Migraine Onset in Adolescent Girls

青春期女孩偏头痛发作

• 批准号: 10561947
• 负责人: Hadas Nahman-Averbuch
• 金额: $ 60.94万
• 依托单位: WASHINGTON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-12-15 至 2027-11-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10561947
• 关键词: Adolescence; Adolescent; Age; Amygdaloid structure; Biological Assay; Childhood; Control Groups; Data; Development; Diagnosis; Early identification; Exclusion; Family history of; Female; Female Adolescents; Frequencies; Functional disorder; Headache; Healthcare Systems; High Prevalence; Hormonal; Hormonal Change; Individual; Injury; Investigation; Measurement; Menarche; Middle frontal gyrus structure; Migraine; Modeling; Operative Surgical Procedures; Pain; Pain Threshold; Participant; Patients; Predictive Factor; Prevalence; Prevention; Prevention strategy; Procedures; Psychophysics; Puberty; Risk; Risk Factors; Sensory; Specialist; Testing; Testosterone; Time; Visit; chronic pain; chronic painful condition; cingulate cortex; conditioned pain modulation; cost; experience; follow-up; functional MRI scan; girls; high risk; meetings; migraine treatment; neural; novel; pain sensitivity; personalized medicine; precision medicine; pressure; recruit; response; sex

Project Summary Migraine is one of the most common chronic pain conditions worldwide, but prevalence differs based on sex and age, with prevalence of migraine being higher in females. In addition to female sex, family history of migraine represents a further risk factor for migraine. However, the factors which contribute to or protect from migraine onset remain uncharacterized, and it is not yet possible to predict whether an individual will experience migraine onset, even among individuals with both risk factors. Thus, this study aims to investigate: Aim 1 – identify the psychophysical and neural factors which can predict migraine onset in adolescent girls; Aim 2a – determine the hormonal, psychophysical, and neural changes associated with migraine onset; and Aim 2b – characterize the temporal relationships between hormonal, psychophysical, and neural changes preceding vs. following migraine onset. Preliminary data support the use of psychophysical and neural factors as predictors of migraine onset. In addition, changes in pain sensitivity and in the functional connectivity of the amygdala are observed in patients with migraine and following changes in headache frequency, and thus support the use of these assays for the investigation of longitudinal changes related to migraine onset. Study participants will be healthy girls (age 10–13) with either a family history of migraine (Fam-His, N = 160) or with no family history of migraine (No-Fam-His, N = 40). In this study, we will perform assessments of psychophysical (pressure pain thresholds [PPT] and conditioned pain modulation [CPM]), neural (functional connectivity [FC] of the amygdala), and hormonal (testosterone levels) factors at baseline, and at 1- and 2-year follow-up time points. For all study visits, participants will also meet with a pediatric headache/pain specialist to determine whether or not they meet the diagnosis criteria for migraine (participants meeting diagnosis criteria at baseline will be excluded from the study). We hypothesize that a pre-existing pronociceptive psychophysical (lower PPT and lower inhibitory capabilities) and neural (greater FC between the right- amygdala and posterior cingulate cortex) profile at baseline will predispose Fam-His girls to migraine onset during adolescence and can be used to predict this onset. We expect that after 2 years, Fam-His girls diagnosed with migraine will have distinct psychophysical, neural, and hormonal changes as compared to those with no migraine onset and No-Fam-His girls. Moreover, we predict that lower increase in testosterone levels will precede migraine onset, while further transition towards a pronociceptive profile will be observed after migraine onset (reduction in PPT and CPM responses, and increase in amygdala FC). Early identification of individuals most likely to be diagnosed with migraine will facilitate the development of a precision medicine approach, allowing for the implementation of early preventive strategies, thereby reducing patient burden and healthcare system costs. In addition, identifying the sensory, neural, and hormonal mechanisms associated with migraine onset will be foundational to the development of novel migraine treatments.

项目概要 偏头痛是全世界最常见的慢性疼痛之一，但患病率因性别而异 和年龄，女性偏头痛的患病率较高。除了女性之外，家族史 偏头痛是偏头痛的另一个危险因素。然而，有助于或防止的因素 偏头痛的发作仍然没有特征，目前还无法预测一个人是否会出现偏头痛。 即使在同时具有这两种风险因素的个体中，也会经历偏头痛发作。因此，本研究旨在调查： 目标 1 – 确定可以预测青春期女孩偏头痛发作的心理物理和神经因素； 目标 2a – 确定与偏头痛发作相关的荷尔蒙、心理物理和神经变化；和 目标 2b – 描述荷尔蒙、心理物理和神经变化之间的时间关系 偏头痛发作之前与之后。初步数据支持心理物理和神经因素的使用 作为偏头痛发作的预测因子。此外，疼痛敏感性和功能连接的变化 在偏头痛患者中观察到杏仁核并跟随头痛频率的变化，因此 支持使用这些测定来研究与偏头痛发作相关的纵向变化。学习 参与者将是有偏头痛家族史（Fam-His，N = 160）或患有偏头痛的健康女孩（10-13 岁） 无偏头痛家族史（No-Fam-His，N = 40）。在本研究中，我们将评估 心理物理（压力痛阈 [PPT] 和条件性疼痛调节 [CPM]）、神经（功能性） 杏仁核的连接性 [FC]）和基线以及 1 年和 2 年的激素（睾酮水平）因素 后续时间点。对于所有研究访问，参与者还将与儿科头痛/疼痛专家会面，以了解 确定他们是否符合偏头痛的诊断标准（符合诊断标准的参与者 基线时将被排除在研究之外）。 We hypothesize that a pre-existing pronociceptive 心理物理（较低的 PPT 和较低的抑制能力）和神经（右脑之间更大的 FC） 杏仁核和后扣带皮层）基线轮廓将使 Fam-His 女孩容易出现偏头痛 青春期期间，可用于预测这种情况的发生。我们预计 2 年后，Fam-His 女孩们 与正常人相比，被诊断患有偏头痛的人会出现明显的心理物理、神经和荷尔蒙变化 那些没有偏头痛发作的女孩和没有家庭的女孩。此外，我们预测睾丸激素的增加会减少 水平将先于偏头痛发作，同时将观察到进一步向伤害性特征转变 偏头痛发作后（PPT 和 CPM 反应减少，杏仁核 FC 增加）。早期识别 最有可能被诊断为偏头痛的个体将促进精准医学的发展 方法，允许实施早期预防策略，从而减轻患者负担 医疗保健系统成本。此外，确定相关的感觉、神经和激素机制 偏头痛的发作将成为开发新型偏头痛治疗的基础。