Headaches and Migraines: Pubertal Parameter and Hormone Predictors in Adolescent Girls

头痛和偏头痛：青春期参数和激素预测因子 项目摘要 头痛是一种非常普遍的健康问题，通常首先发生在儿童时期。之时尚 儿童期头痛在男女两性中都有所增加，直到青春期早期，女孩的频率超过了 在男孩身上。女性头痛的增加可能是青春期发育的结果，因为雌二醇是 已知与偏头痛风险增加有关，也是青春期发育的驱动因素。期间 女性排卵周期，激素变化，即雌二醇波动，可影响偏头痛。 乳腺癌与环境研究计划的青春期队列研究跟踪了1200多名 来自辛辛那提、纽约市和旧金山弗朗西斯科湾区的女孩，从6-8岁开始， 每年进行一次问卷调查，每年或每半年进行一次青春期分期， 检查和生物标本采集。最后的问卷包括偏头痛和 头痛，用于将女孩分为严重头痛，偏头痛，可能的月经偏头痛和 明确的月经偏头痛我们建议利用这一队列的多种研究资源来解决 目标1：利用以前从一大批少女中收集的数据， 761名12 - 16岁女孩的严重头痛和偏头痛患病率， 人体测量和行为特征，并确定是否严重头痛和偏头痛， 与青春期年龄参数相关，如乳房初长年龄、阴毛初长年龄、月经初潮年龄、高峰身高年龄 速度和峰高速度。目的2：在头痛和偏头痛的队列亚组（N=220）中 青春期不同时间点血清激素浓度的数据和重复测量 发育，确定雌二醇（E2），雄烯二酮（DHEAS），雌酮（E1）和睾酮（T）的水平 与后期头痛和偏头痛有关。我们假设偏头痛与 乳房初长、阴毛初长、月经初潮年龄早，身高峰值速度快，身高峰值大。我们也 假设乳房初长时较高的雌二醇（E2）水平与头痛和偏头痛有关。 这项研究的贡献将是第一次评估严重头痛和头痛之间的关系。 青春期女孩偏头痛与初潮年龄和身高峰值速度的关系。虽然雌二醇广泛 被认为是主要的激素驱动月经初潮，月经初潮是已知的增加 严重头痛和偏头痛的患病率，我们知道没有研究已经检查是否更早 雌二醇驱动的事件，如乳房初长和高峰身高速度，也可能相关。我们的子队列， 乳房发育前后血清激素的纵向测量，提供了一个独特的机会， 研究早期激素状态是否相关。当负责这些条件的机制更好时， 了解，更有针对性的治疗和干预措施，以治疗这些条件可以开发，改善 生活质量，降低医疗保健费用，减少年轻妇女的缺勤和出勤。

Headache and Migraine: Pubertal Parameter and Hormone Predictors PROJECT SUMMARY Headache is a highly prevalent health problem, which often first occurs in childhood. The prevalence of childhood headache increases in both sexes until early adolescence, when the frequency in girls exceeds that in boys. The increase of headache in females may be a consequence of pubertal development, as estradiol is known to be associated with increased risk of migraine and also a driver of pubertal development. During the female ovulatory cycle, hormone changes, namely fluctuations in estradiol, can influence migraine. The puberty cohort study of the Breast Cancer and the Environment Research Program followed over 1200 girls from Cincinnati, New York City and the San Francisco Bay Area for 10 years, beginning at age 6-8 years, with yearly questionnaire data collection and annual or semi-annual pubertal staging, anthropometry examinations and biospecimen collection. The final questionnaire included items about migraine and headache, used to classify girls as having severe headaches, migraine, possible menstrual migraine and definite menstrual migraine. We propose to use the multiple research resources of this cohort to address the following Aims: Aim 1: Using previously collected data from a large cohort of adolescent girls, establish the prevalence of severe headaches and migraine among 761 girls at age 12 – 16 years by demographic, anthropometric, and behavioral characteristics and determine if severe headaches and migraine are associated with age at pubertal parameters, such as age at thelarche, pubarche, menarche, age at peak height velocity and peak height velocity. Aim 2: In a subset of the cohort (N=220) with both headache and migraine data and repeated measurements of serum hormone concentrations at various time points during pubertal development, determine if levels of estradiol (E2), androstendione (DHEAS), estrone (E1) and testosterone (T) are associated with later headaches and migraine. We hypothesize that migraine headache will be associated with earlier age at thelarche, pubarche, menarche, peak height velocity and greater peak height. We also hypothesize that higher estradiol (E2) levels at thelarche will be associated with headache and migraine. The contribution of this study will be the first assessment of the association between severe headaches and migraine in adolescent girls and age at thelarche and peak height velocity. Although estradiol is widely recognized as being the primary hormone driving menarche, and menarche is known to increase the prevalence of severe headache and migraine, we know of no study that has examined whether earlier estradiol-driven events, such as thelarche and peak height velocity, may also be related. Our sub-cohort, with longitudinal measures of serum hormones around the time of thelarche, provides an unique opportunity to study whether early hormone status is related. When mechanisms responsible for these conditions are better understood, more targeted therapies and interventions to treat these conditions can be developed, improving quality of life, decreasing health care costs, and alleviating absenteeism and presenteeism in young women.