Cristiana De Ranieri

Migraine equivalents and related symptoms, psychological profile and headache features: Which relationship?

BackgroundMigraine equivalents are common clinical conditions in children suffering from headache. Very few studies dealt with the psychological profile of children/adolescents with migraine equivalents. Our main aim was to compare the psychological profile between migraine children with and without migraine equivalents. Moreover, as secondary aim, exclusively in children with migraine equivalents, we investigated the possible relationship between migraine attack frequency and intensity and psychological factors.MethodsWe enrolled 136 young migraineurs. They were divided in two groups (patients with and without migraine equivalents). The psychological profile was assessed by means of SAFA Anxiety and Somatization questionnaires.ResultsMigraine equivalents were present in 101 patients (74.3 %). Anxiety (p = 0.024) and somatization (p = 0.001) levels, but not hypochondria (p = 0.26), were higher in patients with migraine equivalents. In children with migraine equivalents, a low frequency of attacks was related to separation anxiety (p = 0.034).ConclusionsMigraine equivalents patients tend to feel more fearful and to experience more shyness. This, together with the tendency to somatization, may lead them to become vigilant in attachment relationships with their caregivers.

Hepatitis C virus serotypes and sources of infection in patients with HCV-related chronic liver disease from one geographical area in southeast Italy.

SummaryHepatitis C virus serotypes and sources of infection in HCV-positive patients from a restricted geographical area were evaluated. HCV serotypes were determined by Murex serotyping assay. Of 192 samples, serotypes were detected in 189 (98.5%): type 1 proved to be the most common (53.1%), followed by types 2 (15.2%), 3 (6.2%), 6 (5.3%), 4 (3.6%) and 5 (1.6%). Intravenous drug users were significantly younger than the rest of the patients and infected mainly with HCV type 3. Transmission of HCV 3 has only been observed over the past 20 years; other types have been transmitted for up to 40 years. These results support the view that the prevalence of the infection by different HCV types in one restricted geographical area may be associated with the source and duration of infection.

Role of the Attachment Style in Determining the Association Between Headache Features and Psychological Symptoms in Migraine Children and Adolescents. An Analytical Observational Case–Control Study

We aimed to study the role of attachment style on headache severity and psychological symptoms in migraineurs children/adolescents. Moreover, we investigated the association between attachment style, migraine severity, and psychological symptoms.

Different SEP recovery cycle in adolescent migraineurs with exploding or imploding pain.

Our aim was to investigate whether migraine adolescents with pain directed inside (imploding pain--IP) and outside (exploding pain--EP) the head may have different levels of cortical excitability underlying their migraineous syndrome. Ten migraine children referring prevalent EP (mean age 14.5 ± 1.4 years, 3 girls, 7 boys), 10 patients with IP (mean age 14.1 ± 2.2 years, 4 girls, 6 boys), and 13 control subjects (mean age 13 ± 1.8 years, 6 males, 7 females) participated to the study. The recovery cycle of the somatosensory evoked potentials to electrical median nerve stimuli at interstimulus intervals of 5, 20, and 40 ms was measured. Anger expression, anxiety, and somatic concerns were investigated in migraine patients. Overall, SEP recovery cycle was shorter in migraineurs than in healthy controls. The recovery cycle of the frontal N30 SEP component was significantly shorter in IP than in EP patients. While among the EP patients those with faster N30 recovery cycle had higher Trait-Anger score, the opposite was found among the IP patients. Our results suggest that the inhibitory mechanisms within the somatosensory cortex are more impaired in IP than in EP migraine adolescents. The pathophysiological difference between IP and EP migraineurs was strengthened also by the opposite correlations between the brain excitability and the anger expression.

Maternal Alexithymia and Attachment Style: Which Relationship with Their Children’s Headache Features and Psychological Profile?

Introduction A growing body of literature has shown an association between somatic symptoms and insecure “attachment style.” In a recent study, we found a relationship between migraine severity, ambivalent attachment style, and psychological symptoms in children/adolescents. There is evidence that caregivers’ attachment styles and their way of management/expression of emotions can influence children’s psychological profile and pain expression. To date, data dealing with headache are scarce. Our aim was to study the role of maternal alexithymia and attachment style on their children’s migraine severity, attachment style, and psychological profile. Materials and methods We enrolled 84 consecutive patients suffering from migraine without aura (female: 45, male: 39; mean age 11.8 ± 2.4 years). According to headache frequency, children/adolescents were divided into two groups: (1) high frequency (patients reporting from weekly to daily attacks), and (2) low frequency (patients having ≤3 episodes per month). We divided headache attacks intensity into two groups (mild and severe pain). SAFA “Anxiety,” “Depression,” and “Somatization” scales were used to explore children’s psychological profile. To evaluate attachment style, the semi-projective test SAT for patients and ASQ Questionnaire for mothers were employed. Maternal alexithymia traits were assessed by TAS-20. Results We found a significant higher score in maternal alexithymia levels in children classified as “ambivalent,” compared to those classified as “avoiding” (Total scale: p = 0.011). A positive correlation has been identified between mother’s TAS-20 Total score and the children’s SAFA-A Total score (p = 0.026). In particular, positive correlations were found between maternal alexithymia and children’s “Separation anxiety” (p = 0.009) and “School anxiety” (p = 0.015) subscales. Maternal “Externally-oriented thinking” subscale correlated with children’s school anxiety (p = 0.050). Moreover, we found a correlation between TAS-20 Total score and SAFA-D “Feeling of guilt” subscale (p = 0.014). Our data showed no relationship between TAS-20 and ASQ questionnaires and children’s migraine intensity and frequency. Conclusion Maternal alexithymia and attachment style have no impact on children’s migraine severity. However, our results suggest that, although maternal alexithymic traits have no causative roles on children’s migraine severity, they show a relationship with patients’ attachment style and psychological symptoms, which in turn may impact on migraine severity.

P029. Migraine, body weight and psychological factors in children and adolescents.

Background Several studies have assessed the associations between adult migraine and underweight, pre-obesity or obesity. Prevalence, frequency, and severity of migraine appear to increase in relation to the body mass index, although this evidence is not supported by all the studies examined. The link between body weight and headache has hardly been examined in children. Data on the possible association between the body mass index (BMI) and the psychological profile in migraine children are sparse.

P028. Childhood migraine, epilepsy and tics: Are there similarities in the psychological profile?

Background Migraine, epilepsy and tics are common neurological disorders in children and adolescents. They can affect a patient’s life in a number of ways such as their school, sport and relationships. Although they are clearly different conditions, several studies have stressed the co-occurrence of migraine with both epilepsy and tic disorders. However, no study has compared the psychological/behavioural profile of children/adolescents with migraine, RAP or tics. The main aim of the present study was to compare the occurrence of internalizing and externalizing disorders between migraine, epilepsy and tics patients.