This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. This ongoing study of children and adolescents with headache is designed to measure their reactivity both subjectively and physiologically to a novel, reversible stressor - cold water immersion of the arm. Blood pressure and pulse ratings are taken, then the arm is immersed up to the elbow in ice water at 10 degrees Centigrade. The subjects report how uncomfortable the water is each 10 seconds for 40 seconds on a 10-point scale (from no discomfort to so uncomfortable they want to remove the arm). They are instructed that they can remove the arm whenever they want. Blood pressure and pulse are repeated immediately after the test. The results of this study may shed light on the mechanism causing headache as well as determining who might best benefit from behavioral treatment for headache. A parallel pilot study currently in progress utilizes heart rate variability (HRV) to determine if adolescent migraineurs have autonomic nervous system (ANS) dysfunction when compared to matched healthy, non-headache control subjects. If, in fact, this new pilot study showed ANS dysfunction, AND the current cold pressor study identified ANS 'reactors' (i.e., increased pulse and blood pressure responses) the pieces would be in place for the design of a treatment study. This future treatment study might examine the hypothesis that: (1). Adolescent migraineurs have evidence for ANS dysfunction; (2) CPT with BP and pulse measures might identify this dysfunction at intake into a behavioral treatment program; and (3) clinical improvement might be related to improvement in ANS function as measured by HRV (or perhaps its proxy - CPT with BP/Pulse testing).
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