Nicolardi Valentina, Accogli Giuseppe, Macchitella Luigi, Scoditti Sara, Fanizza Isabella, Spalluto Anna Maria, Trabacca Antonio
Scientific Direction, Scientific Institute IRCCS Eugenio Medea, Via Don L. Monza 20, Bosisio Parini, 2384223842, Italy.
Scientific Hospital for Neurorehabilitation - Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Associazione "La Nostra Famiglia" - IRCCS "E. Medea", Brindisi, 72100, Italy.
Acta Neurol Belg. 2025 Oct 18. doi: 10.1007/s13760-025-02912-x.
Clinical and epidemiological studies have reported a comorbidity between Attention Deficit Hyperactivity Disorder (ADHD) and migraine. Pharmacological treatments such as methylphenidate have also been hypothesized to contribute to the onset of headaches. This study aimed to investigate the percentage of headaches in a pediatric ADHD population, comparing children treated with methylphenidate to those not receiving pharmacological therapy, while also considering the potential influence of family history, sex, and age.
A retrospective cross-sectional analysis was conducted on 118 children and adolescents diagnosed with ADHD (68 treated with methylphenidate, 50 untreated). Headache presence and features were assessed using a structured questionnaire based on international diagnostic criteria. Binomial and multinomial logistic regressions were used to evaluate the effects of methylphenidate use and family history on headache presence and type, controlling for age and sex.
Headache symptoms were significantly more frequent in participants with a family history of headache, regardless of medication status. No main effect of methylphenidate on overall headache percentage was observed. However, the combination of methylphenidate treatment and positive family history was significantly associated with migraine-compatible headache presentations. Cephalalgy was not significantly linked to any of the variables. The absence of family history was strongly associated with the absence of headache symptoms.
Family history appears to be a key factor in headache percentage among children with ADHD. While methylphenidate alone does not increase headache risk, its interaction with familial predisposition may contribute to migraine-like symptoms. Family history should be carefully considered during clinical assessment.
临床和流行病学研究报告了注意缺陷多动障碍（ADHD）与偏头痛之间的共病情况。也有假设认为，诸如哌甲酯之类的药物治疗会促使头痛发作。本研究旨在调查儿科ADHD人群中头痛的发生率，将接受哌甲酯治疗的儿童与未接受药物治疗的儿童进行比较，同时考虑家族史、性别和年龄的潜在影响。
对118名被诊断为ADHD的儿童和青少年进行了回顾性横断面分析（68名接受哌甲酯治疗，50名未治疗）。使用基于国际诊断标准的结构化问卷评估头痛的存在情况和特征。采用二项式和多项逻辑回归来评估使用哌甲酯和家族史对头痛存在情况和类型的影响，并对年龄和性别进行控制。
无论用药状态如何，有头痛家族史的参与者头痛症状明显更频繁。未观察到哌甲酯对总体头痛发生率的主要影响。然而，哌甲酯治疗与阳性家族史的组合与偏头痛样头痛表现显著相关。头痛与任何变量均无显著关联。无家族史与无头痛症状密切相关。
家族史似乎是ADHD儿童头痛发生率的关键因素。虽然单独使用哌甲酯不会增加头痛风险，但其与家族易感性的相互作用可能会导致偏头痛样症状。在临床评估期间应仔细考虑家族史。
