COLD PRESSOR RESPONSE IN RECURRENT PEDIATRIC HEADACHE

这个子项目是许多利用 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得了主要资金， 因此可在其他CRISP条目中表示。所列机构为 中心，但不一定是研究者所在的机构。 这项针对儿童和青少年头痛患者的研究旨在测量他们对一种新型可逆应激源的主观和生理反应--将手臂浸入冷水中。测量血压和脉搏，然后将手臂浸入10摄氏度的冰水中，直至手肘。 受试者每10秒报告一次水有多不舒服，持续40秒，10分制（从没有不舒服到非常不舒服，他们想去掉手臂）。 他们被告知，他们可以随时删除手臂。 测试后立即重复测量血压和脉搏。 这项研究的结果可能有助于阐明导致头痛的机制，以及确定谁可能最受益于头痛的行为治疗。 目前正在进行的一项平行试点研究利用心率变异性（HRV）来确定青少年偏头痛患者与匹配的健康非头痛对照受试者相比是否有自主神经系统（ANS）功能障碍。事实上，如果这项新的初步研究显示ANS功能障碍，而目前的冷加压研究确定了ANS“反应器”（即，增加的脉搏和血压反应），这些部分将用于治疗研究的设计。这项未来的治疗研究可能会检验以下假设：（1）。青少年偏头痛患者有ANS功能障碍的证据;（2）CPT与BP和脉搏测量可能在行为治疗计划中识别这种功能障碍;（3）临床改善可能与通过HRV（或其代理- CPT与BP/脉搏测试）测量的ANS功能改善有关。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This study of children and adolescents with headache is designed to measure their reactivity both subjectively and physiologically to a novel, reversible stressor - cold water immersion of the arm. Blood pressure and pulse ratings are taken, then the arm is immersed up to the elbow in ice water at 10 degrees Centigrade. The subjects report how uncomfortable the water is each 10 seconds for 40 seconds on a 10-point scale (from no discomfort to so uncomfortable they want to remove the arm). They are instructed that they can remove the arm whenever they want. Blood pressure and pulse are repeated immediately after the test. The results of this study may shed light on the mechanism causing headache as well as determining who might best benefit from behavioral treatment for headache. A parallel pilot study currently in progress utilizes heart rate variability (HRV) to determine if adolescent migraineurs have autonomic nervous system (ANS) dysfunction when compared to matched healthy, non-headache control subjects. If, in fact, this new pilot study showed ANS dysfunction, AND the current cold pressor study identified ANS "reactors" (i.e., increased pulse and blood pressure responses) the pieces would be in place for the design of a treatment study. This future treatment study might examine the hypothesis that: (1). Adolescent migraineurs have evidence for ANS dysfunction; (2) CPT with BP and pulse measures might identify this dysfunction at intake into a behavioral treatment program; and (3) clinical improvement might be related to improvement in ANS function as measured by HRV (or perhaps its proxy - CPT with BP/Pulse testing).