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Abstract Details

Exploring the Relationship Between Pain Catastrophizing and Migraine-related Outcomes in Children and Adolescents: A Prospective Clinical Cohort Study
Headache
P3 - Poster Session 3 (5:30 PM-6:30 PM)
12-008

Migraine is a disabling condition affecting ~1 in 10 youth. Pain coping differs in youth with migraine compared to their peers, and pain catastrophizing, which involves maladaptive cognitive responses to pain such as rumination and magnification, occurs at a greater frequency. It was hypothesized that longitudinal changes in headache frequency and migraine-related disability would be influenced by baseline pain catastrophizing. 

To determine whether pain catastrophizing influenced migraine outcomes of disability and headache frequency in a clinically-recruited sample of youth 8-18 years old.

Using a prospective cohort design powered a priori for a modest effect size, a sample (n=123) of youth 8-18 years old was recruited from a tertiary headache centre. Consenting participants diagnosed with migraine had clinical information systematically collected, and completed a battery of baseline instruments, including the Pain Catastrophizing Scale (PCS), the Pediatric Migraine Disability Scale, and headache questionnaires. Follow-up instruments were completed at the next scheduled visit. Multiple linear regression models were used to examine the association between baseline pain catastrophizing and the change in migraine outcomes between visits, adjusted for age, sex, baseline headache frequency, and preventive treatment use. Post-hoc one-tailed paired t-tests were run on a subsample of participants who reported PCS scores at both visits (N=65) to explore if scores decreased between visits.

Univariate and multiple linear regression models did not demonstrate a significant relationship between baseline PCS scores and the change in outcomes between visits. However, pain magnification sub-scale PCS scores were shown to decrease significantly between visits (t(64)=-1.98, p=0.03).

Contrary to expectations, the study failed to demonstrate a relationship between pain catastrophizing and short-term changes in migraine outcomes. This absence of association bears replication, as it may have implications for targeted treatment strategies. Interestingly, pain magnification scores were shown to decrease at follow-up, which merits further exploration.
Authors/Disclosures
Kirsten Sjonnesen, MD
PRESENTER
Dr. Sjonnesen has nothing to disclose.
Alexis Espanioli (Pediatric Headache Research Lab) No disclosure on file
Jonathan Kuziek No disclosure on file
Melanie Noel (University of Calgary) No disclosure on file
Serena Orr, MD (University of Calgary) The institution of Dr. Orr has received research support from Alberta Children's Hospital Research Institute. The institution of Dr. Orr has received research support from Canadian Institutes of Health Research. The institution of Dr. Orr has received research support from Department of Pediatrics, University of Calgary. Dr. Orr has received publishing royalties from a publication relating to health care. Dr. Orr has a non-compensated relationship as a associate editor with Headache: The Journal of Head and Face Pain that is relevant to AAN interests or activities. Dr. Orr has a non-compensated relationship as a editorial board member with Neurology that is relevant to AAN interests or activities. Dr. Orr has a non-compensated relationship as a editorial board member with American Migraine Foundation that is relevant to AAN interests or activities.