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 项目概要 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。患病率 儿童期头痛在两性中都会增加，直到青春期早期，此时女孩的头痛频率超过 在男孩中。女性头痛的增加可能是青春期发育的结果，因为雌二醇 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、激素的变化，即雌二醇的波动，都会影响偏头痛。 乳腺癌与环境研究计划的青春期队列研究跟踪了 1200 多名患者 来自辛辛那提、纽约市和旧金山湾区的女孩，从 6-8 岁开始，为期 10 年， 每年收集问卷数据和每年或半年青春期分期、人体测量 检查和生物样本采集。最终问卷包括有关偏头痛和 头痛，用于将女孩分类为严重头痛、偏头痛、可能的经期偏头痛和 明确的月经性偏头痛。我们建议利用该队列的多种研究资源来解决 目标如下： 目标 1：使用之前从大量青春期女孩中收集的数据，建立 按人口统计，761 名 12 至 16 岁女孩中严重头痛和偏头痛的患病率， 人体测量和行为特征，并确定是否患有严重头痛和偏头痛 与青春期参数年龄相关，例如乳腺发育年龄、阴毛初潮年龄、初潮年龄、身高高峰年龄 速度和峰值高度速度。目标 2：在同时患有头痛和偏头痛的队列子集 (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 与后来的头痛和偏头痛有关。我们假设偏头痛与 乳房发育、阴毛初潮、初潮年龄较早，峰高速度和峰高较大。我们也 假设乳头处较高的雌二醇 (E2) 水平与头痛和偏头痛有关。 这项研究的贡献将是首次评估严重头痛与头痛之间的关联。 青春期女孩的偏头痛以及乳房初发育的年龄和身高峰值速度。尽管雌二醇被广泛 被认为是驱动初潮的主要激素，众所周知，初潮会增加 严重头痛和偏头痛的患病率，据我们所知，尚无研究检验是否较早 雌二醇驱动的事件，例如乳房发育和峰值高度速度，也可能相关。我们的子队列， 在乳房发育期间对血清激素进行纵向测量，提供了一个独特的机会 研究早期激素状态是否相关。当导致这些情况的机制更好时 据了解，可以开发更有针对性的疗法和干预措施来治疗这些疾病，从而改善 生活质量，降低医疗费用，并减少年轻女性的缺勤和出勤率。

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.