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Observational Study
. 2017 Dec;18(1):59.
doi: 10.1186/s10194-017-0764-8. Epub 2017 May 30.

Symptoms of central sensitization and comorbidity for juvenile fibromyalgia in childhood migraine: an observational study in a tertiary headache center

Marina de Tommaso  1 , Vittorio Sciruicchio  2 , Marianna Delussi  3 , Eleonora Vecchio  3 , Marvita Goffredo  4 , Michele Simeone  4 , Maria Grazia Foschino Barbaro  4
Affiliations
Observational Study

Symptoms of central sensitization and comorbidity for juvenile fibromyalgia in childhood migraine: an observational study in a tertiary headache center

Marina de Tommaso et al. J Headache Pain. 2017 Dec.

Abstract

Background: Central sensitization is an important epiphenomenon of the adult migraine, clinically expressed by allodynia, pericranial tenderness and comorbidity for fibromyalgia in a relevant number of patients. This study aimed to evaluate the frequency and the clinical characteristics of allodynia, pericranial tenderness, and comorbidity for Juvenile Fibromialgia (JFM) in a cohort of migraine children selected in a tertiary headache center.

Methods: This was an observational cross-sectional study on 8-15 years old migraine patients. Allodynia was assessed by a questionnaire. Pericranial tenderness and comorbidity for JFM as well as their possible association with poor quality of life and migraine related disability, and with other clinical symptoms as anxiety, depression, sleep disorders and pain catastrophizing, were also evaluated.

Results: One hundred and fifty one patients were selected, including chronic migraine (n°47), migraine without aura (n° 92) and migraine with aura (n° 12) sufferers. Allodynia was reported in the 96,6% and pericranial tenderness was observed in the 68.8% of patients. Pericranial tenderness was more severe in patients with more frequent migraine and shorter sleep duration. Allodynia seemed associated with anxiety, pain catastrophizing and high disability scores. Comorbidity for JFM was present in the 0.03% ofpatients. These children presented with a severe depression and a significant reduction of quality of life as compared to the other patients.

Conclusions: This study outlined a relevant presence of symptoms of central sensitization among children with migraine. Severe allodynia and comorbidity for JFM seemed to cause a general decline of quality of life, which would suggest the opportunity of a routine assessment of these clinical features.

Keywords: Allodynia; Children; Juvenile fibromialgia; Migraine; Pericranial tenderness.

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Figures

Fig. 1
Fig. 1
Flow chart reporting main study design
Fig. 2
Fig. 2
Mean and Standard Deviations of symptoms of central sensitization (TTS, Total Tenderness Score) in migraine children. Divided Into headache diagnosis groups (MA Migraine Without Aura, MWA Migraine With Aura, CM Chronic Migraine. For TTS ANOVA test with group as factor: F 4.09, p < 0.0009; for allodynia F 0.95 n.s. The results of Bonferroni test are reported: CM vs MA and MWA * p < 0.05
Fig. 3
Fig. 3
Quality of life In Juvenile Fibromyalgia (JFM) patients. Total Pediatric Quality of life-Patient (PedQL-T). Physical Pediatric Quality of life-Patient (Ped-QLPHY) . Psychic Pediatric Quality of life-patient (Ped-QLQPSY). Total Pediatric Quality of life-Parent (PedPa QL-T). Physical Pediatric Quality of life-Parent (PedPar-QLPHY) . Psychic Pediatric Quality of life-parent (PedPar-QLQPSY). ANOVA test with group as factor: PedQL-T, F 4.39, p 0.014; Ped-QLPHY, F 3.76, p 0.026; Ped-QLQPSY, F 3,66, p 0.028; PedPa QL-T, F 4.74, p 0.01; PedPar-QLPHY, F 4.47 p 0.013; PedPar-QLQPSY F 3.33, p 0.038
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