Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents

Przekop, Peter; Przekop, Allison; Haviland, Mark G.

doi:10.1016/j.jbmt.2015.02.003

Cited by 16 publications

(12 citation statements)

References 37 publications

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“…The initial search returned 427 records. Following abstract screening and full text assessment, 11 publications were selected for inclusion in this review ( 12 – 22 ). The rate of agreement between reviewers was 99.5% at the abstract check, and 100% at full-text check.…”

Section: Resultsmentioning

confidence: 99%

“…Five papers consisted of single group studies, while the remaining six were RCTs in which a given non-pharmacologic treatment was compared with either treatment as usual (TAU) ( 13 , 16 ), headache education ( 14 , 15 ), education plus amitriptyline ( 12 ), amitriptyline or gabapentin ( 22 ). The majority of the studies evaluated the effects of CBT ( 12 – 16 ).…”

Section: Resultsmentioning

confidence: 99%

“…Three studies included BFB treatment ( 17 – 19 ). The remaining three studies evaluated mindfulness ( 20 ), single-pulse TMS ( 21 ) and a multimodal treatment ( 22 ).…”

Section: Resultsmentioning

confidence: 99%

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Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Andrasik

Grazzi²,

Sansone³

et al. 2018

Front. Neurol.

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Headache disorders are common in children and adolescents. Most of the studies on non-pharmacological treatments have however been carried out on adults. In this review we provide information on recent studies examining non-pharmacological approaches for managing headache in children and adolescents. Our search of SCOPUS for primary studies conducted between January 2010 and July 2018 uncovered 11 controlled studies, mostly addressing behavioral approaches, in which a total of 613 patients with a diagnosis of primary headache, and average age 10.2–15.7 years (30–89% females) were recruited. Non-pharmacological treatments were shown to produce sizeable effects on the classical primary endpoint, i.e., headache frequency, with reductions from baseline ranging between 34 and 78%. Among commonly reported secondary endpoints, particularly disability, quality of life, depression and anxiety, marked improvements were noted as well. Taken as a whole, our findings suggest that non-pharmacological treatments constitute a valid option for the prevention of primary headaches in young age. Future research with higher-quality studies is needed. Particular attention needs to be given to studies that randomize patients to condition, blind researchers in charge of evaluating treatment outcomes, routinely include headache frequency as the primary endpoint, include adequate-length follow-up, address changes in biomarkers of disease and other possible mediators of outcome, and that employ predictive models to enhance the level of evidence for these approaches.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Andrasik

Grazzi²,

Sansone³

et al. 2018

Front. Neurol.

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“…Przekop et al compared a multimodal (“osteopathic manipulative treatments, mindfulness, and qi gong”) and pharmacologic (amitriptyline or gabapentin) treatment in children and adolescents with chronic TTH, showing that the multimodal treatment was significant in reducing headache frequency and pain in increasing participants’ quality of life, reducing the physical and emotional problems reported by patients ( 75 ).…”

Section: The Role Of Metacognition Cognitive Behavioral Therapy (Cbtmentioning

confidence: 99%

Metacognition and Headache: Which Is the Role in Childhood and Adolescence?

et al. 2017

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Headache, in particular migraine, is one of the most frequent neurological symptoms in children and adolescents and it affects about 60% of children and adolescents all over the world. Headache can affect several areas of child’s functioning, such as school, physical activities, peer, and family relationship. The global and severe burden of this disease requires a multidisciplinary strategy and an effective treatment addressed all of the patient’s needs and based on cutting-edge scientific research. In recent years, research has focused on cognitive factors specifically in functions called metacognitive processes. Metacognition can be defined as the knowledge, beliefs, and cognitive processes involved in monitoring, control, and assessment of cognition. Metacognition seems to be closely related to the ability of theory of mind, the ability to infer, and reason about the mental states of other people in order to predict and explain own behavior. Recent studies found a relationship between metacognitive skills and anxiety, depression, motivation, academic performance, human social interactions, and stress symptoms. This relationship is very interesting for headache treatment, because these factors are the most commonly reported triggers in this disorder and there is a high comorbidity with anxiety and depression in children and adolescents with headache. So, headache and these comorbidities, in particular anxiety and depression, may have in common persistent and maladaptive patterns of thinking which are related to maladaptive metacognitive beliefs. Further research should assess metacognitive processes of children and adolescents with headache in order to increase their ability to control their own cognitive processes and consequently monitor factors which may trigger the attacks.

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“…[13][14][15] Nonpharmacologic treatments are generally included in clinical guidelines for the prevention of primary headaches. The European Federation of Neurological Societies guideline, 16 the Italian guideline for primary headaches, 17 in patients with CTTH is based on the high prevalence of musculoskeletal dysfunctions [19][20][21][22] and on the role of affective and social touch in pain modulation. 23 The activation in the insular and orbitofrontal cortex after brain response to soft brush stroking is mediated by unmyelinated low-threshold mechanoreceptors (C tactile) that respond to gentle touch.…”

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confidence: 99%

Osteopathic Manipulative Therapy in Patients With Chronic Tension-Type Headache: A Pilot Study

Deodato¹,

Guolo²,

Monticco³

et al. 2019

Journal of Osteopathic Medicine

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Context: Nonpharmacologic treatment, such as osteopathic manipulative therapy (OMTh; manipulative care provided by foreign-trained osteopaths) may be a beneficial complementary treatment for tension-type headache. However, to the authors' knowledge, the benefit of OMTh in the management of tension-type headache has not been explored, especially chronic tension-type headache (CTTH). Objective: To investigate the effectiveness of OMTh compared with traditional treatment in reducing pain intensity, frequency, and duration of CTTH, and to evaluate the objective postural measurement of the forward head posture (FHP) as an integral parameter in the assessment of the effects of OMTh and traditional management of CTTH. Methods: Patients with CTTH were registered at the Headache Centre of Trieste in Italy. At the time of the study, none of the patients had been taking any headache prophylaxis in the past 3 months. A 3-month baseline period was recorded by all patients with an ad hoc diary. Patients were randomly placed in the test or control group using a simple randomization program in Excel (Microsoft). Patients in the OMTh group underwent a 3-month period of OMTh, and patients in the control group were treated with amitriptyline. Pain intensity, frequency, and duration of headaches, as well as FHP were analyzed. Results: The study enrolled 10 patients (mean [SD] age, 42.6 [15.2] years) in the OMTh group and 10 patients (51.4 [17.3] years) in the control group. The final assessment of OMTh patients showed statistically significant changes in all headache parameters: pain intensity decreased from a mean (SD) score of 4.9 (1.4) to 3.1 (1.1) (P=.002); frequency decreased from 19.8 (6) to 8.3 (6.2) days per month (P=.002); and the duration of headaches decreased from 10 (4.2) to 6 (3) hours (P=.01). Significant improvement of all parameters was found in the control group as well: pain intensity decreased from a mean (SD) score of 5.9 (0.7) to 4.2 (1.75) (P=.03); frequency decreased from 23.4 (7.2) to 7.4 (8.7) days per month (P=.003); and duration decreased from 7.8 (2.9) to 3.6 (2.1) hours (P=.002). Forward head posture significantly improved in OMTh patients (P=.003). Conclusions: Our data suggested that OMTh may be an effective treatment to improve headaches in patients with CTTH. Our results also suggest that OMTh may reduce FHP.

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Multimodal compared to pharmacologic treatments for chronic tension-type headache in adolescents

Cited by 16 publications

References 37 publications

Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Non-pharmacological Approaches for Headaches in Young Age: An Updated Review

Metacognition and Headache: Which Is the Role in Childhood and Adolescence?

Osteopathic Manipulative Therapy in Patients With Chronic Tension-Type Headache: A Pilot Study

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