with migraine: A systematic review and meta-analysis. [Published online ahead of print September 18, 2019]. Headache. doi: 10.1111/head.13645.

Osmophobia is a specific clinical marker of migraine, but not tension-type headache, a new study found. Researchers conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache, or a combination of these. Each patient was asked to describe in detail osmophobia, when present, in the 4 headache attacks. Among the findings:

• 45.7% of migraine with aura attacks were associated with osmophobia.
• 67.2% of patients with migraine reported osmophobia in at least a quarter of the attacks.
• No tension-type headache attack was associated with osmophobia.

Terrin A, et al. A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks. [Published online ahead of print September 19, 2019]. Cephalalgia. doi: 10.1177/0333102419877661.

Osmophobia is a specific clinical marker of migraine, but not tension-type headache, a new study found. Researchers conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache, or a combination of these. Each patient was asked to describe in detail osmophobia, when present, in the 4 headache attacks. Among the findings:

• 45.7% of migraine with aura attacks were associated with osmophobia.
• 67.2% of patients with migraine reported osmophobia in at least a quarter of the attacks.
• No tension-type headache attack was associated with osmophobia.

Terrin A, et al. A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks. [Published online ahead of print September 19, 2019]. Cephalalgia. doi: 10.1177/0333102419877661.

Osmophobia is a specific clinical marker of migraine, but not tension-type headache, a new study found. Researchers conducted a prospective study on 193 patients suffering from migraine without aura, migraine with aura, episodic tension-type headache, or a combination of these. Each patient was asked to describe in detail osmophobia, when present, in the 4 headache attacks. Among the findings:

• 45.7% of migraine with aura attacks were associated with osmophobia.
• 67.2% of patients with migraine reported osmophobia in at least a quarter of the attacks.
• No tension-type headache attack was associated with osmophobia.

Terrin A, et al. A prospective study on osmophobia in migraine versus tension-type headache in a large series of attacks. [Published online ahead of print September 19, 2019]. Cephalalgia. doi: 10.1177/0333102419877661.

Unmet medical needs are of concern to patients who experience migraine treated with triptans and there may be an undertreatment with preventive therapies whose benefit is insufficient, a new study found. The study cohort consisted of participants with ≥4 triptan dose units per month, selected from the general population. Patients were stratified into: possible Low-Frequency Episodic Migraine (pLF-EM: 4-9 triptan dose units per month), possible High-Frequency Episodic Migraine (pHF-EM: 10-14 triptan dose units per month), and possible Chronic Migraine (pCM: 14 triptan dose units per month). Researchers found:

• Of 10,270,683 adults, 8 per 1000 were triptan users and of these, 38.2% were migraineurs with unmet medical needs.
• 72.3% of patients were affected by pLF-EM, 17.4% by pHF-EM, and 10.3% by pCM.
• 19.1% of patients used oral preventive drugs.
• Triptan use reduction was found in 22.3% of patients, decreasing with the intensification of need levels.

Piccinni C, Cevoli S, Martini N. A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years. [Published online ahead of print June 27, 2019]. J Headache Pain. doi: 10.1186/s10194-019-1027-7.

Unmet medical needs are of concern to patients who experience migraine treated with triptans and there may be an undertreatment with preventive therapies whose benefit is insufficient, a new study found. The study cohort consisted of participants with ≥4 triptan dose units per month, selected from the general population. Patients were stratified into: possible Low-Frequency Episodic Migraine (pLF-EM: 4-9 triptan dose units per month), possible High-Frequency Episodic Migraine (pHF-EM: 10-14 triptan dose units per month), and possible Chronic Migraine (pCM: 14 triptan dose units per month). Researchers found:

• Of 10,270,683 adults, 8 per 1000 were triptan users and of these, 38.2% were migraineurs with unmet medical needs.
• 72.3% of patients were affected by pLF-EM, 17.4% by pHF-EM, and 10.3% by pCM.
• 19.1% of patients used oral preventive drugs.
• Triptan use reduction was found in 22.3% of patients, decreasing with the intensification of need levels.

Piccinni C, Cevoli S, Martini N. A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years. [Published online ahead of print June 27, 2019]. J Headache Pain. doi: 10.1186/s10194-019-1027-7.

Unmet medical needs are of concern to patients who experience migraine treated with triptans and there may be an undertreatment with preventive therapies whose benefit is insufficient, a new study found. The study cohort consisted of participants with ≥4 triptan dose units per month, selected from the general population. Patients were stratified into: possible Low-Frequency Episodic Migraine (pLF-EM: 4-9 triptan dose units per month), possible High-Frequency Episodic Migraine (pHF-EM: 10-14 triptan dose units per month), and possible Chronic Migraine (pCM: 14 triptan dose units per month). Researchers found:

• Of 10,270,683 adults, 8 per 1000 were triptan users and of these, 38.2% were migraineurs with unmet medical needs.
• 72.3% of patients were affected by pLF-EM, 17.4% by pHF-EM, and 10.3% by pCM.
• 19.1% of patients used oral preventive drugs.
• Triptan use reduction was found in 22.3% of patients, decreasing with the intensification of need levels.

Piccinni C, Cevoli S, Martini N. A real-world study on unmet medical needs in triptan-treated migraine: prevalence, preventive therapies and triptan use modification from a large Italian population along two years. [Published online ahead of print June 27, 2019]. J Headache Pain. doi: 10.1186/s10194-019-1027-7.

Variables such as disability, depression, and lack of anger control are among the key factors associated with headache chronicity in patients who experience migraine, a new study found. The cross-sectional study included a target sample of 250 patients with acute or chronic migraine. All participants filled out questionnaires related to demographic characteristics, pain intensity, disability, depression, emotional intelligence, and anger. Researchers found:

• Patients with chronic migraine experienced higher levels of disability, depression, anger, and had lower levels of emotional intelligence vs patients with acute migraine.
• Variables that had a significant effect on headache chronicity were female gender, married status, lower level of education, headache duration, disability, depression, and anger.

Emadi F, Sharif F, Shaygan M, Sharifi N, Ashjazadeh N. Comparison of pain-related and psychological variables between acute and chronic migraine patients, and factors affecting headache chronicity. Int J Community Based Nurs Midwifery. 2019;7(3):192-200. doi: 10.30476/IJCBNM.2019.44994.

Variables such as disability, depression, and lack of anger control are among the key factors associated with headache chronicity in patients who experience migraine, a new study found. The cross-sectional study included a target sample of 250 patients with acute or chronic migraine. All participants filled out questionnaires related to demographic characteristics, pain intensity, disability, depression, emotional intelligence, and anger. Researchers found:

• Patients with chronic migraine experienced higher levels of disability, depression, anger, and had lower levels of emotional intelligence vs patients with acute migraine.
• Variables that had a significant effect on headache chronicity were female gender, married status, lower level of education, headache duration, disability, depression, and anger.

Emadi F, Sharif F, Shaygan M, Sharifi N, Ashjazadeh N. Comparison of pain-related and psychological variables between acute and chronic migraine patients, and factors affecting headache chronicity. Int J Community Based Nurs Midwifery. 2019;7(3):192-200. doi: 10.30476/IJCBNM.2019.44994.

Variables such as disability, depression, and lack of anger control are among the key factors associated with headache chronicity in patients who experience migraine, a new study found. The cross-sectional study included a target sample of 250 patients with acute or chronic migraine. All participants filled out questionnaires related to demographic characteristics, pain intensity, disability, depression, emotional intelligence, and anger. Researchers found:

• Patients with chronic migraine experienced higher levels of disability, depression, anger, and had lower levels of emotional intelligence vs patients with acute migraine.
• Variables that had a significant effect on headache chronicity were female gender, married status, lower level of education, headache duration, disability, depression, and anger.

Emadi F, Sharif F, Shaygan M, Sharifi N, Ashjazadeh N. Comparison of pain-related and psychological variables between acute and chronic migraine patients, and factors affecting headache chronicity. Int J Community Based Nurs Midwifery. 2019;7(3):192-200. doi: 10.30476/IJCBNM.2019.44994.

A very low-calorie ketogenic diet (VLCKD) has a preventive effect in overweight, episodic patients who experience migraine that appears within 1 month, a new study found. Researchers sought to determine the therapeutic effect of a very low-calorie diet in overweight, episodic patients who experience migraine during a weight-loss intervention in which participants alternated randomly between a VLCKD and a very low-calorie non-ketogenic diet (VLCnKD) each for 1 month. The primary outcomes measure was the reduction of migraine days each month compared to a 1-month pre-diet baseline. Among the findings:

• Thirty-five obese migraine sufferers were allocated blindly to 1-month successive VLCKD or VLCnKD in random order.
• During the VLCKD patients experienced ‒3.73 migraine days respect to VLCnKD.
• The 50% responder rate for migraine days was 74.28% during the VLCKD period and 8.57% during VLCnKD.
• Migraine attacks decreased by ‒3.02 during VLCKD respect to VLCnKD.

Di Lorenzo C, Pinto A, Lenca R, et al. A randomized double-blind, cross-over trial of very low-calorie diet in overweight migraine patients: A possible role for ketones? [Published online ahead of print July 28, 2019]. Nutrients. doi: 10.3390/nu11081742.

A very low-calorie ketogenic diet (VLCKD) has a preventive effect in overweight, episodic patients who experience migraine that appears within 1 month, a new study found. Researchers sought to determine the therapeutic effect of a very low-calorie diet in overweight, episodic patients who experience migraine during a weight-loss intervention in which participants alternated randomly between a VLCKD and a very low-calorie non-ketogenic diet (VLCnKD) each for 1 month. The primary outcomes measure was the reduction of migraine days each month compared to a 1-month pre-diet baseline. Among the findings:

• Thirty-five obese migraine sufferers were allocated blindly to 1-month successive VLCKD or VLCnKD in random order.
• During the VLCKD patients experienced ‒3.73 migraine days respect to VLCnKD.
• The 50% responder rate for migraine days was 74.28% during the VLCKD period and 8.57% during VLCnKD.
• Migraine attacks decreased by ‒3.02 during VLCKD respect to VLCnKD.

Di Lorenzo C, Pinto A, Lenca R, et al. A randomized double-blind, cross-over trial of very low-calorie diet in overweight migraine patients: A possible role for ketones? [Published online ahead of print July 28, 2019]. Nutrients. doi: 10.3390/nu11081742.

A very low-calorie ketogenic diet (VLCKD) has a preventive effect in overweight, episodic patients who experience migraine that appears within 1 month, a new study found. Researchers sought to determine the therapeutic effect of a very low-calorie diet in overweight, episodic patients who experience migraine during a weight-loss intervention in which participants alternated randomly between a VLCKD and a very low-calorie non-ketogenic diet (VLCnKD) each for 1 month. The primary outcomes measure was the reduction of migraine days each month compared to a 1-month pre-diet baseline. Among the findings:

• Thirty-five obese migraine sufferers were allocated blindly to 1-month successive VLCKD or VLCnKD in random order.
• During the VLCKD patients experienced ‒3.73 migraine days respect to VLCnKD.
• The 50% responder rate for migraine days was 74.28% during the VLCKD period and 8.57% during VLCnKD.
• Migraine attacks decreased by ‒3.02 during VLCKD respect to VLCnKD.

Di Lorenzo C, Pinto A, Lenca R, et al. A randomized double-blind, cross-over trial of very low-calorie diet in overweight migraine patients: A possible role for ketones? [Published online ahead of print July 28, 2019]. Nutrients. doi: 10.3390/nu11081742.

The white matter hyperintensities (WMH) in patients with sporadic hemiplegic migraine (SHM) is significantly more in the parietal lobe when compared with those with migraine headaches, a new study found. Fifty patients met the criteria for SHM and 100 patients met the criteria for migraine headaches. Patients in the study group were similar to the control groups in terms of age and gender. Researchers found:

• WMH were found in 28 (56%) patients with SHM and 44 (44%) in patients with migraine headache.
• The proportion of patients with WMH was not different between the groups.
• WMH burden was higher in patients with SHM, and larger white matter lesions occurred more frequently in these patients compared to ordinary migraineurs.

Nagarajan E, Bollu PC, Manjamalai S, Yelam A, Quereshi AI. White matter hyperintensities in patients with sporadic hemiplegic migraine. [Published online ahead of print July 15, 2019]. J Neuroimaging. doi: 10.1111/jon.12656.

The white matter hyperintensities (WMH) in patients with sporadic hemiplegic migraine (SHM) is significantly more in the parietal lobe when compared with those with migraine headaches, a new study found. Fifty patients met the criteria for SHM and 100 patients met the criteria for migraine headaches. Patients in the study group were similar to the control groups in terms of age and gender. Researchers found:

• WMH were found in 28 (56%) patients with SHM and 44 (44%) in patients with migraine headache.
• The proportion of patients with WMH was not different between the groups.
• WMH burden was higher in patients with SHM, and larger white matter lesions occurred more frequently in these patients compared to ordinary migraineurs.

Nagarajan E, Bollu PC, Manjamalai S, Yelam A, Quereshi AI. White matter hyperintensities in patients with sporadic hemiplegic migraine. [Published online ahead of print July 15, 2019]. J Neuroimaging. doi: 10.1111/jon.12656.

The white matter hyperintensities (WMH) in patients with sporadic hemiplegic migraine (SHM) is significantly more in the parietal lobe when compared with those with migraine headaches, a new study found. Fifty patients met the criteria for SHM and 100 patients met the criteria for migraine headaches. Patients in the study group were similar to the control groups in terms of age and gender. Researchers found:

• WMH were found in 28 (56%) patients with SHM and 44 (44%) in patients with migraine headache.
• The proportion of patients with WMH was not different between the groups.
• WMH burden was higher in patients with SHM, and larger white matter lesions occurred more frequently in these patients compared to ordinary migraineurs.

Nagarajan E, Bollu PC, Manjamalai S, Yelam A, Quereshi AI. White matter hyperintensities in patients with sporadic hemiplegic migraine. [Published online ahead of print July 15, 2019]. J Neuroimaging. doi: 10.1111/jon.12656.

Individuals who had a median intake of 0.84-1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54% to 60%, relative to those who consumed ≤0.56 g/day, a new study found. The migraine group (n=514) was recruited from a tertiary headache clinic while controls consisted of 582 sex-matched healthy volunteers randomly selected from the general population. A validated 168-item semi-quantitative food frequency questionnaire was used for dietary intake assessments. Researchers found:

• Multiple regression models were adjusted for age, sex, body mass index, total daily energy intake, dietary intakes of total carbohydrates, animal-based protein, plant-based protein, total fat, saturated fat, and cholesterol.

• There was a negative association between tryptophan intake and migraine risk.

Razeghi Jahromi S, Togha M, Ghorbani Z, et al. The association between dietary tryptophan intake and migraine. [Published online ahead of print June 28, 2019]. Neurol Sci. doi: 10.1007/s10072-019-03984-3.

Individuals who had a median intake of 0.84-1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54% to 60%, relative to those who consumed ≤0.56 g/day, a new study found. The migraine group (n=514) was recruited from a tertiary headache clinic while controls consisted of 582 sex-matched healthy volunteers randomly selected from the general population. A validated 168-item semi-quantitative food frequency questionnaire was used for dietary intake assessments. Researchers found:

• Multiple regression models were adjusted for age, sex, body mass index, total daily energy intake, dietary intakes of total carbohydrates, animal-based protein, plant-based protein, total fat, saturated fat, and cholesterol.

• There was a negative association between tryptophan intake and migraine risk.

Razeghi Jahromi S, Togha M, Ghorbani Z, et al. The association between dietary tryptophan intake and migraine. [Published online ahead of print June 28, 2019]. Neurol Sci. doi: 10.1007/s10072-019-03984-3.

Individuals who had a median intake of 0.84-1.06 g of tryptophan per day had reduced odds of developing migraine by approximately 54% to 60%, relative to those who consumed ≤0.56 g/day, a new study found. The migraine group (n=514) was recruited from a tertiary headache clinic while controls consisted of 582 sex-matched healthy volunteers randomly selected from the general population. A validated 168-item semi-quantitative food frequency questionnaire was used for dietary intake assessments. Researchers found:

• Multiple regression models were adjusted for age, sex, body mass index, total daily energy intake, dietary intakes of total carbohydrates, animal-based protein, plant-based protein, total fat, saturated fat, and cholesterol.

• There was a negative association between tryptophan intake and migraine risk.

Razeghi Jahromi S, Togha M, Ghorbani Z, et al. The association between dietary tryptophan intake and migraine. [Published online ahead of print June 28, 2019]. Neurol Sci. doi: 10.1007/s10072-019-03984-3.

Migraine is a traumatic brain injury (TBI) risk factor, according to a recent population-based study in Taiwan. Researchers identified 7267 patients with newly diagnosed migraine between 1996 and 2010. The migraineurs to non-migraineurs ratio was 1:4. Multivariate Cox proportional hazard regression models were used to assess the effects of migraines on the risk of TBI after adjusting for potential confounders. Among the findings:

• The overall TBI risk was 1.78 times greater in the migraine group vs the non-migraine group after controlling for covariates.
• Additionally, patients with previous diagnoses of alcohol-attributed disease, mental disorders, and diabetes mellitus had a significantly higher TBI risk compare with those with no history of these diagnoses.

Wang QR, Lu YY, Su YJ, et al. Migraine and traumatic brain injury: a cohort study in Taiwan. [Published online ahead of print July 30, 2019]. BMJ Open. doi: 10.1136/bmjopen-2018-027251.

Migraine is a traumatic brain injury (TBI) risk factor, according to a recent population-based study in Taiwan. Researchers identified 7267 patients with newly diagnosed migraine between 1996 and 2010. The migraineurs to non-migraineurs ratio was 1:4. Multivariate Cox proportional hazard regression models were used to assess the effects of migraines on the risk of TBI after adjusting for potential confounders. Among the findings:

• The overall TBI risk was 1.78 times greater in the migraine group vs the non-migraine group after controlling for covariates.
• Additionally, patients with previous diagnoses of alcohol-attributed disease, mental disorders, and diabetes mellitus had a significantly higher TBI risk compare with those with no history of these diagnoses.

Wang QR, Lu YY, Su YJ, et al. Migraine and traumatic brain injury: a cohort study in Taiwan. [Published online ahead of print July 30, 2019]. BMJ Open. doi: 10.1136/bmjopen-2018-027251.

Migraine is a traumatic brain injury (TBI) risk factor, according to a recent population-based study in Taiwan. Researchers identified 7267 patients with newly diagnosed migraine between 1996 and 2010. The migraineurs to non-migraineurs ratio was 1:4. Multivariate Cox proportional hazard regression models were used to assess the effects of migraines on the risk of TBI after adjusting for potential confounders. Among the findings:

• The overall TBI risk was 1.78 times greater in the migraine group vs the non-migraine group after controlling for covariates.
• Additionally, patients with previous diagnoses of alcohol-attributed disease, mental disorders, and diabetes mellitus had a significantly higher TBI risk compare with those with no history of these diagnoses.

Wang QR, Lu YY, Su YJ, et al. Migraine and traumatic brain injury: a cohort study in Taiwan. [Published online ahead of print July 30, 2019]. BMJ Open. doi: 10.1136/bmjopen-2018-027251.

The Psychosocial Assessment Tool (PAT) is a promising tool for screening psychosocial risk that could potentially facilitate identification of psychosocial treatment needs among youth with recurrent headache at risk for poor outcomes, a new study found. Youth with recurrent migraine or tension-type headache completed the PAT and validated measures of adolescent emotional and behavioral functioning, parent emotional functioning, and family functioning at baseline (n=239) and 6-month follow-up (n=221). Researchers found:

• Internal consistency for the PAT total score was strong (α = .88).
• At baseline, the PAT total score was significantly associated in the expected direction with established measures of child emotional and behavioral functioning, parent anxiety and depressive symptoms, and family functioning.
• Predictive validity was demonstrated by a significant association between the PAT total scores at baseline with child emotional and behavioral functioning, parent anxiety, parent depression, and family functioning at 6-month follow-up.

Law EF, et al. Screening family and psychosocial risk in pediatric migraine and tension-type headache: Validation of the Psychosocial Assessment Tool (PAT). [Published online ahead of print July 18, 2019]. Headache. doi: 10.1111/head.13599.

The Psychosocial Assessment Tool (PAT) is a promising tool for screening psychosocial risk that could potentially facilitate identification of psychosocial treatment needs among youth with recurrent headache at risk for poor outcomes, a new study found. Youth with recurrent migraine or tension-type headache completed the PAT and validated measures of adolescent emotional and behavioral functioning, parent emotional functioning, and family functioning at baseline (n=239) and 6-month follow-up (n=221). Researchers found:

• Internal consistency for the PAT total score was strong (α = .88).
• At baseline, the PAT total score was significantly associated in the expected direction with established measures of child emotional and behavioral functioning, parent anxiety and depressive symptoms, and family functioning.
• Predictive validity was demonstrated by a significant association between the PAT total scores at baseline with child emotional and behavioral functioning, parent anxiety, parent depression, and family functioning at 6-month follow-up.

Law EF, et al. Screening family and psychosocial risk in pediatric migraine and tension-type headache: Validation of the Psychosocial Assessment Tool (PAT). [Published online ahead of print July 18, 2019]. Headache. doi: 10.1111/head.13599.

The Psychosocial Assessment Tool (PAT) is a promising tool for screening psychosocial risk that could potentially facilitate identification of psychosocial treatment needs among youth with recurrent headache at risk for poor outcomes, a new study found. Youth with recurrent migraine or tension-type headache completed the PAT and validated measures of adolescent emotional and behavioral functioning, parent emotional functioning, and family functioning at baseline (n=239) and 6-month follow-up (n=221). Researchers found:

• Internal consistency for the PAT total score was strong (α = .88).
• At baseline, the PAT total score was significantly associated in the expected direction with established measures of child emotional and behavioral functioning, parent anxiety and depressive symptoms, and family functioning.
• Predictive validity was demonstrated by a significant association between the PAT total scores at baseline with child emotional and behavioral functioning, parent anxiety, parent depression, and family functioning at 6-month follow-up.

Law EF, et al. Screening family and psychosocial risk in pediatric migraine and tension-type headache: Validation of the Psychosocial Assessment Tool (PAT). [Published online ahead of print July 18, 2019]. Headache. doi: 10.1111/head.13599.

Sodium divalproate (SD) in low alternating doses appears to be effective as with higher doses, but may induce modest weight gain, a new study found. Consecutive migraineurs to whom SD was prescribed as monotherapy were studied retrospectively. The doses were 250 mg alternated with 500 mg. Headache frequency compared to baseline, adherence expressed by returning to a visit after 2 and 4 months, and side effects reported by patients were evaluated. The study included 68 patients (53 women, 15 men) aged 18 to 58 years.
 

Researchers found:

• The average headache frequency (HF) during baseline was decreased from 8.2 to 5.1 headache days/month among the 50 out of 68 patients returning at 2 months, with adherence rate at 73.5%.
• Weight gain was reported in 30% of patients.
• At 4 months, HF was reduced to 4.2 days/month, with adherence rate at 61.8%, and weight gain reported by 42.8% of patients.

Krymchantowski AV, et al. Sodium divalproate in low alternating daily doses for migraine prevention: A retrospective study. [Published online ahead of print July 1, 2019]. Headache. doi:  10.1111/head.13579.

Sodium divalproate (SD) in low alternating doses appears to be effective as with higher doses, but may induce modest weight gain, a new study found. Consecutive migraineurs to whom SD was prescribed as monotherapy were studied retrospectively. The doses were 250 mg alternated with 500 mg. Headache frequency compared to baseline, adherence expressed by returning to a visit after 2 and 4 months, and side effects reported by patients were evaluated. The study included 68 patients (53 women, 15 men) aged 18 to 58 years.
 

Researchers found:

• The average headache frequency (HF) during baseline was decreased from 8.2 to 5.1 headache days/month among the 50 out of 68 patients returning at 2 months, with adherence rate at 73.5%.
• Weight gain was reported in 30% of patients.
• At 4 months, HF was reduced to 4.2 days/month, with adherence rate at 61.8%, and weight gain reported by 42.8% of patients.

Krymchantowski AV, et al. Sodium divalproate in low alternating daily doses for migraine prevention: A retrospective study. [Published online ahead of print July 1, 2019]. Headache. doi:  10.1111/head.13579.

Sodium divalproate (SD) in low alternating doses appears to be effective as with higher doses, but may induce modest weight gain, a new study found. Consecutive migraineurs to whom SD was prescribed as monotherapy were studied retrospectively. The doses were 250 mg alternated with 500 mg. Headache frequency compared to baseline, adherence expressed by returning to a visit after 2 and 4 months, and side effects reported by patients were evaluated. The study included 68 patients (53 women, 15 men) aged 18 to 58 years.
 

Researchers found:

• The average headache frequency (HF) during baseline was decreased from 8.2 to 5.1 headache days/month among the 50 out of 68 patients returning at 2 months, with adherence rate at 73.5%.
• Weight gain was reported in 30% of patients.
• At 4 months, HF was reduced to 4.2 days/month, with adherence rate at 61.8%, and weight gain reported by 42.8% of patients.

Krymchantowski AV, et al. Sodium divalproate in low alternating daily doses for migraine prevention: A retrospective study. [Published online ahead of print July 1, 2019]. Headache. doi:  10.1111/head.13579.