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Risks of colic, later migraines linked in study

Wednesday April 17, 2013
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In a European study including children and adolescents ages 6 to 18, those who had experienced migraine headaches were more likely to have had colic as an infant.

"Infantile colic is a common cause of inconsolable crying during the first months of life," according to background information in the article, which is published in the April 17 issue of the Journal of the American Medical Association. "The pathogenesis and the age-specific presentation of colic are not well understood. Infantile colic is usually interpreted as a pain syndrome and may be multifactorial.

"Migraine is a common cause of headache pain in childhood. Whether there is an association between these two types of pain is unknown."

To investigate, Silvia Romanello, MD, of the APHP-Hospital Robert Debré in Paris, and colleagues conducted a study of the possible association between migraine and colic. The case-control study included 208 children ages 6 to 18 who presented to the ED and were diagnosed as having migraines in three European tertiary care hospitals between April 2012 and June 2012. The control group was composed of 471 children in the same age range who visited the ED of each participating center for minor trauma during the same period.

A structured questionnaire identified personal history of infantile colic for case and control participants, confirmed by health booklets. A second study of 120 children diagnosed with tension-type headaches was done to test the specificity of the association.

The researchers found that children with migraine were more likely to have experienced infantile colic than those without migraine (72.6% vs. 26.5%). The subgroup analysis for migraine subtypes confirmed the association between infantile colic and either migraine without aura (73.9% vs. 26.5%) or migraine with aura (69.7% vs. 26.5%). This association was not found for children with tension-type headaches.

"The link between infantile colic and migraine could be based on a pathogenetic mechanism common to migraine without aura and also migraine with aura," the authors wrote. "We found that among migraine characteristics, only pulsatile pain was more frequent in children with a history of infantile colic than among children with migraine but without infantile colic.

"Infants with colic might experience a similar sensitization of the perivascular nerve terminals in the gut, although this hypothesis needs to be tested." The authors added that molecules known to be involved in the modulation of sensory activity also could be involved.

Longitudinal studies are needed to further explore the association between colic and childhood migraines, the researchers concluded.

The study abstract is available at http://jama.jamanetwork.com/article.aspx?articleid=1679399.


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