How Early Life Stress Affects Migraine Risk
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Key Questions
- What are adverse childhood experiences (ACEs), and how has the definition evolved?
- What is the association between ACEs and the risk of migraine or headache disorders in adulthood?
- Do adverse childhood experiences have a biological, not just psychological, impact on neurodevelopment that predisposes a child to migraines?
- Is there evidence that certain developmental periods are more vulnerable to the effects of adverse childhood experiences on headache or migraine risk?
- How does a parent’s history of chronic pain or mental health conditions influence their child’s risk of migraine?
- In pediatric and adult migraine care, what does an effective, sensitive screening process for psychosocial stressors look like in clinical practice?
- Are there additional clinical considerations for children or adults with migraine who have a history of adverse childhood experiences?
- What research over the next decade could help clarify links between early adversity and migraine?
Interview Notes
- Pediatric Headache Research Lab (PeHRL)
- Dr. Serena Orr MD, MSc, FRCPC
- Bluesky: @serenaorr.bsky.social
- Article: “Relationship of Childhood Abuse and Household Dysfunction to Many of the Leading Causes of Death in Adults: The Adverse Childhood Experiences (ACE) Study”
- Study Review: “Migraine and trauma-informed care: A review of the literature and recommendations for clinical practice and research”
- Study: “Adverse childhood experiences and primary headache disorders”
- Study: “Early life stress in adolescent migraine and the mediational influence of symptoms of depression and anxiety in a Canadian cohort”
- Study: “Adverse childhood experiences and onset of migraine in Canadian adolescents: A cohort study”
- Study review: “Annual research review: Early adversity, the hypothalamic–pituitary–adrenocortical axis, and child psychopathology”
- Study: “Adverse childhood experiences, DNA methylation age acceleration, and cortisol in UK children: A prospective population-based cohort study”
- Article: “Migraine and Trauma-Informed Care: A Review of the Literature and Recommendations for Clinical Practice and Research”
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Disclaimer: The Migraine World Summit aims to bring you a variety of perspectives and expertise, free from bias or judgment. Alternative theories presented in this video have not been medically reviewed. Views expressed in this interview do not necessarily represent the views of the Migraine World Summit. Please always consult your health care professional and do your own research before making changes to your treatment plan. Captions are auto-generated and may contain errors.
Serena Laura Orr, MD, MSc
Associate Professor of Pediatrics | Pediatric Neurologist
University of Calgary | Alberta Children's Hospital
Dr. Serena Orr is associate professor of pediatrics, community health sciences, and clinical neurosciences at the University of Calgary, and an attending pediatric neurologist at the Alberta Children’s Hospital (ACH). She is a clinician-scientist and is principal investigator of the Pediatric Headache Research Lab. She also directs the Pediatric Headache Program in the Section of Neurology at ACH.
Her main research interest is in furthering our understanding of migraine in children and adolescents. Specifically, she is interested in improving our knowledge of how to optimize acute migraine treatment, both at home and in the emergency department. She leads clinical trials and is interested in novel neuromodulation and technology-based solutions for treating migraine. Dr. Orr is also interested in the relationship between migraine and mental health (i.e., anxiety and depression) and in how this relationship may help us to better understand migraine etiology and biology.
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Miles for Migraine is a registered 501(c)(3) nonprofit organization with the mission of improving the lives of people with migraine and other headache disorders, and their families, by raising public awareness about this disease, and helping to find a cure. Miles for Migraine produces fun walk/run events, typically a 2-mile walk and 5K and 10K races to raise money for migraine research. We also host adult education days, and a youth program for kids and teens impacted by migraine and other headache disorders.
Lundbeck is a global pharmaceutical company focused exclusively on transformative treatments in neuroscience for people with high unmet need. Every day, we strive for improved treatment anda better life for people living with brain disease. We are committed to supporting the migraine community and helping to eliminate barriers that prevent people from being their best.
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