COLD PRESSOR RESPONSE IN RECURRENT PEDIATRIC HEADACHE

这个子项目是许多研究子项目中利用 资源由NIH/NCRR资助的中心拨款提供。子项目和 调查员(PI)可能从NIH的另一个来源获得了主要资金， 并因此可以在其他清晰的条目中表示。列出的机构是 该中心不一定是调查人员的机构。 这项对患有头痛的儿童和青少年的研究旨在主观和生理上衡量他们对一种新的可逆应激源--手臂冷水浸泡--的反应性。测量血压和脉搏，然后将手臂浸入10摄氏度的冰水中，直到肘部。受试者在满分为10分的40秒内，每10秒报告水的不适程度(从没有不适到非常不舒服，以至于想要移除手臂)。他们被告知，他们可以随时移除手臂。测试结束后，立即重复血压和脉搏。 这项研究的结果可能有助于阐明引起头痛的机制，并确定谁可能从头痛的行为治疗中受益最大。 目前正在进行的一项平行试点研究利用心率变异性(HRV)来确定与匹配的健康、非头痛控制对象相比，青少年偏头痛患者是否存在自主神经系统(ANS)功能障碍。事实上，如果这项新的先导研究显示ANS功能障碍，并且目前的冷加压研究确定ANS“反应”(即，脉搏和血压反应增加)，那么这些片段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结合血压和脉搏测量可以在接受行为治疗计划时发现这种功能障碍；以及(3)临床改善可能与HRV(或可能其替代的CPT结合BP/脉冲测试)测量的ANS功能的改善有关。

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).