Demographic parameters of study population
A total number of 76 pediatric participants was included in the study. The migraine group accounted for 37 (48.7%), the non-migraineur group 39 (51.3%). Age group 8 to 12 years consisted of 34 (44.7%) participants, of whom 14 (37.8%) were migraineurs, 42 participants (55.3%) in age group 13 to 17 years, of whom 23 (62%) were migraineurs (p = 0.239). The study contained 33 (43.4%) male and 43 (56.6%) female participants. Eighteen (48.6%) of migraineurs and 25 (64%) of non-migraineurs were female (p = 0.174). Median age at time of questionnaire was 13.00 years (10.00–16.00). Average age of onset in migraine was 9.22 ± 3.34 years.
Treatment, medical care and triggering factors of migraineurs
In the group of migraineurs (n = 37), migraine accompanying symptoms (Fig. 1) included nausea, photo- and phonophobia and dizziness. “Visual aura” was the most frequent aura symptom, in 11 participants (29.7%) and was depicted with blurred vision (n = 5, 45.5%), flickering (n = 3, 27.3%), spots (n = 3, 27.3%), light circle (n = 1, 9.1%) and limited field of view (n = 1, 9.1%). 33 (89.2%) patients used medication, 32 (86.5%) only in case of migraine attack while 2 (5.4% of) patients used preventative medication as well. Substances indicated as used “attack medication” were ibuprofen by 18 (56.3%), paracetamol by 8 (25.0%), mefenamic acid by 7 (21.9%), acetylic-salicylic acid by 5 (15.6%), caffeine by 2 (6.3%), and metamizole and naproxen each by one (3.1%). Substances used for “preventative medication” were propranolol (n = 1) and zonisamid (n = 1). None of the participants needed medical care at an emergency unit or outpatient clinic on a regular basis, but in total 5 (13.5%) patients have visited the hospital and 13 (35.1%) patients have visited the GP due to migraine attacks since they were diagnosed. Triggering situations were indicated in 30 (81.1%) of migraine responses (Fig. 2). Triggering hobbies were noted in 6 (16.2%) of migraineurs, mostly use of digital media. Triggers for going-out mainly included concerts and clubbings, as depicted in Fig. 3. In 13 to 17-year-olds (Fig. 3), problems with sex were stated by 1 (4.3%) of 23 migraineurs, sex influenced migraine for the better in three (13.0%). A bad influence of the contracepting pill was reported by one (4.3%) of 13 to 17-year-olds, four (17.4%) indicated a negative influence of menstruation.
Physical functioning
Non-migraineurs skipped trendwise fewer meals than migraineurs (χ2 (1) = 4.530, p = 0.039, p.adjust = 0.108, for details see Table 1). Breakfast, morning snack, afternoon snack and dinner did not show any significance. Dietary restrictions, daily fluid intake, coffee per day or smoking did not differ between the groups.
Impairment in physical exercising due to migraine was stated by eleven (29.7%) migraineurs. A significant relationship was found between physical exercise per week and migraine (χ2 (3) = 8.091, p = 0.045): Migraineurs exercised less often ≥3 times per week than non-migraineurs did (χ2 (1) = 4.415, p = 0.036, p.adjust = 0.108).
Though migraineurs used digital media more often, it resulted in no significant difference, only mobile phone (U = 563, p = 0.097) showed a trend towards significance, with migraineurs spending more median time with their mobile phones.
Socioeconomic functioning
There was no relationship between maternal nationality and migraine (χ2 (1) = 0.781, p = 0.377), but their might been between paternal nationality and migraine (χ2 (1) = 4.356, p = 0.037, p.adjust = 0.108): Migraineurs more often had Austrian fathers than non-migraineurs.
Maternal and paternal education did not have a relationship to migraine. Neither did residence with Vienna (57.9%), or federal state, Lower Austria (38.2%) and Tyrol (3.9%). Migraineurs did not occupy a significantly smaller living space (U = 719, p = 0.979).
There were no significant results in appreciation or pressure by parents, siblings, friends, school colleagues, or teachers. Migraineurs received appreciation most frequently from parents in 36 cases (97.3%) and if pressure was applied, it was mostly by teachers in 17 cases (45.9%).
School functioning
More than a third (12 out of 37, 32%) of migraineurs think that their grades would be better without migraine. In 8 to 12-year olds, one of 14 (7.1%) suffered from headaches before a school test, two (14.3%) afterwards. In 13 to 17-year olds, one of 23 (4.3% of cases) stated that migraine influenced the choice of education. This is underlined by the results of the PedsQL 4.0 (school functioning) questionnaire [30] showing a significantly lower score in school functioning of migraineurs than non-migraineurs (U = 468, p = 0.008, p.adjust = 0.04). Migraineurs did report less good grades, represented by subjective evaluation of school achievements, than non-migraineurs (χ2 (1) = 6.338, p = 0.012, p.adjust = 0.048).
Binomial logistic regression
To determine the likelihood of certain variables causing participants to have migraine, binomial logistic regression was conducted. None of the tested variables, except for paternal nationality, showed a significant result in binomial logistic regression and therefore a causal relationship towards migraine in our cohort.
“Paternal nationality” had significant results (χ2 (1) = 4.564, p = 0.033), the coefficient of “Austria” being significant (Wald test, p = 0.047). Austrian fathers were 4.07 times more likely in migraineurs than fathers from other countries. Furthermore, children with fathers from “other country” had 75.5% lower odds to have migraine than children with fathers from Austria.
None of the other variables showed significant results in the Omnibus-Test, therefore further analysis was not performed.