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素 项目总结 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。疾病的流行 儿童期头痛在男女中都会增加，直到青春期早期，女孩的头痛频率超过这个数字 在男孩身上。女性头痛的增加可能是青春期发育的结果，就像雌二醇会 已知与偏头痛风险增加有关，也是青春期发育的驱动因素。在.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。 青春期乳腺癌队列研究与环境研究项目跟踪调查1200余例 来自辛辛那提、纽约市和旧金山湾区的女孩，从6到8岁开始，为期10年， 通过每年一次的问卷数据收集和每年或每半年一次的青春期分期，人体测量 检查和生物标本收集。最终的调查问卷包括关于偏头痛和 头痛，用于将女孩归类为有严重头痛、偏头痛、可能的月经偏头痛和 肯定是月经期偏头痛。我们建议利用这一群体的多种研究资源来解决 以下目标：目标1：利用以前从一大批青春期女孩那里收集的数据，建立 761名12-16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，并确定严重头痛和偏头痛是否 与青春期年龄相关的参数，如初潮年龄、耻骨初潮年龄、月经初潮年龄、高峰年龄 速度和峰值高度速度。目的2：在同时患有头痛和偏头痛的队列(N=220)的子组中 青春期不同时间点血清激素水平的数据和重复测量 发育，测定雌二醇(E2)、雄烯二酮(DHEAS)、雌酮(E1)和睾酮(T)水平 与后来的头痛和偏头痛有关。我们假设偏头痛会与 初潮、耻骨初潮、月经初潮年龄早，峰高速度快，峰高大。我们也 假设在乳房期较高的雌二醇水平与头痛和偏头痛有关。 这项研究的贡献将是对严重头痛和 青春期女孩偏头痛与年龄、年龄、身高峰值速度的关系。虽然雌二醇广泛存在于 被认为是驱动月经初潮的主要激素，而月经初潮已知会增加 严重头痛和偏头痛的患病率，我们知道没有研究检查过更早 雌二醇驱动的事件，如乳房和峰高速度，也可能是相关的。我们的次队列，有 月经初潮前后血清激素的纵向测量，提供了一个独特的机会 研究早期荷尔蒙状况是否相关。当导致这些情况的机制更好时 理解，可以开发更有针对性的治疗和干预措施来治疗这些疾病，改善 提高生活质量，降低医疗费用，减少年轻女性的缺勤和出勤。

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.