Electronic Momentary Assessment of Weather Changes as a Trigger of Headaches in Children
Electronic Momentary Assessment of Weather Changes as a Trigger of Headaches in Children
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DOI：
10.1111/j.1526-4610.2009.01586.x
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发表时间：
2010-05-01
期刊：
影响因子：
5
通讯作者：
Bickel, Jennifer
中科院分区：
文献类型：
--
作者：
Connelly, Mark;Miller, Todd;Bickel, Jennifer
背景：迄今为止，仅使用回顾性报告对被认为会引发儿童偏头痛或紧张型头痛发作的变量进行了研究。因此，几乎没有经验证据支持假定的头痛触发因素与儿童实际头痛发生之间的实际预测关联。目的。-本研究试图确定，在使用严格的前瞻性方法（“电子瞬时评估”）进行评估时，天气波动（儿童常见的头痛触发因素）是否会预测头痛发生的可能性增加。方法。-25 名年龄在 8-17 岁之间的儿童（21 名女孩，4 名男孩）参加新患者神经科诊所预约，并诊断为慢性头痛。偏头痛、慢性紧张型或阵发性偏头痛（有或没有先兆）参与了该研究。儿童完成了头痛特征、假定的头痛触发因素和情绪的基线测量，随后接受了使用电子日记记录头痛信息的培训。然后，孩子们在两周时间内在手持电脑上完成三次每日日记（每个孩子进行 42 次评估），同时每次完成日记时都会记录孩子所在地理位置的天气变量数据（温度、露点温度、气压、湿度、降水和阳光）。使用多级模型分析数据。结果-在天气变量中，相对湿度和降水的存在可以显着预测新的头痛发作，在儿童所在地区降水或湿度升高期间，头痛发生的概率增加近 3 倍，b = 0.38，t(821) = 2.10，P = .04，b = 0.02，t(821) = 2.81，P = .01，分别。在考虑了情绪波动后，这些关联仍然存在，而且对于那些在基线时认为天气会引发头痛的儿童来说，这种关联并没有明显更强。在该样本中，温度、露点温度、气压和阳光的变化并不能显着预测新头痛发作的发生。结论：本研究的结果支持了患有复发性头痛的儿童普遍持有的观点，即天气变化可能会导致头痛发作。尽管电子瞬时评估方法在这一人群中是可行的，并且有可能识别儿童的特定头痛诱因，但如何最好（甚至是否）将此信息纳入治疗建议仍有待确定。
Background.-Variables that are thought to precipitate migraine or tension-type headache episodes in children hitherto have only been studied using retrospective reports. As such, there is little empirical evidence to support the actual predictive association between presumed headache triggers and actual headache occurrence in children.Objective.-The present study sought to determine if fluctuations in weather, a commonly reported headache trigger in children, predict increased likelihood of headache occurrence when evaluated using rigorous prospective methodology ("electronic momentary assessment").Methods.-Twenty-five children (21 girls, 4 boys) between the ages of 8-17 years attending a new patient neurology clinic appointment and having a diagnosis of chronic migraine, chronic tension-type, or episodic migraine headache (with or without aura) participated in the study. Children completed baseline measures on headache characteristics, presumed headache triggers, and mood and subsequently were trained in the use of electronic diaries to record information on headaches. Children then completed thrice daily diaries on handheld computers for a 2-week time period (42 assessments per child) while data on weather variables (temperature, dew point temperature, barometric pressure, humidity, precipitation, and sunlight) in the child's geographic location were recorded each time a diary was completed. Data were analyzed using multilevel models.Results.-Of the weather variables, relative humidity and presence of precipitation were significantly predictive of new headache onset, with nearly a 3-fold increase in probability of headache occurrence during times of precipitation or elevated humidity in the child's area, b = 0.38, t(821) = 2.10, P = .04, and b = 0.02, t(821) = 2.81, P = .01, respectively. These associations remained after accounting for fluctuations in mood, and associations were not significantly stronger in children who at baseline thought that weather was a headache trigger for them. Changes in temperature, dew point temperature, barometric pressure, and sunlight were not significantly predictive of new headache episode occurrence in this sample.Conclusions.-Results of the present study lend some support to the belief commonly held by children with recurrent headaches that weather changes may contribute to headache onset. Although electronic momentary assessment methodology was found to be feasible in this population and to have the potential to identify specific headache triggers for children, it remains to be determined how best (or even whether) to incorporate this information into treatment recommendations.