Summary: Migraine headaches are pretty common in children and adolescents, too. However, there are few treatment options in this age group, as FDA has approved very few drugs for treating migraine in children. It means that doctors often have to use some medications off-label. Studies suggest that untreated migraine in children may affect not only schooling but also brain development. Fortunately, an Israeli company has now developed a remote neurostimulation device that is even better than most commonly used medicines for migraine pain treatment in young adults.
Migraine headaches are pretty common in children and young adults. Studies show that migraine and cluster headaches even affect preschool children. In school-aged children, almost 10% may have migraine headaches, and these numbers may be pretty high for adolescent females.
Migraine headaches pose specific challenges in this age group, as they can disrupt education and affect development. Moreover, doctors find it quite challenging to manage such headaches due to a limited number of treatment options. Most drugs used to treat migraine in adults are not approved for use in children and young adults.
Therefore, doctors are left with few options, like prescribing over-the-counter medications that often fail to provide sufficient relief. Or doctors can prescribe migraine drugs like CGRP inhibitors off-label, which is not an ethical way to treat these headaches.
There is a reason why doctors often need to use unapproved drugs to treat migraine in children and young adults. Studies show that frequent migraine attacks may affect neurodevelopment. It may reduce the formation of ‘gray matter’ in different brain parts2.
Hence, doctors are faced with a dilemma. If they do not treat migraine, this would have a long-term negative impact on brain development. However, treating migraine with drugs not approved for use in young adults carries certain risks.
Thus, doctors think that there is an urgent need to find safer treatment options for managing migraine headaches in children and young adults, and it appears that there is one such way.
Of course, using devices to treat headaches have some distinct benefits, like lower risk of unforeseeable side effects. An Israeli medical tech company has developed a device called Nerivio as a new migraine treatment in both young and older adults.
It is a remote neuromodulation device. The device is worn on the upper arm and is controlled through a smartphone app. It generates electric impulses to stimulate nerves and thus disrupt migraine pain signals. Early studies have already shown that the device works, and it is pretty simple to use.
In a new study published in the journal Pain Medicine, researchers demonstrated that Nerivio is safe and effective for treating migraine headaches in adolescents. The latest study was done on 35 adolescents aged 12 to 17 living with migraines. It was a comparative study done for two months. Researchers compared the ability of the device to help with migraine headaches with over-the-counter drugs and oral triptans.
The findings of the study were quite encouraging. After two hours, 37% of patients reported complete pain relief compared to just 8.6% with medications. In addition, more than 80% of the patients reported some pain relief from the device compared to 57% with drug therapy.
Since the device was safe and did not cause any side effects, and was considerably better than medications, experts concluded that it could be used as a first-line treatment in young adults or adolescents. Moreover, the device is relatively inexpensive and a long-term investment. Finally, since it is an FDA-approved device, it is also covered by insurance.
Theranica, the company that produces these devices, is planning to check if their device can also help prevent migraine headaches. Not only that, the company plans to test the device for other chronic pain conditions in addition to migraine.
Summary: One-fifth of the US population is living with chronic pain, and some of them with high impact chronic pain. A new study shows that poorly managed chronic pain is a leading cause of faster cognitive decline, memory loss, and thus increased Alzheimer’s risk. Further investigation found that people with low socioeconomic status were particularly at risk due to healthcare disparities. The study also suggests that these health disparities may partially explain the higher prevalence of Alzheimer’s in black Americans. Hence, the study highlights the need for equal access to chronic pain treatment for various population groups.
Almost half of all adults may experience prolonged episodes of pain in their lifetime. However, data suggests that 20% of the population in the US continues to live with chronic pain at any given time, and these are massive numbers. Even worse, 8% of adults have high-impact chronic pain, and most have to live with it due to poor pain management.
Chronic pain is distressing, to say the least. However, in recent years, doctors have started to realize that chronic pain is also responsible for an increased risk of many chronic health disorders. For example, those living with poorly managed chronic pain are more likely to develop high blood pressure, heart disorders, depression, sleep disorders, and more. Now the new study suggests that chronic pain may be a risk factor for cognitive decline. This finding is especially relevant, considering the rise of dementia. Dementia is now among the leading causes of premature death and disability, affecting millions of lives.
The new study was published in the Journal of Alzheimer’s Disease. The study carried out detailed check-ups of 147 adults between the ages of 45 and 85. Researchers focused particularly on sociodemographic information and cognitive assessment and used MRI brain scans. They found that pain increased dementia risk, particularly in those with low education levels, low income, and thus with poor access to healthcare. In addition, they found that compared to those with better socioeconomic and education status, these individuals demonstrated 4% less gray matter. Thus, these findings were not merely subjective and were supported by objective data.
Of course, losing gray matter with aging is a common phenomenon. Early studies show that people gradually start losing gray matter as they age. This process generally begins in the 50s or 60s in different individuals. Generally, this decline is about half a percent each year. Thus, 3-4 percent equates to 6 to 8 years. It means that the brain of socially and economically deprived individuals age much faster. However, what is worrisome is that most people are diagnosed with conditions like Alzheimer’s in their 50s or later. This reduced gray matter in socially deprived individuals also suggests that they are at a greater risk of developing Alzheimer’s.
Researchers have also been focusing on how various stressors may contribute to an increased Alzheimer’s risk. For example, they found that the risk of developing dementia is almost twice as high in blacks compared to whites. Hence, this study found that this difference is not explained solely by genetics or ethnicity. Instead, it seems that health disparities are also an important contributing factor. These kinds of disparities lead to higher pain and stress exposure and thus resulting in faster brain aging, memory issues, and a greater risk of Alzheimer’s in blacks compared to whites.
Moreover, the study also suggests a relationship between pain intensity and brain aging. It appears that the risk of faster brain aging is proportionate to the pain intensity. It means that those with poorly managed chronic pain are more likely to develop dementia. This is not the first study. An early study that was done in 2017 also had similar kind of findings. It found that those older than 60 and living with chronic pain were more likely to see a sharp decline in their cognitive abilities.
However, there is some good news for those living with poorly treated chronic pain. A study in 2009 found that treating chronic pain well may even help reverse some of the changes in the brain. All these findings highlight the importance of managing chronic pain and providing sufficient relief.
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