New Way to Treat Chronic Migraine in Children and Adolescents

Chronic migraine doesn't just affect adults. It can also impact children and adolescents. Now, scientists have found that the use of cognitive behavioral therapy (CBT) can reduce the frequency of headaches and migraine-related disability. The findings are important for treating children in the future.

"In adults, more than 2 percent of the population has chronic migraine and in children and adolescents the prevalence is up to 1.75 percent," wrote the researchers in the article. "In pediatric patients who seek care in headache specialty clinics, up to 69 percent have chronic migraine; however, there are no interventions approved by the U.S. Food and Drug Administration for the treatment of chronic migraine in young persons. As a result, current clinical practice is not evidence-based and quite variable."

In order to find out a treatment for children, the researchers randomized 135 participants ages 10 to 17. These volunteers were diagnosed with chronic migraine. Then, the scientists conducted interventions that included 10 CBT, which were education sessions involving equivalent time and therapist attention. This included training in pain coping, modified to include a biofeedback component. Each group also received amitriptyline.

In the end, the scientists discovered that CBT resulted in a decrease of 11.5 headache days versus the 6.8 days with headache education. At the 12-month follow-up, the researchers found that 86 percent of CBT participants had a 50 percent or greater reduction in days with headache versus 69 percent of the headache education group.

The findings reveal that CBT could be used in headache management for children and adolescents. This could be huge for helping these individuals in the future.

"Now that there is strong evidence for CBT in headache management, it should be routinely offered as a first-line treatment for chronic migraine along with medications and not only as an add-on if medications are not found to be sufficiently effective," the authors wrote in a news release. "Also, CBT should be made more accessible to patients by inclusion as a covered service by health insurance as well as testing of alternate formats of delivery, such as using online or mobile formats, which can be offered as an option if in-person visits are a barrier."

The findings are published in the journal JAMA.