The Relationship Between Pain Catastrophizing Level, Extreme Sensory Processing Patterns and Headache Severity Among Adolescents With Migraine

Introduction:

Headache is one of the leading chronic conditions bothering children (Newacheck PW 1992) and the most common pain complaint when seeking medical advice (Genizi J 2013), with an evidence for increased incidence of primary headaches in children and adolescents in the last 50 years (Abu-Arefeh I 1994, Goodman JE 1991). As reported by studies, a clear and reliable estimate of the magnitude of the problem has showed that around 60% of the children and adolescents are prone to headache, with attacks of variable frequency (Abu-Arafeh I 2010). The headache begins to emerge during the early years of life, but the disorder usually becomes more evident and frequent from the impact of school life, with a peak around 7 years old (Sillanpa AM 1996).

Migraine and Tension-type headaches (TTH) are the most frequent types of primary headaches in children: The prevalence of migraine is about 10% for girls and about 5% for boys (7% overall), the prevalence of TTH is 0.9% to 24% (Zwart JA 2004, Asuni C 2010).

The diagnosis of primary headaches is mainly supported by anamnestic data and neurological examination (Hershey AD 2010). While Migraine attack has fairly clear diagnostic criteria, with some references to the unique features in children and adolescents, TTH's diagnosis is based almost completely on exclusion criteria, meaning absence of any feature which can fit another type of headache, and no attribution to any special features in children (The International Classification of Headache Disorders: 2nd edition.( ICHD-II)).

Headaches and sensory modulation We didn't find any previous studies on the sensory modulation of patients with headaches, however, children who suffer from primary headaches have an increased risk for emotional and even psychiatric comorbidity such as anxiety and mood disorders (Francesco Margari 2013). In addition, they also have a greater risk of developing psychological disorders in adulthood (Egger HL 1999). Moreover, adolescents who suffer from chronic headaches were found to have more somatic complaints such as abdominal pain and disordered sleep (Genizi J 2013), which can also explains why headaches correlates with a significant reduction in quality of life (Andreas Straube 2013).Aromaa et al. (Aromaa, et al 2000) investigated the pain experiences of headaches in children and their family members and found that Headache children seemed to be more cautious in play and hobbies, because they were afraid of getting hurt. When migraine children were compared with tension- type headache children the following differences were found: headache pain was significantly more intensive among migraine children. They also reported that the mothers of tension-type headache children were more often extremely sensitive to pain compared to mothers of migraine children.