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Nutraceuticals safety and efficacy in migraine without aura in a population of children affected by neurofibromatosis type I

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Abstract

Neurofibromatosis type 1 (NF1) is one of the most common autosomal dominant disorders with a prevalence of one in 4,000 people worldwide, associated with many neurological comorbidities, such as headache. Despite the high prevalence of headache in this population, little data exist regarding the classification of headaches experienced by patients with NF1. Aim of this study is to verify the efficacy and safety of a nutraceutical complex containing Ginkgolide B/Coenzyme Q10/Riboflavin/Magnesium for prophylaxis in a sample of children affected by NF1 presenting migraine without aura. Ginkgolide B/Coenzyme Q10/Riboflavin/Magnesium complex was orally administered twice a day for 6 months, to 18 school-aged patients with NF1 and presenting symptoms of migraine without aura (10 M, mean age 8.4 ± 1.65). Each patient kept a journal to record: number, intensity (according VAS scale), duration of attacks and concomitant symptoms. In addition, the PedMIDAS scale was administered to assess migraine-related disability. To verify the efficacy of the association, we tested the starting frequency (T 0) of headache after 6 months (T 1) and then we calculated the migraine frequency delta percentage to express the decrease in monthly frequency. After treatment, a reduction was reported (p < 0.001) in all migraine outcomes (frequency, duration, intensity, and grade of disability). In conclusion, the present study should be considered as the first report on the efficacy and safety of nutraceutical complex containing Ginkgolide B/Coenzyme Q10/Riboflavin/Magnesium for the prophylaxis of migraine in children affected by NF1. Our findings suggest that headache symptoms should be considered a therapeutic target independent of primary disorder.

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References

  1. OMIM™. Online Mendelian Inheritance in Men™ (2004) McKusick catalog of human genes. Johns Hopkins University Library, Johns Hopkins University Press, Baltimore, http://www.ncbi.nlm.nih.gov/omim

  2. Huson SM, Hughes RAC (1994) The neurofibromatoses. A pathogenetic and clinical overview. Chapman & Hall, London

    Google Scholar 

  3. Friedman J, Gutman DH, McCollin M, Riccardi VM (1999) Neurofibromatosis Phenotype, Natural History and Pathogenesis. Johns Hopkins University Press, Baltimore

    Google Scholar 

  4. Cnossen MH, Moon KGM, Garssen MPJ et al (1998) Minor disease features in neurofibromatosis type 1 (NF1) and their possible value in diagnosis of NF1 children<6 years and clinically suspected of having NF1. J Med Genet 35:624–627

    Article  PubMed  CAS  Google Scholar 

  5. Ruggieri M (1999) The different forms of neurofibromatosis. Child’s Nerv Syst 15:295–308

    Article  CAS  Google Scholar 

  6. Upadhyaya M, Cooper DN (1998) Neurofibromatosis type 1. From genotype to phenotype, Bios Scientific, Oxford

    Google Scholar 

  7. Ashwal S, Rust R (2003) Child neurology in the 20th century. Pediatr Res 53:345–361

    Article  PubMed  Google Scholar 

  8. Hughes RAC (1994) Neurological complications of neurofibromatosis type 1. In: Huson SM, Hughes RAC (eds) The neurofibromatoses. A pathogenetic and clinical overview. Chapman & Hall, London, pp 204–232

    Google Scholar 

  9. Creange A, Zeller J, Roastaing-Rigattieri S et al (1999) Neurological complications of neurofibromatosis type 1 in adulthood. Brain 122:473–481

    Article  PubMed  Google Scholar 

  10. Riccardi VM (1986) Neurofibromatosis. Phenotype, Natural History and Pathogenesis, Johns Hopkins University Press, London

    Google Scholar 

  11. Dunn DW (1987) Neurofibromatosis in childhood. Curr Probl Pediatr 17(8):445–497

    PubMed  CAS  Google Scholar 

  12. Schorry EK, Stowens DW, Crawford AH, Stowens PA, Schwartz WR, Dignan PS (1989) Summary of patient data from a multidisciplinary neurofibromatosis clinic. Neurofibromatosis 2:129–134

    PubMed  CAS  Google Scholar 

  13. Clementi M, Battistella PA, Rizzi L, Boni S, Tenconi R (1996) Headache in patients with neurofibromatosis type 1. Headache 36(1):10

    Article  PubMed  CAS  Google Scholar 

  14. DiMario FJ Jr, Langshur S (2000) Headaches in patients with neurofibromatosis-1. J Child Neurol 15(4):235–238

    Article  PubMed  Google Scholar 

  15. Kernick D, Campbell J (2009) Measuring the impact of headache in children: a critical review of the literature. Cephalalgia 29:3–16

    Article  PubMed  CAS  Google Scholar 

  16. Heuschkel R, Kim S, Korf B, Schneider G, Bousvaros A (2001) Abdominal migraine in children with neurofibromatosis type 1: a case series and review of gastrointestinal involvement in NF1. J Pediatr Gastroenterol Nutr 33(2):149–154

    Article  PubMed  CAS  Google Scholar 

  17. Maizels M, Blumenfeld A, Burchette R (2004) A combination of riboflavin, magnesium, and fever few for migraine prophylaxis: a randomized trial. Headache 44:885–890

    Article  PubMed  Google Scholar 

  18. Condo M, Posar A, Arbizzani A, Parmeggiani A (2009) Riboflavin prophylaxis in pediatric and adolescent migraine. J Headache Pain 10:361–365. doi:10.1007/s10194-009-0142-2

    Article  PubMed  Google Scholar 

  19. Castelli S, Meossi C, Domenici R, Fontana F, Stefani G (1993) Magnesium in the prophylaxis of primary headache and other periodic disorders in children. Pediatr Med Chir 15(5):481–488

    PubMed  CAS  Google Scholar 

  20. Mazzotta G, Sarchielli P, Alberti A et al (1999) Intracellular Mg++concentration and electromyographical ischemic test in juvenile headache. Cephalalgia 19:802–809

    Article  PubMed  CAS  Google Scholar 

  21. Mauskop A, Altura BM (1998) Role of magnesium in the pathogenesis and treatment of migraines. Clin Neurosci 5:24–27

    PubMed  CAS  Google Scholar 

  22. Wang F, Van Den Eeden SK, Ackerson LM et al (2003) Oral magnesium oxide prophylaxis of frequent migrainous headache in children: a randomized, double-blind, placebo-controlled trial. Headache 43:601–610

    Article  PubMed  Google Scholar 

  23. Sàndor S, Di Clemente L, Coppola G et al (2005) Efficacy of coenzyme Q10 in migraine prophylaxis: a randomized controlled trial. Neurology 64:713

    Article  PubMed  Google Scholar 

  24. Menke T (2008) Coenzyme Q10 in childhood: detection methods, reference values and disease-related changes in the coenzyme Q10 status. Georgian Med News 156:24–32

    PubMed  Google Scholar 

  25. Peres MFP (2005) Melatonin, the pineal gland and their implications for headache disorders. Cephalalgia 25:403–411

    Article  PubMed  CAS  Google Scholar 

  26. Miano S, Parisi P, Pelliccia A, Luchetti A, Paolino MC, Villa MP (2008) Melatonin to prevent migraine or tension-type headache in children. Neurol Sci 29:285–287

    Article  PubMed  Google Scholar 

  27. Owen JM, Green BN (2004) Homeopathic treatment of headaches: a systematic review of the literature. J Chiropr Med 3(2):45–52

    Article  PubMed  Google Scholar 

  28. D’Andrea G, Bussone G, Allais G, Aguggia M, D’Onofrio F, Maggio M, Moschiano F, Saracco MG, Terzi MG, Petretta V, Benedetto C (2009) Efficacy of Ginkolide B in the prophylaxis of migraine with aura. Neurol Sci 30(Suppl 1):S121–S124

    Article  PubMed  Google Scholar 

  29. Esposito M, Carotenuto M (2011) Ginkgolide B complex efficacy for brief prophylaxis of migraine in school-aged children: an open-label study. Neurol Sci. 32(1):79–81. doi:10.1007/s10072-010-0411-5

    Article  PubMed  Google Scholar 

  30. Esposito M, Ruberto M, Pascotto A, Carotenuto M (2012) Nutraceutical preparations in childhood migraine prophylaxis: effects on headache outcomes including disability and behaviour. Neurol Sci 33(6):1365–1368. doi:10.1007/s10072-012-1019-8

    Article  PubMed  Google Scholar 

  31. van Beek TA (2005) Ginkgolides and bilobalide: their physical, chromatographic and spectroscopic properties. Bioorg Med Chem 13:5001–5012

    Article  PubMed  Google Scholar 

  32. Vogensen SB, Stromgaard K, Shindou H, Jaracz S, Suehiro M, Ishii S et al (2003) Preparation of 7-substituted ginkgolide derivatives: potent platelet activating factor (PAF) receptor antagonists. J Med Chem 46:601–608

    Article  PubMed  CAS  Google Scholar 

  33. Headache Classification Subcommittee of the International Headache Society (2004) The International Classification of Headache Disorders, edn 2. Cephalalgia 24(Suppl 1):1–15

    Google Scholar 

  34. Hershey AD, Powers SW, Vockell AL, LeCates S, Kabbouche MA, Maynard MK (2001) PedMIDAS: development of a questionnaire to assess disability of migraines in children. Neurology 57(11):2034–2039

    Article  PubMed  CAS  Google Scholar 

  35. Neurofibromatosis. Conference statement. (1988) National Institutes of Health Consensus Conference. Arch Neurol 45:575–578

  36. Hachon C, Iannuzzi S, Chaix Y (2011) Behavioural and cognitive phenotypes in children with neurofibromatosis type 1 (NF1): the link with the neurobiological level. Brain Dev 33(1):52–61. doi:10.1016/j.braindev.2009.12.008

    Article  PubMed  Google Scholar 

  37. Gutmann DH, Aylsworth A, Carey JC et al (1997) The diagnostic evaluation and multidisciplinary management of neurofibromatosis 1 and neurofibromatosis 2. JAMA 278(1):51–57

    Article  PubMed  CAS  Google Scholar 

  38. Banerjee S, Crouse NR, Emnett RJ, Gianino SM, Gutmann DH (2011) Neurofibromatosis-1 regulates mTOR-mediated astrocyte growth and glioma formation in a TSC/Rheb-independent manner. Proc Natl Acad Sci USA 108(38):15996–16001. doi:10.1073/pnas.1019012108

    Article  PubMed  CAS  Google Scholar 

  39. Tada K, Kochi M, Saya H, Kuratsu J, Shiraishi S, Kamiryo T, Shinojima N, Ushio Y (2003) Preliminary observations on genetic alterations in pilocytic astrocytomas associated with neurofibromatosis 1. Neuro Oncol 5(4):228–234

    Article  PubMed  CAS  Google Scholar 

  40. Elia M, Amato C, Bottitta M, Grillo L, Calabrese G, Esposito M, Carotenuto M (2012) An atypical patient with cowden syndrome and PTEN gene mutation presenting with cortical malformation and focal epilepsy. Brain Dev 34(10):873–876. doi:10.1016/j.braindev.2012.03.005

    Article  PubMed  Google Scholar 

  41. Violante IR, Ribeiro MJ, Cunha G, Bernardino I, Duarte JV et al (2012) Abnormal brain activation in neurofibromatosis type 1: a link between visual processing and the default mode network. PLoS One 7(6):e38785. doi:10.1371/journal.pone.0038785

    Article  PubMed  CAS  Google Scholar 

  42. Mautner VF, Kluwe L, Thakker SD, Leark RA (2002) Treatment of ADHD in neurofibromatosis type 1. Dev Med Child Neurol 44:164–170

    Article  PubMed  Google Scholar 

  43. Hyman SL, Arthur Shores E, North KN (2006) Learning disabilities in children with neurofibromatosis type 1: subtypes, cognitive profile, and attention-deficit-hyperactivity disorder. Dev Med Child Neurol 48:973–977

    Article  PubMed  Google Scholar 

  44. Friedman JM, Birch P, Greene C (1993) National neurofibromatosis foundation international database. Am J Med Genet 45:88–91

    Article  PubMed  CAS  Google Scholar 

  45. North K (2000) Neurofibromatosis type 1. Am J Med Genet 97:119–127

    Article  PubMed  CAS  Google Scholar 

  46. Levine TM, Materek A, Abel J, O’Donnell M, Cutting LE (2006) Cognitive profile of neurofibromatosis type 1. Semin Pediatr Neurol 13:8–20

    Article  PubMed  Google Scholar 

  47. Johnson H, Wiggs L, Stores G, Huson SM (2005) Psychological disturbance and sleep disorders in children with neurofibromatosis type 1. Dev Med Child Neurol 47(4):237–242

    Article  PubMed  Google Scholar 

  48. Reiter-Purtill J, Schorry EK, Lovell AM, Vannatta K, Gerhardt CA, Noll RB (2008) Parental distress, family functioning, and social support in families with and without a child with neurofibromatosis 1. J Pediatr Psychol 33(4):422–434

    Article  PubMed  Google Scholar 

  49. Noll RB, Reiter-Purtill J, Moore BD, Schorry EK, Lovell AM, Vannatta K, Gerhardt CA (2007) Social, emotional, and behavioral functioning of children with NF1. Am J Med Genet A 143A(19):2261–2273

    Article  PubMed  Google Scholar 

  50. Verrotti A, Agostinelli S, D’Egidio C et al (2012) Impact of a weight loss program on migraine in obese adolescents. Eur J Neurol doi:10.1111/j.1468-1331201203771x

    Google Scholar 

  51. Bruni O, Galli F, Guidetti V (1999) Sleep hygiene and migraine in children and adolescents. Cephalalgia 19(Suppl 25):57–59

    PubMed  Google Scholar 

  52. Carotenuto M, Gallai B, Parisi L, Roccella M, Esposito M (2013) Acupressure therapy for the insomnia in adolescents: a polysomnographic study. Neuropsychiatr Dis Treat 9:157–162. doi:10.2147/NDT.S41892

    PubMed  Google Scholar 

  53. Esposito M, Roccella M, Parisi L, Gallai B, Carotenuto M (2013) Hypersomnia in children affected by migraine without aura: a questionnaire-based case-control study. Neuropsychiatr Dis Treat 9:289–294. doi:10.2147/NDT.S42182

    PubMed  Google Scholar 

  54. Esposito M, Pascotto A, Gallai B et al (2012) Can headache impair intellectual abilities in children? An observational study. Neuropsychiatr Dis Treat 8:509–513. doi:10.2147/NDT.S36863

    Article  Google Scholar 

  55. Esposito M, Verrotti A, Gimigliano F et al (2012) Motor coordination impairment and migraine in children: a new comorbidity? Eur J Pediatr 171(11):1599–1604. doi:10.1007/s00431-012-1759-8

    Article  PubMed  Google Scholar 

  56. Carotenuto M, Guidetti V, Ruju F, Galli F, Tagliente FR, Pascotto A (2005) Headache disorders as risk factors for sleep disturbances in school aged children. J Headache Pain 6(4):268–270

    Article  PubMed  Google Scholar 

  57. Vendrame M, Kaleyias J, Valencia I, Legido A, Kothare SV (2008) Polysomnographic findings in children with headaches. Pediatr Neurol 39(1):6–11

    Article  PubMed  Google Scholar 

  58. Carotenuto M, Esposito M, Precenzano F, Castaldo L, Roccella M (2011) Cosleeping in childhood migraine. Minerva Pediatr 63(2):105–109

    PubMed  CAS  Google Scholar 

  59. Carotenuto M, Esposito M, Pascotto A (2010) Migraine and enuresis in children: an unusual correlation? Med Hypotheses 75(1):120–122. doi:10.1016/j.mehy.2010.02.004

    Article  PubMed  CAS  Google Scholar 

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Acknowledgments

The authors thank Joseph Sepe, MD, for revising the text.

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  1. Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical and Preventive Medicine, Center for Childhood Headache, Second University of Naples, Via Sergio Pansini 5 PAD XI, 80131, Naples, Italy

    Marco Carotenuto & Maria Esposito

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  1. Marco Carotenuto
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  2. Maria Esposito
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Correspondence to Marco Carotenuto.

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Carotenuto, M., Esposito, M. Nutraceuticals safety and efficacy in migraine without aura in a population of children affected by neurofibromatosis type I. Neurol Sci 34, 1905–1909 (2013). https://doi.org/10.1007/s10072-013-1403-z

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  • DOI: https://doi.org/10.1007/s10072-013-1403-z

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