Primary headache disorders in adolescents in North- and South-Tyrol: Findings of the EVA-Tyrol-Study

Katharina Kaltseis, Florian Frank, Benoît Bernar, Sophia Kiechl, Bernhard Winder, Ursula Kiechl-Kohlendorfer, Michael Knoflach, Gregor Broessner, Early Vascular Ageing (EVA) Tyrol Study Group, Katharina Kaltseis, Florian Frank, Benoît Bernar, Sophia Kiechl, Bernhard Winder, Ursula Kiechl-Kohlendorfer, Michael Knoflach, Gregor Broessner, Early Vascular Ageing (EVA) Tyrol Study Group

Abstract

Objective: Assessment of the prevalence of primary headache disorders, associated risk factors and use of acute/preventive medication in a representative large sample of adolescents.

Methods: Within the EVA-Tyrol project, a community-based non-randomized controlled cross-sectional study, data was collected from adolescents aged 14-19 years from 45 sites across North-, East- and South Tyrol. Headaches were classified according to the latest ICHD-3 and assessed by headache specialists in face-to-face interviews.

Findings: Of 1923 participants 930 (48.4%) reported having headaches. Female to male ratio was 2:1. Migraine, tension-type headache and other headache were diagnosed in 10%, 30.2% and 8.2% respectively. Medication overuse was diagnosed in 3.4%, increasing up to 21.7% in participants with chronic headache. The use of preventative medication was not reported by any adolescent. Sleep disturbances (p < 0.05), alcohol consumption (p < 0.05), low physical activity (p < 0.01) and high screen time exposure (p < 0.01) were associated with an increased risk of headaches.

Conclusion: We report high prevalence of primary headache disorders and medication overuse in a large community-based sample of teenagers. Acute and preventive non-drug and pharmacological treatments are not established due to lack of paediatric headache outpatient clinics. Promoting health education in teenagers and encouraging public awareness, including that of health care providers is pivotal.Trial registration: EVA-Tyrol has been retrospectively registered at clinicaltrials.gov under https://ichgcp.net/clinical-trials-registry/NCT03929692 since April 29, 2019.

Keywords: Migraine; adolescents; headache; life-style modification; preventive medication.

Conflict of interest statement

Declaration of conflicting interests: The authors declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: FF reports personal fees from Novartis AG, personal fees from Eli Lilly and Company, personal fees from TEVA Pharmaceutics, outside of the submitted work. FF is recipient of a scientific grant of the Austrian Academy of Sciences at the Department of Neurology, Medical University of Innsbruck.

GB has recieved unrestricted grants, honoraria, personal fees, and travel grants from: Allergan, AMGEN, Menarini, Pfizer, Linde AG, Astra Zeneca, St. Jude Medical, Reckitt Benkiser, Novartis, TEVA, Fresenius, Janssen Cilag, and Lilly.

KK, BW, MK, SK, UK have no potential conflict of interest to declare.

Figures

Figure 1.
Figure 1.
Study Flow Chart. 2102 adolescents were included in the EVA-Tyrol study and all of them were amongst other things asked, “Have you ever experienced any headache in your lifetime?” Of the randomly selected 1573 adolescents that completed the baseline examination and received cardiovascular health counselling, 1000 participated in the follow-up examination after approximately 2 years. 529 adolescents without participation in a health promotion program served as a control group. 179 adolescents were excluded from the analysis due to missing data and/or age >19 years at examination. Of the final sample of 1923 teenagers, 930 experienced headaches and 993 did not report any.
Figure 2.
Figure 2.
Health Self-Assessment depending on the headache frequency.

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Source: PubMed

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