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Migraine and its association with pubertal maturation and behavioral traits among adolescent girls

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Abstract

Objective

To determine if the ages at pubertal milestones are associated with the prevalence of adolescent migraine.

Background

Migraine headaches are a common disease in adolescent girls. Past studies have evaluated the relationship between age of onset of menarche and migraine headache, but none have studied earlier pubertal milestones such as thelarche and pubarche.

Methods

In this cross-sectional study, a previously validated questionnaire was administered to girls (15–18 years) in Breast Cancer and the Environment Research Program puberty cohort to ascertain if they met criteria for migraine over the past year. Ages of pubertal development were ascertained by serial examinations beginning at 6–8 years of age and ending in late puberty. Logistic regression analyses determined if age of onset of each pubertal milestone (thelarche, pubarche, menarche separately) was associated with adolescent migraine after adjusting for other risk factors.

Results

Of 761girls, 222 (29.2%) met the criteria for migraine. Later thelarche was associated with a lower odds of adolescent migraine (OR 0.83; 95% CI 0.72–0.97, p = 0.019). In models further adjusted for BASC-2 internalizing problems (n = 490), both later thelarche (OR 0.78; 95% CI 0.64–0.96, p = 0.016) and later menarche (OR 0.81; 95%CI 0.67–0.98, p = 0.026) were associated with a lower migraine prevalence. Internalizing problems (OR 1.05; 95% CI 1.03–1.07) externalizing problems (OR 1.05; 95% CI 1.02–1.07) and behavioral symptoms (OR 1.05; 95% CI 1.03–1.08) were associated with increased prevalence of migraine in separate models.

Conclusions

Age of onset of thelarche and menarche, and internalizing, externalizing, and behavioral symptoms were all associated with adolescent migraine.

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Data availability statement

The data on which this analysis was based are available from the authors in accordance with the Breast Cancer and the Environment Research Program data sharing policies.

Abbreviations

BASC:

Behavioral assessment system for children

BSI:

Behavior symptoms Index

BCERP:

Breast cancer and the environment research program

BMI:

Body mass index

CIN:

Cincinnati

CI:

Confidence interval

IRB:

Institutional review board

ICHD-3:

International classification of headache disorder-III

NYC:

New York City

OR:

Odds ratio

SFBA:

San Francisco Bay Area

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Funding

R03HD094236, U01ES012770, U01ES012801, U01ES019435, U01ES019453, U01ES019457, U01ES012771, U01ES019454, P30ES006096, T32ES010957. Sponsors had no role in the design the study design, collection, analysis and interpretation of data, the writing of the report and the decision to submit the manuscript for publication.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Vincent T. Martin

  2. Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA

    Cecily S. Fassler & Kelly J. Brunst

  3. Department of Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, USA

    Jun Ying

  4. Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA

    Susan Teitelbaum, Mary S. Wolff & Susan M. Pinney

  5. California Department of Public Health, Richmond, CA, USA

    Gayle C. Windham

  6. School of Public Health, University of California, Berkeley, Berkeley, CA, USA

    Julianna Deardorff

  7. Division of Research, Kaiser Permanente, Oakland, CA, USA

    Lawrence H. Kushi

  8. Department of Pediatrics, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, USA

    Frank M. Biro

  9. Kettering Lab Building, Room 208, 160 Panzeca Way, Cincinnati, OH, 45267-0056, USA

    Susan M. Pinney

Authors
  1. Vincent T. Martin
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  11. Susan M. Pinney
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Contributions

Conception and design-Martin, Fassler, Brunst, Ying, Teitelbaum, Windham, Deardorff, Wolff, Kushi, Biro, Pinney; Acquisition of data-Teitelbaum, Windham, Deardorff, Wolff, Kushi, Biro, Pinney; Analysis and interpretation of data—Martin, Fassler, Brunst, Ying, Biro, Pinney; Drafting the manuscript—Martin, Fassler, Brunst, Ying, Teitelbaum, Windham, Deardorff, Wolff, Kushi, Biro, Pinney; Revision for intellectual content- Martin, Fassler, Brunst, Biro, Pinney; Final approval—Martin, Fassler, Brunst, Ying, Teitelbaum, Windham, Deardorff, Wolff, Kushi, Biro, Pinney.

Corresponding author

Correspondence to Susan M. Pinney.

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Martin, V.T., Fassler, C.S., Brunst, K.J. et al. Migraine and its association with pubertal maturation and behavioral traits among adolescent girls. Acta Neurol Belg 123, 1279–1289 (2023). https://doi.org/10.1007/s13760-022-02161-2

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