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Juvenile fibromyalgia (JFM) is a chronic pain syndrome with onset in developmental age, characterized by widespread musculoskeletal pain associated with other neurological or nonneurological symptoms. Headache is one of the most frequent comorbid conditions with JFM, but this association is still poorly studied in the juvenile population. The literature review was conducted searching through PubMed, Scopus, and Web of Science with a combination of the following free-text terms: “fibromyalgia,” “juvenile fibromyalgia,” “headache,” “primary headache,” “migraine,” “children,” “adolescents,” and “comorbidity.” The research resulted only in two specific studies regarding comorbidity JFM + Juvenile Headache (JH). From each study, we extracted data about sample features, clinical characteristics of both JFM and PH, and assessment tools. The clinical approach to JFM and JH should include a complete examination of the main causes of comorbid diseases, thus improving the therapeutic approach to the patient in developmental age.

Lucia Margari,1 Andrea De Giacomo,1 Francesco Craig,2 Roberto Palumbi,1 Antonia Peschechera,1 Mariella Margari,1 Francesca Picardi,3 Marina Caldarola,3 Marilena Anna Maghenzani,4 Franca Dicuonzo3 1Department of Basic Medical Sciences, Neuroscience and Sense Organs, Child Neuropsychiatry Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy; 2Scientific Institute, IRCCS E. Medea, Unit for Severe Disabilities in Developmental Age and Young Adults, Developmental Neurology and Neurorehabilitation, Brindisi, Italy; 3Department of Basic Medical Sciences, Neuroscience and Sense Organs, Neuroradiology Unit, University of Bari Aldo Moro, Azienda Ospedaliero Universitaria Consorziale Policlinico di Bari, Bari, Italy; 4Emergency Department, Anesthesia and Intensive Care Unit, University of Bari Aldo Moro, Azienda Ospedaliero-Universitaria Policlinico di Bari, Bari, Italy Purpose: Recently, neuroimaging studies were performed using 1H-magnetic resonance spectroscopy (1H-MRS), revealing a quantitative alteration of neurochemicals (such as neurotransmitters and metabolites) in several brain regions of patients with autism spectrum disorder (ASD). The involvement of the frontal lobe in the neurobiology of ASD has long been documented in the literature. Therefore, the aim of this study was to analyze the alterations of N-acetylaspartate/creatine (NAA/Cr) and choline/Cr(Cho/Cr) ratios in the frontal lobe subcortical white matter (WM) in ASD patients, in order to reveal any alteration of metabolites that might be the expression of specific clinical features of the disorder.Patients and methods: An 1H-MRS study of the frontal lobe subcortical WM was performed in 75 children with ASD and in 50 age-matched controls to evaluate the functional activity of this brain region.Results: NAA/Cr and Cho/Cr ratios were significantly altered in ASD, compared to control subjects. Moreover, in the ASD group, NAA/Cr was significantly lower in patients with a cognitive impairment.Conclusion: Results from this study confirm the existence of brain metabolites’ alterations in frontal lobe WM in children with ASD, supporting the relevance of this brain region in the clinical expressions of this disorder, including its role in the cognitive impairment. Further 1H-MRS investigations will allow to comprehensively explain the relationship between metabolic alteration in a specific brain region and specific clinical features of ASD. Keywords: autism, neurodevelopmental disorder, cognitive impairment, neuroimaging, brain metabolites

Francesco Craig,1 Francesco Margari,2 Anna R Legrottaglie,1 Roberto Palumbi,1 Concetta de Giambattista,1 Lucia Margari1 1Child Neuropsychiatry Unit, 2Psychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari “Aldo Moro”, Bari, Italy Abstract: Executive dysfunction has been shown to be a promising endophenotype in neurodevelopmental disorders such as autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD). This article reviewed 26 studies that examined executive function comparing ASD and/or ADHD children. In light of findings from this review, theASD+ ADHD group appears to share impairment in both flexibility and planning with the ASD group, while it shares the response inhibition deficit with the ADHD group. Conversely, deficit in attention, working memory, preparatory processes, fluency, and concept formation does not appear to be distinctive in discriminating from ASD, ADHD, or ASD + ADHD group. On the basis of neurocognitive endophenotype, the common co-occurrence of executive function deficits seems to reflect an additive comorbidity, rather than a separate condition with distinct impairments. Keywords: executive function, autism spectrum disorder, attention-deficit/hyperactivity disorder, ASD + ADHD, neurocognitive endophenotype