Generalized Anxiety Disorder: A Predictor for Poor Responsiveness to Botulinum Toxin Type A Therapy for Pediatric Migraine.


Journal

Pediatric neurology
ISSN: 1873-5150
Titre abrégé: Pediatr Neurol
Pays: United States
ID NLM: 8508183

Informations de publication

Date de publication:
05 2022
Historique:
received: 03 09 2021
revised: 19 10 2021
accepted: 14 02 2022
pubmed: 20 3 2022
medline: 27 4 2022
entrez: 19 3 2022
Statut: ppublish

Résumé

To assess the efficacy, safety, and predictors for poor responsiveness of botulinum toxin type A (BoNT-A) for chronic migraine in the adolescent and young adult population. A retrospective analysis of 56 patients who received BoNT-A for chronic migraine with an age range from 13 to 21 years was performed. Of 56 patients, 34 were enrolled in the study based on the inclusion criterion. Patients who received three dosages of BoNT-A were assessed at nine months from the first injection. Variables including age, body mass index, headache intensity, frequency, character, and side effects were assessed. The patients were divided into two groups based on response to BoNT-A therapy, responders and nonresponders. Overall among the 34 patients enrolled in the study, the average headache frequency decreased from 18.6 of 28 to 9.9 of 28 days, P value, <0.001 from baseline. There was significant decrease in the average headache intensity, 8.1 to 4.3. Of 34 patients, 25 (73%) patients responded to treatment with decrease in headache frequency by ≥ 50% from the baseline. Among the nonresponder patients, a significant number of patients (six of nine, 67%) had generalized anxiety disorder with Generalized Anxiety Disorder-7 score greater than 15 versus the responder group (six of 25, 24%, P value 0.040). BoNT-A remains a safe and effective therapy for adolescent and young adult patients with chronic migraines at nine months of follow-up. Generalized anxiety disorder with Generalized Anxiety Disorder-7 score greater than 15 can be a major predictor of poor response to this therapy.

Sections du résumé

BACKGROUND
To assess the efficacy, safety, and predictors for poor responsiveness of botulinum toxin type A (BoNT-A) for chronic migraine in the adolescent and young adult population.
METHODS
A retrospective analysis of 56 patients who received BoNT-A for chronic migraine with an age range from 13 to 21 years was performed. Of 56 patients, 34 were enrolled in the study based on the inclusion criterion. Patients who received three dosages of BoNT-A were assessed at nine months from the first injection. Variables including age, body mass index, headache intensity, frequency, character, and side effects were assessed. The patients were divided into two groups based on response to BoNT-A therapy, responders and nonresponders.
RESULTS
Overall among the 34 patients enrolled in the study, the average headache frequency decreased from 18.6 of 28 to 9.9 of 28 days, P value, <0.001 from baseline. There was significant decrease in the average headache intensity, 8.1 to 4.3. Of 34 patients, 25 (73%) patients responded to treatment with decrease in headache frequency by ≥ 50% from the baseline. Among the nonresponder patients, a significant number of patients (six of nine, 67%) had generalized anxiety disorder with Generalized Anxiety Disorder-7 score greater than 15 versus the responder group (six of 25, 24%, P value 0.040).
CONCLUSIONS
BoNT-A remains a safe and effective therapy for adolescent and young adult patients with chronic migraines at nine months of follow-up. Generalized anxiety disorder with Generalized Anxiety Disorder-7 score greater than 15 can be a major predictor of poor response to this therapy.

Identifiants

pubmed: 35305510
pii: S0887-8994(22)00020-0
doi: 10.1016/j.pediatrneurol.2022.02.002
pii:
doi:

Substances chimiques

Neuromuscular Agents 0
Botulinum Toxins, Type A EC 3.4.24.69

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

21-27

Informations de copyright

Copyright © 2022 Elsevier Inc. All rights reserved.

Auteurs

Ajay Goenka (A)

Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio. Electronic address: goenkaa@childrensdayton.org.

Sarah Grace Yu (S)

Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Mahesh Chikkannaiah (M)

Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Monica Cathryn George (MC)

Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Sarah MacDonald (S)

Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Adrienne Stolfi (A)

Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio.

Gogi Kumar (G)

Department of Neurology, Dayton Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, Ohio.

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Classifications MeSH