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Objective: To assess agreement for migraine day between self‐report and diagnostic guidelines for children and adolescents using a headache diary. Background: Trial guidelines recommend prospective collection of headache features and adoption of migraine day as an outcome measure, but there is no clear consensus on the definition of migraine day. Methods: This is a secondary analysis of data from two projects—a prospective cohort study validating a pediatric scale of treatment expectancy and a clinical trial of occipital nerve blocks to treat status migrainosus. Participants completed a text message‐based diary for 4 or 12 weeks (depending on treatment), and a detailed headache assessment on a random 20% of headache days. Using this assessment, we determined whether a headache day qualified for migraine or probable migraine, based on the International Classification of Headache Disorders, 3rd edition (ICHD‐3). Results: Of 122 enrolled children and adolescents, 106 (86.9%) completed ≥1 detailed headache assessment (438 entries). We found moderate agreement between self‐reported and ICHD‐derived migraine day, with a Cohen's Kappa of 0.50 (positive predictive value [PPV]: 0.66; negative predictive value [NPV]: 0.85; correlation: 0.51). Allowing for ICHD‐derived probable migraine significantly increased PPV (0.66 vs. 0.94; 95% CI: 0.57–0.74 vs. 0.90–0.97), but decreased NPV (0.85 vs. 0.293; CI: 0.77–0.90 vs. 0.199–0.40), Cohen's Kappa (0.50 vs. 0.237; CI: 0. 389–0.60 vs. 0.139–0.352), and correlation (r = 0.51 vs. 0.302; CI: 0.41–0.61 vs. 0.192–0.41). Pain severity (OR: 5.7; CI: 2.39–13.8), photophobia (OR: 4.1; CI: 1.02–16.6), and phonophobia (OR: 7.5; CI: 1.95–29.3) were significantly associated with participants' perception of migraine. Conclusion: We found only moderate agreement between self‐reported and ICHD‐derived migraine day, suggesting both measures are not equal but may represent overlapping aspects of migraine as a disease. This highlights the difficulty of applying ICHD criteria to individual attacks. We recommend greater methodological transparency in future research to avoid readers conflating both measures. [ABSTRACT FROM AUTHOR]

How obesity exacerbates migraine and other pain disorders remains unknown. Trigeminal nociceptive processing, crucial in migraine pathophysiology, is abnormal in mice with diet induced obesity. However, it is not known if this is also true in genetic models of obesity. We hypothesized that obese mice, regardless of the model, have trigeminal hyperalgesia. To test this, we first evaluated trigeminal thermal nociception in leptin deficient (ob/ob) and control mice using an operant thermal assay. Unexpectedly, we found significant hypoalgesia in ob/ob mice. Because thermal hypoalgesia also occurs in mice lacking the transient receptor potential vanilloid 1 channel (TRPV1), we tested capsaicin-evoked trigeminal nociception. Ob/ob and control mice had similar capsaicin-evoked nocifensive behaviors, but ob/ob mice were significantly less active after a facial injection of capsaicin than were diet-induced obese mice or lean controls. Conditioned place aversion in response to trigeminal stimulation with capsaicin was similar in both genotypes, indicating normal negative affect and pain avoidance. Supporting this, we found no difference in TRPV1 expression in the trigeminal ganglia of ob/ob and control mice. Finally, we assessed the possible contribution of hyperphagia, a hallmark of leptin deficiency, to the behavior observed in the operant assay. Ob/ob and lean control mice had similar reduction of intake when quinine or capsaicin was added to the sweetened milk, excluding a significant contribution of hyperphagia. In summary, ob/ob mice, unlike mice with diet-induced obesity, have trigeminal thermal hypoalgesia but normal responses to capsaicin, suggesting specificity in the mechanisms by which leptin acts in pain processing. • Obese leptin deficient mice (ob/ob) are insensitive to thermal stimulation of the face. • Ob/ob mice have normal nocifensive responses to trigeminal stimulation with capsaicin. • Leptin deficiency, but not diet-induced obesity, is associated with capsaicin-evoked immobility. • These finding suggest that leptin deficiency decreases thermal nociception without affecting responses to capsaicin. [ABSTRACT FROM AUTHOR]

Background: International guidelines recommend diaries in migraine trials for prospective collection of headache symptoms. Studies in other patient populations suggest higher adherence with electronic diaries instead of pen-and-paper. This study examines the feasibility of a text message-based (texting) diary for children and adolescents with headache. Methods: This is a secondary analysis of data from a study validating a pediatric scale of treatment expectancy. We developed a Health Insurance Portability and Accountability Act-compliant texting diary collecting headache characteristics, medication use, and disability with 3–5 core daily questions for 4 or 12 weeks depending on headache treatment. Adherence was incentivized. Results: 93 participants consented to the expectancy study. Five participants opted for a paper diary for follow-up. 88 participants chose the texting diary with 28 4-week and 60 12-week participants. Five participants did not complete the enrollment visit. Of those remaining 83, 89% of 4-week and 93% of 12-week participants responded on at least 80% of days. On average, participants fully completed 88% (4-week cohort) and 90% (12-week) of diary entries. Conclusions: Text messages are a promising method for collecting patient-reported data. Adherence was similar to that reported for paper diaries in other pediatric migraine trials, but time-stamped entries ensure real-time data collection. [ABSTRACT FROM AUTHOR]