Completing their study in 2013, Dr. Aylward and Dr. Powers compared the baseline impact of migraine on teens’ functioning with changes at 6 months after starting biobehavioral treatment—treatment involving preventive medication and lifestyle education. There were significant improvements in functioning at the 6-month visit, but not for all. This is important evidence that a treatment program combining preventive medication and lifestyle education can be helpful for teen sufferers.

FINAL REPORT: The Multidimensional Impact of Migraine in Adolescents Presenting to Specialty Care

Published in JAMA, December 2013.

Summary

The functional consequences of adolescent migraine can be widespread and have a negative effect on many aspects of normal daily life. To examine this, a longitudinal, multi-method and multifaceted assessment of migraine was conducted in a sample of adolescents presenting to a pediatric headache center. The purpose was to identify and compare the baseline impact of migraine on physical, emotional, social, and school functioning with changes at six months after starting biobehavioral treatment involving preventive medication and lifestyle education. One-hundred and fifteen adolescents participated in the six-month study. Overall, physical functioning at baseline suggested moderate disability. However, there was significant improvement in functioning at the six-month visit.

In addition, a mobile application (iMigraine) was developed by a team of researchers, clinicians, and technology experts to enable adolescents to electronically enter and wirelessly transmit data about headache events and associated symptoms. Participants were prompted to assess their condition daily using the iMigraine app. They reported having a headache on 49% of days they completed at least one prompt. On average, each participant reported having 23 headaches during the 45 day period.

Hypothesis vs. Findings

The working hypothesis of the study was that the experience of migraine in adolescence would be associated with measurable negative impact on physical (including sleep quality), school, emotional, social, and family functioning. Overall, decreased physical and psychosocial functioning were evident in a number of participants in the study. They showed significant improvements in migraine-associated disability at the six-month follow-up visit. This improvement was also associated with changes in other areas, such as emotional functioning and sleep.

Unanswered Questions

Although there were significant improvements in functioning at the six-month follow-up, some participants continued to experience decreased physical and psychosocial functioning and may represent a distinct subset of adolescents with migraine who were not responsive to clinical care. Understanding risk factors and potential mediators of treatment response can help identify targets for future interventions with these individuals.

What This Research Means to You

Increased attention and research into understanding the broad impact migraine can have can aid in the development and implementation of effective and sustainable interventions for adolescents presenting to specialty care. Technology has the potential to transform treatments provided to youth and their families by giving them a familiar way to actively participate in their own healthcare by recording health symptoms remotely. This can result in personalized and effective clinical care.