Autonomic dysfunction in pediatric patients with headache: migraine versus tension-type headache

Abstract

The need for prospective research investigating autonomic dysfunction in pediatric headache patients is discussed.

Symptoms of Autonomic Dysfunction Among Those With Persistent Posttraumatic Headache Attributed to Mild Traumatic Brain Injury: A Comparison to Migraine and Healthy Controls

“…21 Although a few studies have assessed the presence of symptoms related to autonomic dysfunction in those with migraine, there is a lack of studies using validated questionnaires to broadly assess symptoms of autonomic dysfunction in migraine. 32,34,36 The total COMPASS-31 scores of the individuals with PPTH in this study suggest fairly severe symptoms of autonomic dysfunction, a severity comparable to patients with confirmed small fiber polyneuropathies. The mean total weighted COMPASS-31 score of our PPTH group was 37.22, similar to a mean score of 38.8 in patients with small fiber polyneuropathy in the study by Treister et al, 40 and less than the 48.05 in POTS subjects, and 50.82 in autonomic failure subjects in the study by Rea et al 48 While the average score of the aforementioned POTS and autonomic failure subjects were higher, the interquartile To our knowledge, there are no prior studies comparing PPTH or mTBI with migraine populations with regards to symptoms of autonomic dysfunction.…”

“…Several studies have concluded that migraine is associated with decreased parasympathetic activity with increased sympathetic activity at night, pupillary hypofunction, lack of sympathetic/parasympathetic control, generalized autonomic hypofunction, hyperactivity of parasympathetic and sympathetic nervous system, impaired sympathetic function, sympathetic instability, and sympathetic hyperactivity . Although a few studies have assessed the presence of symptoms related to autonomic dysfunction in those with migraine, there is a lack of studies using validated questionnaires to broadly assess symptoms of autonomic dysfunction in migraine …”

“…Investigations that deeply phenotype individuals with PTH and compare the PTH phenotype to migraine might lead to identification of features that are more representative of PTH compared to migraine. Based on our clinical observations and published literature demonstrating evidence for autonomic dysfunction following mild traumatic brain injury (mTBI) and in those with migraine, we hypothesized that PTH is often accompanied by autonomic symptoms such as orthostatic intolerance, and that symptoms of autonomic dysfunction are more severe among those with PTH compared to those with migraine …”

“…Based on our clinical observations and published literature demonstrating evidence for autonomic dysfunction following mild traumatic brain injury (mTBI) and in those with migraine, we hypothesized that PTH is often accompanied by autonomic symptoms such as orthostatic intolerance, and that symptoms of autonomic dysfunction are more severe among those with PTH compared to those with migraine. [18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] The objective of this study was to compare symptoms of autonomic dysfunction between individuals with persistent posttraumatic headaches (PPTH) attributed to mTBI vs those with migraine vs healthy controls using the Composite Autonomic Symptom Score 31 (COMPASS-31) questionnaire. [38][39][40] We also interrogated correlations between COMPASS-31 scores and headache characteristics (headache days per month and years with headache) to investigate the association between headache burden and autonomic dysfunction in the PPTH and migraine groups and correlations between lifetime number of TBIs and COMPASS-31 scores among those with PPTH.…”

Autonomic Function Tests, Heart Rate Variability, and Electrophysiological Evaluation in Patients With a Primary Episodic Headache: An Observational Study

“…He explained that these symptoms in headache groups is possibly because of sympathetic hyperfunction, as increased sympathetic discharge may activate the small nerve fibers connected to sweat glands to cause excessive sweating. 18 Although numerous studies have documented the presence of ANS dysfunction in primary episodic headaches with special reference to migraine, [5][6][7] the results are conflicting. The most common findings are sympathetic hypofunction, but higher sympathetic tone or parasympathetic dysfunction had also been reported.…”