# Migraine Prognosis in Adolescents

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2024 · $600,878

## Abstract

Project Summary
Migraine is a highly prevalent and disabling disorder that affects 15% of children and adolescents worldwide.
Adolescents with migraine frequently undergo changes in their disease symptoms during puberty, with
individuals experiencing increases, decreases, or no change in headache frequency. It is not currently possible
to predict if an individual will experience improvement, no change, or worsening of migraine symptoms, and the
underlying mechanisms controlling these changes remain uncharacterized. Thus, in the proposed study, we
aim to identify the baseline factors determining migraine prognoses in adolescents (Aim 1), determine the
hormonal, neural, and psychophysical changes related to migraine prognoses in adolescents (Aim 2a), and
identify the temporal relationships between hormonal, neural, and psychophysical changes preceding vs.
following changes in headache frequency (Aim 2b). Preliminary data support testosterone levels, conditioned
pain modulation (CPM) response, and functional connectivity (FC) of the amygdala as factors that may
determine migraine prognosis. Our preliminary data indicate that CPM response and amygdalar FC at baseline
may predict the change in headache frequency following a behavioral intervention in adolescents with
migraine. In addition, changes in testosterone levels are associated with changes in migraine symptoms. Study
participants will be adolescents with episodic migraine (ages 10–13, 50% females, migraine onset > 6 months,
headache frequency between 4–15/month, without or with a stable preventative treatment for migraine).
Psychophysical, neural, and hormonal factors will be assessed at baseline and at 1- and 2-year follow-ups.
Participants will meet with a headache specialist at all study visits to confirm migraine diagnosis and for
rigorous characterization of migraine symptoms. Migraine outcomes will be categorized as an increase or
decrease (> 30%) or no change (< 30%) in headache frequency from baseline to 2-year follow-up. A healthy
control group will complete all study procedures to control for normal pubertal changes. We hypothesize that
male sex and greater CPM responses, lower amygdala-prefrontal cortex (PFC) FC, and higher testosterone
levels at baseline will be associated with a decrease in headache frequency after two years. We expect that
adolescents with increased headache frequency will have a greater reduction in CPM efficiency, increased
amygdala-PFC FC, and a smaller increase in testosterone levels compared to adolescents with a decrease or
no change in headache frequency and healthy adolescents. We expect smaller increases in testosterone
levels to precede increases in headache frequency and greater reductions in CPM efficiency and increases in
amygdala-PFC FC to follow increases in headache frequency. Characterizing the mechanisms underlying
changes in migraine symptoms is imperative for the development of new migraine treatments. Identification of
adolescents who are at...

## Key facts

- **NIH application ID:** 10981169
- **Project number:** 1R01NS134986-01A1
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Hadas Nahman-Averbuch
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $600,878
- **Award type:** 1
- **Project period:** 2024-07-01 → 2029-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10981169

## Citation

> US National Institutes of Health, RePORTER application 10981169, Migraine Prognosis in Adolescents (1R01NS134986-01A1). Retrieved via AI Analytics 2026-06-03 from https://api.ai-analytics.org/grant/nih/10981169. Licensed CC0.

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