Abstract
An association between primary headaches and attention-deficit/hyperactivity disorder (ADHD) has long been suggested. Moreover, headache is regarded as a common side effect of stimulants, the most effective treatment for ADHD. So far, no systematic review has evaluated the potential association between ADHD and headache. We performed a systematic review of the literature and a meta-analysis of all reported studies on ADHD and primary headaches. Our analysis showed a positive association between ADHD and migraine (OR 1.322, 95% CI 1.018–1717, p value 0.036), but not with tension-type headache. There is a significant association between migraine and ADHD. The mechanisms underlying this association remain to be elucidated, warranting further studies.
Similar content being viewed by others
References
Moffitt TE, Houts R, Asherson P et al (2015) Is adult ADHD a childhood-onset neurodevelopmental disorder? Evidence from a four-decade longitudinal cohort study. Am J Psychiatry 172(10):967–977. doi:10.1176/appi.ajp.2015.14101266
Caye A, Rocha TB, Anselmi L et al (2016) Attention-deficit/hyperactivity disorder trajectories from childhood to young adulthood: evidence from a birth cohort supporting a late-onset syndrome. JAMA Psychiatry 73(7):705–712. doi:10.1001/jamapsychiatry.2016.0383
Garner AA, O’Connor BC, Narad ME et al (2013) The relationship between ADHD symptom dimensions, clinical correlates, and functional impairments. J Dev Behav Pediatr 34(7):469–477
Saylor KE, Amann BH (2016) Impulsive aggression as a comorbidity of attention-deficit/hyperactivity disorder in children and adolescents. J Child Adolesc Psychopharmacol 26(1):19–25. doi:10.1089/cap.2015.0126
Halmøy A, Fasmer OB, Gillberg C et al (2009) Occupational outcome in adult ADHD: impact of symptom profile, comorbid psychiatric problems and treatment: a cross sectional study of 414 clinically diagnosed adult ADHD patients. J Atten Disord 13:75–87
Cortese S, Angriman M, Maffeis C et al (2008) Attention-deficit/hyperactivity disorder (ADHD) and obesity: a systematic review of the literature. Crit Rev Food Sci Nutr 48:524–537
Ozge A, Sasmaz T, Cakmak SE et al (2010) Epidemiological-based childhood headache natural history study: after an interval of six years. Cephalalgia 30:703–712
Gunner KB, Smith HD (2007) Practice guideline for diagnosis and management of migraine headaches in children and adolescents: part one. J Pediatr Health Care 21:327–332
Oakley CB, Kossoff EH (2014) Migraine and epilepsy in pediatric population. Curr Pain Headache Rep 18(3):402. doi:10.1007/s11916-013-0402-3
Smitherman TA, Burch R, Sheikh H et al (2013) The prevalence, impact, and treatment of migraine and severe headaches in the United States: a review of statistics from national surveillance studies. Headache 53(3):427–436. doi:10.1111/head.12074
Agarwal R, Goldenberg M, Perry R et al (2012) The quality of life of adults with attention deficit hyperactivity disorder: a systematic review. Innov Clin Neurosci 9(5–6):10–21
Instanes JT, Klungsoyr K, Halmoy A, et al. Adult ADHD and comorbid somatic disease: a systematic literature review. J Atten Disord. 2016. doi:10.1177/1087054716669589
Zeni CP, Guimarães AP, Polanczyk GV et al (2007) No significant association between response to methylphenidate and genes of the dopaminergic and serotonergic systems in a sample of Brazilian children with attention-deficit/hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 144B(3):391–394
Albers L, von Kries R, Heinen F et al (2015) Headache in school children: Is the prevalence increasing? Curr Pain Headache Rep 19:4. doi:10.1007/s11916015-0477-0
Mahajnah M, Sharkia R, Shorbaji N et al (2017) The clinical characteristics of ADHD diagnosed in adolescents in comparison with younger children. J Atten Disord 1:1087054717696768. doi:10.1177/1087054717696768
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. APA, Washington, DC
American Psychiatric Association (2000) Diagnostic and statistical manual of mental disorders, 4th edn. APA, Washington, DC
Headache Classification Committee of the International Headache Society (2004) The international classification of headache disorders: 2nd edition. Cephalalgia 24(Suppl. 1):9–160
Truman BI, Smith-Akin CK, Hinman AR et al (2000) Developing the Guide to Community Preventive Services—overview and rationale. The Task Force on Community Preventive Services. Am J Prev Med 18(1 Suppl):18–26
Briss PA, Brownson RC, Fielding JE et al (2004) Developing and using the Guide to Community Preventive Services: lessons learned about evidence-based public health. Annu Rev Public Health 25:281–302
Fasmer OB, Riise T, Lund A et al (2012) Comorbidity of migraine with ADHD. J Atten Disord 16(4):339–345. doi:10.1177/1087054710385784
Fasmer OB, Halmoy A, Oedegaard KJ et al (2011) Adult attention deficit hyperactivity disorder is associated with migraine headaches. Eur Arch Psychiatry Clin Neurosci 261(8):595–602. doi:10.1007/s00406-011-0203-9
Arruda MA, Arruda R (2014) Psychological adjustment in children with episodic migraine: a population-based study. Psychol Neurosci 7:33–41. doi:10.3922/j.psns.2014.1.06
Genizi J, Gordon S, Kerem NC et al (2013) Primary headaches, attention deficit disorder and learning disabilities in children and adolescents. J Headache Pain 14:54. doi:10.1186/1129-2377-14-54
Pavone P, Rizzo R, Conti I et al (2012) Primary headaches in children: clinical findings on the association with other conditions. Int J Immunopathol Pharmacol 25(4):1083–1091
Riva D, Usilla A, Aggio F et al (2012) Attention in children and adolescents with headache. Headache 52(3):374–384. doi:10.1111/j.1526-4610.2011.02033.x
Genizi J, Marom D, Srugo I, et al. The relations between attention deficit hyperactivity disorder and headaches in a non-clinical sample of adolescents. Acad J Ped Neonatolo. 2016;2(2):AJPN.MS.ID.555583
Strine TW, Okoro CA, McGuire LC et al (2006) The associations among childhood headaches, emotional and behavioral difficulties, and health care use. Pediatrics 117(5):1728–1735
Lateef TM, Merikangas KR, He J et al (2009) Headache in a national sample of american children: prevalence and comorbidity. J Child Neurol 24(5):536–543. doi:10.1177/0883073808327831
Pitrou I, Shojaei T, Chan-Chee C et al (2010) The associations between headache and psychopathology: a survey in school children. Headache 50:1537–1548. doi:10.1111/j.1526-4610.2010.01781.x
Jameson ND, Sheppard BK, Lateef T et al (2016) Medical comorbidity of attention-deficit/hyperactivity disorder in US adolescents. J Child Neurol 31(11):1282–1289
Arruda MA, Bigal ME (2012) Migraine and migraine subtypes in preadolescent children: association with school performance. Neurology 79(18):1881–1888. doi:10.1212/WNL.0b013e318271f812
Arruda MA, Guidetti V, Galli F et al (2010) Migraine, tension-type headache, and attention-deficit/hyperactivity disorder in childhood: a population-based study. Postgrad Med 122(5):18–26. doi:10.3810/pgm.2010.09.2197
Mazzone L, Vitiello B, Incorpora G et al (2006) Behavioural and temperamental characteristics of children and adolescents suffering from primary headache. Cephalalgia 26(2):194–201
Reddy DS (2013) Current pharmacotherapy of attention deficit hyperactivity disorder. Drugs Today (Barc) 49(10):647–665. doi:10.1358/dot.2013.49.10.2008996
Clavenna A, Bonati M (2014) Safety of medicines used for ADHD in children: a review of published prospective clinical trials. Arch Dis Child 99(9):866–872. doi:10.1136/archdischild-2013-304170
Leviton A (1986) Do learning handicaps and headache cluster? J Child Neurol 1:372–377
Calandre EP, Bembibre J, Arnedo ML et al (2002) Cognitive disturbances and regional cerebral blood flow abnormalities in migraine patients: their relationship with the clinical manifestations of the illness. Cephalalgia 22:291–302
Bellini B, Arruda M, Cescut A et al (2013) Headache and comorbidity in children and adolescents. J Headache Pain 14(1):79. doi:10.1186/1129-2377-14-79
Gümüş YY, Çakin Memik N, Ağaoğlu B (2015) Anxiety disorders comorbidity in children and adolescents with attention deficit hyperactivity disorder. Noro Psikiyatr Ars 52(2):185–193. doi:10.5152/npa.2015.7024
Eyre O, Langley K, Stringaris A et al (2017) Irritability in ADHD: associations with depression liability. J Affect Disord 25(215):281–287. doi:10.1016/j.jad.2017.03.050
Özdemir O, Boysan M, Güzel Özdemir P et al (2015) Relations between post-traumatic stress disorder, dissociation and attention deficit/hyperactivity disorder among earthquake survivors. Noro Psikiyatr Ars 52(3):252–257. doi:10.5152/npa.2015.7616
Berkol TD, Yargiç İ, Özyildirim İ et al (2014) Comorbidity of adult attention deficit and hyperactivity disorder in bipolar patients: prevalence, sociodemographic and clinical correlates. Noro Psikiyatr Ars 51(2):97–102. doi:10.4274/npa.y6376
Son YD, Han DH, Kim SM et al (2017) A functional connectivity comparison between attention deficit hyperactivity disorder and bipolar disorder in medication-naïve adolescents with mood fluctuation and attention problems. Psychiatry Res 17(263):1–7. doi:10.1016/j.pscychresns.2017.02.006
McGough JJ, Smalley SL, McCracken JT et al (2005) Psychiatric comorbidity in adult attention deficit hyperactivity disorder: findings from multiplex families. Am J Psychiatry 162(9):1621–1627
Kessler RC, Adler L, Barkley R et al (2006) The prevalence and correlates of adult ADHD in the United States: results from the National Comorbidity Survey Replication. Am J Psychiatry 163(4):716–723
Villa TR, Correa Moutran AR, Sobirai Diaz LA et al (2009) Visual attention in children with migraine: a controlled comparative study. Cephalalgia 29:631–634. doi:10.1111/j.1468-2982.2008.01767.x
Biederman J, Ball SW, Monuteaux MC et al (2008) New insights into the comorbidity between ADHD and major depression in adolescent and young adult females. J Am Acad Child Adolesc Psychiatry 47(4):426–434
Edden RAE, Crocetti D, Zhu H et al (2012) Reduced GABA concentration in attention-deficit/hyperactivity disorder. Arch Gen Psychiatry 69(7):750–753
Naaijen J, Bralten J, Poelmans G et al (2017) Glutamatergic and GABAergic gene sets in attention-deficit/hyperactivity disorder: association to overlapping traits in ADHD and autism. Transl Psychiatry 7(1):e999. doi:10.1038/tp.2016.273
Camarda C, Monastero R, Pipia C et al (2007) Interictal executive disfunction in migraineurs without aura: relationship with duration and intensity o attacks. Cephalalgia 27:1094–1110
Williams NM, Zaharieva I, Martin A et al (2010) Rare chromosomal deletions and duplications in attention-deficit hyperactivity disorder: a genome-wide analysis. Lancet 376(9750):1401–1408. doi:10.1016/S0140-6736(10)61109-9
Kattimani S, Mahadevan S (2011) Treating children with attention-deficit/hyperactivity disorder and comorbid epilepsy. Ann Indian Acad Neurol 14(1):9–11. doi:10.4103/0972-2327.78042
Kim EH, Yum MS, Kim HW, Ko TS (2014) Attention-deficit/hyperactivity disorder and attention impairment in children with benign childhood epilepsy with centrotemporal spikes. Epilepsy Behav 37:54–58. doi:10.1016/j.yebeh.2014.05.030
Kanemura H, Sano F, Ishii S, Ohyama T, Sugita K, Aihara M (2013) Characteristics of headache in childer with epilepsy. Seizure 22(8):647–650
Papetti L, Nicita F, Parisi P, Spalice A, Villa MP, Trenite DGAK (2013) Headache and epilepsy—how are they connected? Epilepsy Behav 26(3):386–393
Zhang C, Kutyifa V, Moss AJ, McNitt S, Zareba W, Kaufman ES (2015) Long-QT syndrome and therapy for attention deficit/hyperactivity disorder. J Cardiovasc Electrophysiol 26(10):1039–1044. doi:10.1111/jce.12739
Paisley RD, Arora HS, Nazeri A, Massumi A, Razavi M (2009) Migraine and vasodepressor syncope in a large family. Tex Heart Inst J 36(5):468–469
Curfman D, Chilungu M, Daroff RB, Alshekhlee A, Chelimsky G, Chelimsky TC (2012) Syncopal migraine. Clin Auton Res 22(1):17–23. doi:10.1007/s10286-011-0141-7
Parisi P, Verrotti A, Paolino MC, Ferretti A, Raucci U, Moavero R, Villa MP, Curatolo P (2014) Headache and attention deficit and hyperactivity disorder in children: common condition with complex relation and disabling consequences. Epilepsy Behav 32:725
Paolino MC, Ferretti A, Villa MP, Parisi P (2015) Headache and ADHD in pediatric age: possible physiopathological links. Curr Pain Headache Rep 19(7):25
Parisi P, Verrotti A, Paolino MC, Miano S, Urbano A, Bernabucci M, Villa MP (2010) Cognitive profile, parental education and BMI in children: reflections on common neuroendrocrinobiological roots. Pediatr Endocrinol Metab 23(11):113341
Nguyen JCD, Killcross AS, Jenkins TA (2014) Obesity and cognitive decline: role of inflammation and vascular changes. Front Neurosci 8:375. doi:10.3389/fnins.2014.00375
Wang C, Chan JSY, Ren L, Yan JH (2016) Obesity reduces cognitive and motor functions across the lifespan. Neural Plast 2016:2473081. doi:10.1155/2016/2473081
Parisi P, Verrotti A, Paolino MC, Urbano A, Bernabucci M, Castaldo R, Villa MP (2010) Headache and cognitive profile in children: a crosssectional controlled study. J Headache Pain 11(1):4551
Moutran ARC, Villa TR, Diaz LAS, Noffs MHS, Pinto MMP; Gabbai AA; Carvalho DS. Migraine and cognition in children: a controlled study. Arq Neuro Psiquiatr. 2011. doi:10.1590/S0004-282X2011000200010. (São Paulo)
Ozbaran B, Kose S, Yuzuguldu O et al (2015) Combined methylphenidate and atomoxetine pharmacotherapy in attention deficit hyperactivity disorder. World J Biol Psychiatry 16(8):619–624. doi:10.3109/15622975.2015.1051109
Tenore GC, Daglia M, Orlando V et al (2015) Coffee and depression: a short review of literature. Curr Pharm Des 21(34):5034–5040
Lee MJ, Choi HA, Choi H et al (2016) Caffeine discontinuation improves acute migraine treatment: a prospective clinic-based study. J Headache Pain 17(1):71. doi:10.1186/s10194-016-0662-5
Stark JG, Engelking D, McMahen R et al (2016) A randomized crossover study to assess the pharmacokinetics of a novel amphetamine extended-release orally disintegrating tablet in healthy adults. Postgrad Med 128(7):648–655. doi:10.1080/00325481.2016.1216716
Ames D, Carr-Lopez SM, Gutierrez MA et al (2016) Detecting and managing adverse effects of antipsychotic medications: current state of play. Psychiatr Clin N Am 39(2):275–311. doi:10.1016/j.psc.2016.01.008
Schrantee A, Tamminga HGH, Bouziane C et al (2016) Age-dependent effects of methylphenidate on the human dopaminergic system in young vs adult patients with attention-deficit/hyperactivity disorder. JAMA Psychiatry 73(9):955–962. doi:10.1001/jamapsychiatry.2016.1572
Schrantee A, Bouziane C, Bron EE et al (2017) Long-term effects of stimulant exposure on cerebral blood flow response to methylphenidate and behavior in attention-deficit hyperactivity disorder. Brain Imaging Behav. doi:10.1007/s11682-017-9707-x
Kral MC, Lally MD, Boan AD (2017) Effectiveness and side effect profile of stimulant medication for the treatment of attention-deficit/hyperactivity disorder in youth with epilepsy. J Child Adolesc Psychopharmacol. doi:10.1089/cap.2016.0186
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interests
The authors declare that they have no conflict of interests associated and that no funding of any kind is associated with this work.
Rights and permissions
About this article
Cite this article
Salem, H., Vivas, D., Cao, F. et al. ADHD is associated with migraine: a systematic review and meta-analysis. Eur Child Adolesc Psychiatry 27, 267–277 (2018). https://doi.org/10.1007/s00787-017-1045-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00787-017-1045-4