When Mom Has Migraine: An Observational Study of the Impact of Parental Migraine on Adolescent Children.

OBJECTIVE: The current study aimed to describe the impact of parental migraine on adolescent children (aged 11-17) living at home with a parent with migraine. BACKGROUND: Emerging evidence suggests that migraine impacts the family members of people with migraine. However, there has been little research to evaluate the perspective of the child of a parent with migraine. METHODS: This cross-sectional observational study included parents who met International Classification of Headache Disorders criteria for migraine and their 11-17-year-old children currently living with the parent with migraine recruited from neurologist offices and online. Parents completed measures of demographics, a diagnostic migraine criteria screener, parental illness impact (Parental Illness Impact Survey - Revised; subscales = Burden of Daily Help, Emotional Impact, Social Impact, Communication and Understanding, Impact on Personal Future, Friends Reactions, Parent/Child Relationship, and Global Well-Being), migraine-related disability (MIDAS), headache attack frequency, and headache attack pain intensity. Children completed measures of demographics, parental illness impact, and a migraine diagnostic screener if applicable. RESULTS: Children (n = 40) reported the greatest impact of their parent's migraine on the Global Well-Being (M = 3.3, SD = 0.9) and Parent/Child Relationship (M = 3.5, SD = 0.6) subscales. There were no significant differences between the average child and parent rating of parental migraine impact on children. Correlations between parent and child ratings of parental migraine impact were strongest for the Social Impact subscale (ρ = 0.55, P < .001), and non-significant for the Parent/Child Relationship (ρ = 0.13, P = .416) and Friends Reactions (ρ = 0.18, P = .257) subscales. Higher attack frequency and endorsing severe disability on the MIDAS were associated with higher child-rated impact (eg, lower scores) on Global Well-Being (frequency ρ = -0.35, P = .028; MIDAS t(38) = 2.74, P = .009) and Impact on Personal Future (frequency ρ = -0.41, P = .009; MIDAS t(35.7) = 2.49, P = .017) subscales. Higher attack pain intensity was associated with higher child-rated impact (eg, lower scores) on Burden of Daily Help (r = -0.34, P = .031) and Emotional Impact (r = -0.40, P = .010). Over half of children (23/40, 57.5%) reported some kind of service or intervention to help them manage the impact of their parent's migraine on their lives would be helpful. CONCLUSIONS: Parental migraine impacts children aged 11-17 living in the home, particularly in the domains of global well-being and the parent/child relationship. Parent and child reports are not strongly correlated across all domains of parental impact.

So many migraines, so few subspecialists: analysis of the geographic location of United Council for Neurologic Subspecialties (UCNS) certified headache subspecialists compared to United States headache demographics.

OBJECTIVE: To evaluate the geographic location of the United Council for Neurologic Subspecialties (UCNS)-certified headache subspecialists as compared with ratios of expected migraine and chronic migraine populations in the United States. BACKGROUND: The UCNS is a professional medical organization that accredits fellowship programs and certifies physicians who demonstrate competence in various neurologic subspecialties, including headache medicine. There are a limited number of UCNS-certified headache subspecialists currently practicing in the United States. METHODS: All of the UCNS-certified headache subspecialists were geographically located and compared with demographic data about state populations obtained from the U.S. Census. The expected migraine and chronic migraine populations were calculated for each state based on recently published epidemiologic data. Ratios of UCNS-certified headache subspecialists to expected migraine and chronic migraine populations were compared for each state. These data were then organized by U.S. Census region and division. RESULTS: As of the 2012 examination cycle, 416 UCNS-certified headache subspecialists are currently practicing in the United States. The states with the highest number of headache subspecialists include New York, California, Ohio, Texas, Florida, and Pennsylvania. Six states have zero headache subspecialists, eight states have one headache subspecialist, and five states have two headache subspecialists. As per the U.S. Census, the total U.S. population for ages 12 years and older is 259,908,563. The total expected migraine population (11.79% of the general population) for ages 12 years and older is 30,594,362. The total expected chronic migraine population (0.91% of the general population) for ages 12 years and older is 2,361,397. The states with the best ratios of headache subspecialists to expected migraine and chronic migraine populations include the District of Columbia, New Hampshire, New York, and Nebraska. Besides states with zero headache subspecialists, the states with the worst ratios of headache subspecialists to expected migraine and chronic migraine populations include Oregon, Mississippi, Arkansas, and Kansas. When organized by U.S. Census regions, the Northeast has the best ratios of headache subspecialists to expected migraine and chronic migraine populations, while the West has the worst ratios of headache subspecialists to expected migraine and chronic migraine populations. In terms of U.S. Census divisions, the Middle Atlantic has the best ratios of headache subspecialists to expected migraine and chronic migraine populations, while the East South Central has the worst ratios of expected migraine and chronic migraine populations. CONCLUSIONS: There is a disproportionately small number of UCNS-certified headache subspecialists compared with the extensive expected migraine and chronic migraine populations in the United States. More UCNS-accredited fellowship programs and more UCNS-certified headache subspecialists are needed in order to ameliorate this disparity.