Caffeine consumption as a risk factor for childhood and adolescence migraine.

BACKGROUND
Caffeine consumption is a risk factor for chronic daily headache, but few studies have addressed relationships between pediatric patient caffeine levels and headache severity. We examined associations between serum and urine caffeine levels and headache severity in childhood and adolescence migraine cases.


METHODS
Levels of caffeine and caffeine metabolites in serum and urine samples were determined by LC-MS/MS. Wilcoxon rank-sum test was used for comparisons of age, sleep time, headache severity, caffeine consumption, and caffeine detection. Spearman's rank correlation coefficient (ρ) was calculated for associations. Correlations with ρ≥ 0.3 and differences with p< 0.05 were considered statistically significant.


RESULTS
Of the 40 patients studied, 34 declared caffeine consumption and 6 declared no caffeine consumption. These two groups did not differ significantly in any of the above clinical parameters. LC-MS/MS analysis of both serum and urine samples revealed 9 caffeine-negative (level <0.0625 μM) and 31 caffeine-positive cases. HIT-6 score was higher (p= 0.033) for the caffeine-positive vs. caffeine-negative group. Caffeine was detected by LC-MS/MS in serum and/or urine for 3 of the 6 patients who declared no caffeine consumption. No significant correlations were observed among age, sleep times, headache severity score, or levels of caffeine and caffeine metabolites.


CONCLUSION
31 of 40 (77.5%) cases of childhood/ adolescence migraine showed serum and urine caffeine-positivity based on LC-MS/MS. HIT-6 score, a measure of headache severity, was significantly higher for caffeine-positive vs. -negative cases. Symptoms of childhood/ adolescence migraine were exacerbated by caffeine consumption.