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This article, published in the journal Neuropediatrics, explores the association between migraine and muscular hyperalgesia in young adults. The study focuses on the myofascial involvement of neck muscles and uses point-of-care measures like algometry and ultrasound to assess alterations in the upper trapezius muscle (UTM) in migraine patients compared to healthy controls. The results show that migraine patients have a higher frequency and duration of neck pain and lower pressure pain thresholds above the UTM. The study suggests that assessing muscular involvement in headache patients is important for treatment and monitoring. [Extracted from the article]

This article, published in the journal Neuropediatrics, explores the benefits of repetitive neuromuscular magnetic stimulation (rNMS) in pediatric posttraumatic headache (PTH) patients. The study found that rNMS sessions targeting the upper trapezius muscle resulted in a significant decrease in maximum headache intensity and a trend towards lower minimum intensity. Additionally, patients experienced a reduction in hyperalgesia above the trapezius muscle. The authors suggest that rNMS treatment could be a beneficial noninvasive and non-pharmaceutical option for pediatric PTH patients. Further research is needed to confirm these findings. [Extracted from the article]

Question To assess clinical and muscular effects of a repetitive neuromuscular magnetic stimulation (rNMS) intervention targeting to the upper trapezius muscles (UTM) in pediatric patients with headache disorders. Methods A retrospective chart review resulted in 23 patients with migraine, migraine + tension-type headache (TTH), or post-traumatic headache (PTH), who received 28 rNMS interventions in a pediatric headache center. During 6 sessions, rNMS was delivered to UTM bilaterally (duration: 15min/side, frequency: 20 Hz, 7s ON-time, 10s OFF-time). Headache frequency, duration, and intensity 3 months before and after treatment were recorded using a customized standardized questionnaire prior to the first treatment and at follow-up (FU). We categorized patients into responder classes based on the relative reduction in headache frequency (≥25%, ≥50%, ≥75%). Effects on the muscular level were assessed by pressure pain thresholds (PPTs) above the UTM before, during rNMS treatment, and at FU after 4 to 20 weeks. Results Data from 20 patients were analyzed (14.10 ± 2.69 years; 60% females) as 2 patients were lost to FU and data of 1 patient was classified as outlier based on a late FU (3 SDs above mean FU time) and excluded from analysis. Compared to baseline, headache frequency (p=.017) and minimum and maximum headache intensities (p=.017; p=.023) were significantly reduced at FU. 11 patients (44%) were classified as ≥25% responders, with 7 patients (28%) experiencing a ≥75% reduction of monthly headache days. PPTs above the UTM significantly increased from baseline (left lateral: 2.00 ± 1.37, left medial: 1.96 ± 1.27, right medial: 1.83 ± 1.26, right lateral: 1.94 ± 1.37) to the last treatment session (left lateral: 3.28 ± 2.21, left medial: 3.17 ± 1.99, right medial: 3.17 ± 2.06, right lateral: 3.24 ± 2.25) (left lateral: p=.002, left medial: p=.002, right medial: p=.001, right lateral: p=.003). This increase from baseline sustains until FU (left lateral: 2.87 ± 2.11, left medial: 2.95 ± 2.11, right medial: 2.95 ± 2.11, right lateral: 2.81 ± 2.04) (left lateral: p=.047, left medial: p=.012, right medial: p=.002, right lateral: p=.028). After 14 rNMS interventions in the primary headache group, 6 patients (43%) were classified as ≥25% responders, with 2 patients (14%) experiencing a ≥75% reduction of monthly headache days. After 11 rNMS interventions in the PTH group, 5 patients (46%) were classified as ≥25% responders, with 5 patients (46%) experiencing a ≥75% reduction of monthly headache days. Conclusion Beneficial effects regarding headache characteristics and muscular PPTs were documented in pediatric patients with headache disorders. The latter having a sustained effect up to weeks to months. Based on the concept of the trigemino-cervical complex, rNMS of the UTM may act via neuromodulation of nociceptive processing at the central level. [ABSTRACT FROM AUTHOR]

Question To assess the safety of and satisfaction with a repetitive neuromuscular magnet stimulation (NMS) intervention targeting to the upper trapezius muscles (UTM) in pediatric patients with headache disorders. Methods Retrospective chart review including 33 patients with migraine, tension-type headache, or post-traumatic headache, who had received at least one test rNMS session targeting to UTM. In patients choosing to undergo rNMS intervention, adherence rate was calculated based on the number of completed rNMS sessions. For patients undergoing the rNMS intervention, safety of and satisfaction with the intervention were assessed by customized questionnaires. Results 33 patients (13.94 ± 2.51 years; 61% females) received at least a test rNMS session to become acquainted with the stimulation setting, resulting in 182 rNMS sessions. In 142 sessions (78%) no adverse events were reported. 43 adverse events were documented for 40 sessions (22%). Related side effects during stimulation included tingling (32.6%), shoulder pain (9.3%), back pain (9.3%), feeling of heaviness (4.7%), trembling (2.3%), and unpleasant tension (2.3%). Related side effects in-between interventions included muscle sore (25.5%), headache (4.7%), and a short-lasting muscle cramp in the upper arm (2.3%). Adverse events categorized unlikely related to the intervention were described in 3 sessions by 2 patients and included shoulder pain (4.7%) and an electrifying feeling radiating to the right hip (2.3%). In these 33 patients, 6 patients (18%) did not continue after the test rNMS session and 4 patients (12%) who started the intervention did not complete the full treatment. 23 patients (70%) completed 28 rNMS interventions with at least 5 of 6 sessions. At follow-up (FU) of 24 interventions, patients completed the customized satisfaction questionnaire. After 13 interventions (54.2%), the treatment was rated as "the therapy helped very well", after 5 interventions (20.8%) as "the therapy helped well", after 1 intervention (4.2%) as "indecisive", after 3 interventions as "the therapy rather did not help", and after 2 interventions as "the therapy did not help". At FU of 25 interventions, patients completed the customized questionnaire regarding repetition of the treatment. After 23 interventions (88.5%), patients would repeat the treatment. At FU of 19 interventions, patients completed the questionnaire regarding recommendation of treatment. After 18 interventions (96.2%), patients would recommend rNMS to other affected patients. Conclusion Stimulation by rNMS was found to be a feasible, safe, and well-accepted treatment option for children and adolescents with headache disorders. Thus, rNMS of the UTM may become a valuable non-invasive, non-pharmacological treatment option for pediatric headache disorders. [ABSTRACT FROM AUTHOR]