Quality of life in children and adolescents with migraine: an Austrian monocentric, cross-sectional questionnaire study

DOI: https://doi.org/10.1186/s12887- 019- 1537- 0

Abstract-Summary Migraine is a disabling primary headache disorder that occurs in about 10% of chil- dren and might lead to a lower quality of life.

The objective of this Austrian monocentric study was to identify migraine trig- gers and the areas, in which children and adolescents with migraine have a lower quality of life than healthy, headache-free children.

In this cross-sectional, questionnaire study, 76 children from ages 8 to 17 years

were included.

Participants filled in a questionnaire surveying the areas of physical, socio-

economic and school functioning.

In socio-economic functioning, the father’s nationality being Austrian might be

related to migraine (p.adjust = 0.108).

Children with migraine had a significantly lower quality of life in school func- tioning (PedsQL 4.0 questionnaire, p.adjust = 0.04) and had significantly less often “good” grades than children without migraine (p.adjust = 0.048).

Children with migraine show a reduced quality of life in the areas of physical,

socio-economic and school functioning.

Extended: The recommendations to future researchers would be: (1) to focus on only one area of functioning to carve out key aspects of the variables, (2) to clarify misleading phrases and descriptions, (3) to enlarge the sample size.

Background Migraine can develop at all ages [283], and affects 7.7–9.1% of children and adoles- cents [216, 217].

Population based studies have identified a number of physical and emotional

triggering factors, which can induce a migraine attack.

Physical factors that can trigger migraine are age [284–286], comorbidities (i.e. atopic disorders [287], food intolerances and allergy [288], obesity [289, 290], sleep disorders (sleep walking, sleep talking, nightmares, bruxism) [291, 292]), caffeine consumption [288, 293], skipping meals [294], alcohol consumption [288], immo- bility [289], weather [295, 296], noise, menstruation [295] and smoking [289].

School stress is the biggest predicator for migraine [297]. In children with migraine absenteeism is increased, whilst school performance is

reduced [297].

Objectives To substantiate that, in a single-center cohort, Austrian children and adolescents with migraine have a lower quality of life than healthy controls in specific areas of life.

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1 Public Health

Methods Participants for this study were recruited in a Viennese pediatric outpatient clinic, the “First Vienna Pediatric Medical Center,” and were asked to fill in the question- naire after giving written consent.

Children and adolescents diagnosed with migraine, 8–17  years of age, being under regular medical treatment at the pediatric outpatient clinic were asked to par- ticipate in this study.

Two types of questionnaires were handed out to the participants and asked to be filled in: (1) Questionnaire for children from 8 to 12 years of age, who could accept their parents support in filling in the questionnaire. (2) Questionnaire for adoles- cents from 13 to 17 years of age, which has some additional, age-typical questions and could be completed independently.

Additional self-designed questions of school functioning included: a. Are there

more migraine attacks before or after school tests?

Statistical evaluation was applied to the total number of study participants, as

well as the subgroups of migraine, “migraineur” and “non-migraineur”.

Results A significant relationship was found between physical exercise per week and migraine (χ2 (3) = 8.091, p = 0.045): Migraineurs exercised less often ≥3 times per week than non-migraineurs did (χ2 (1) = 4.415, p = 0.036, p.adjust = 0.108).

There was no relationship between maternal nationality and migraine (χ2 (1)  =  0.781, p  =  0.377), but their might been between paternal nationality and migraine (χ2 (1) = 4.356, p = 0.037, p.adjust = 0.108): Migraineurs more often had Austrian fathers than non-migraineurs.

This is underlined by the results of the PedsQL 4.0 (school functioning) ques- tionnaire [298] showing a significantly lower score in school functioning of migraineurs than non-migraineurs (U = 468, p = 0.008, p.adjust = 0.04).

Discussion To identify the impact of the disease on the patients’ quality of life with regards to physical and socioeconomic functioning we conducted a monocentric, cross- sectional questionnaire study on children and adolescent migraine patients and compared the results to age and sex-matched healthy non-migraineurs.

Due to the monocentric approach, only 76 pediatric patients were enrolled in this study, which might explain some of the non-significant results being in contrast to reports in literature, such as a possible association of migraine and gender or age [105, 225].

With regard to physical functioning, our migraine patients exercised less often 3 or more times per week than non-migraineurs, which was accompanied by an impaired ability for physical exercising due to migraine in one third of migraineurs and which might be explained by the assumption that exercise might trigger a migraine attack [299, 300].

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Personal and Societal Burden

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Conclusion Migraine triggers and implications of migraine on areas of life are controversially reported on in population-based studies.

Our results implicate that pediatric migraine patients do not only need special

medical attendance but support in other areas of life.

Acknowledgement A machine generated summary based on the work of Koller, Lydia Stella; Diesner, Susanne C.; Voitl, Peter. 2019 in BMC Pediatrics.

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