A recently released eight-year follow-up study of adolescents 12- to 14-years-old with chronic daily headache (CDH) showed a significant decline in the frequency of headache as the adolescents got older.
This study looked at primary CDH. Primary CDH is CDH which is not the result of another underlying disorder. For this study is was defined having headache or Migraine 15 or more days per month, averaging more than four hours per day, for more than three months.
In the United States and Europe, 4-5% of the population experiences CDH, bringing it to light as a public health concern.
103 participants with CDH at the beginning of the study completed the study: 26 male, 77 female.
Based on the MIDAS disability scale, 28 participants began the study with moderate or severe disability.
The study began with evaluation and enrollment in 2000. There were two short-term follow-up interviews in 2001 and 2002, and a final follow-up in 2008.
All headache and Migraine diagnoses were made following the International Headache Society's International Classification of Headache Disorders, 2nd Edition (ICHD-II).
At the 2008 follow-up, only 12 (11.6%) participants still met the criteria for CDH.
Among those with episodic (not chronic) headache at the 2008 follow-up, 80 (75%) had Migraine or probable Migraine and 20 (25%) had tension-type headache.
Approximately 40% of participants reported significant improvement in the intensity of their headaches over the course of the study; 24% reported no improvement; 20% reported no change; 14% reported worsening.
"This long-term follow-up study revealed a marked decline in the frequency of chronic daily headache (CDH). However, one fourth of patients still had significant headache disability. Migraine history was a major factor in evolution of CDH into young adulthood. Early onset and longer duration of CDH implied a protracted disease course."1
Study author Dr. Shuu-Juin Want, stated,
"This long-term community-based study found that, after eight years of follow-up, chronic daily headache in adolescents is not a protracted disorder. Even though many patients still had headache, most subjects did not have chronic daily headaches at the latest follow-up."2
Summary and comments:
The results of this study represent good news for the majority of adolescents with chronic daily headache. Over the eight-year period, nearly 88% of the participants went from chronic headache to episodic headache. Of those who still fit the criteria for CDH, it's of significant note that 75% of them had Migraines. This demonstrates again that there is a significant difference between the long-term impact of Migraine as opposed to other headache disorders.
1 Wang, Shuu-Juin, MD; Fuh, Jong-Ling, MD; Lu, Shiang-Ru, MD. "Chronic daily headache in adolescents." Neurology. July, 2009. Pub ahead of print at www.neurology.org.
2 Gordon, Serena. "Many Kids Outgrow Chronic Headaches." HealthScout. July 15, 2009.