Search Our Scientific Publications & Authors

Diagn Interv Radiol 2020 May 21. Epub 2020 May 21.

Purpose: Nusinersen is a drug approved in December 2016 for treatment of spinal muscular atrophy (SMA). We want to share our initial experience with image-guided, non-image-guided, and port-delivered nusinersen injections in a large single-center SMA patient cohort, treating both pediatric and adult patients with focus on technical considerations and other patient concerns from a combined perspective of patient, neurologist, and radiologist.

Methods: All nusinersen injections between February 2017 and September 2018 were retrospectively reviewed. Read More

J Cerebrovasc Endovasc Neurosurg 2019 Sep 30;21(3):163-168. Epub 2019 Sep 30.

Department of Neurosurgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Sinus pericranii (SP) is a rare vascular anomaly of the scalp that consists of an abnormal pericranial venous channel connected to adjacent dural venous sinuses. Most SP are asymptomatic and are found in the pediatric age group. We aim to report a case of symptomatic SP in adult and describe the clinical, radiological, and pathohistological findings to help understand and differentiate this lesion from other scalp lesions. Read More

J Health Psychol 2019 Nov 1:1359105319884596. Epub 2019 Nov 1.

Boston Children's Hospital, USA.

This study examined parenting factors associated with children's self-regulation and physician-rated treatment adherence using a self-determination theory framework in pediatric chronic headache. Participants were 58 children and adolescents (aged 10-17 years), who underwent initial and follow-up multidisciplinary evaluation at a headache clinic, and their mothers. Regression analyses showed that higher maternal autonomy support and structure were significantly related to children's lower treatment-related reactance and higher adherence. Read More

Autoimmun Rev 2019 Oct 8;18(10):102363. Epub 2019 Aug 8.

Institute of Pediatrics, Fondazione Policlinico Universitario Agostino Gemelli, IRCCS, Rome, Italy.

The contribution of autoimmune phenomena to dysfunction of hypophysis or hypothalamus is far to be unraveled and also the specific pathways of hypophysitis are poorly understood until now, mostly for the pediatric population. Primary hypophysitis is rare in children and often regarded as an autoimmune disorder, following the evidence of lymphoplasmacytic infiltration in the pituitary gland, detection of anti-pituitary antibodies (APA) and anti-hypotalamus antibodies (AHA) by indirect immunofluorescence on cryostatic sections of human or primate hypophysis and hypothalamus, and coexistence with other autoimmune disorders. The rarity of this condition and the lack of ad hoc studies make hard any assessment of the real incidence of hypophysitis in pediatric patients, and also the role of APA and AHA has been poorly investigated in children with idiopathic hypopituitarism. Read More

Psychooncology 2019 09 16;28(9):1901-1909. Epub 2019 Jul 16.

Patient Partner, Toronto, Ontario, Canada.

Objective: Today, more than 80% of children diagnosed with cancer are expected to survive. Despite the high prevalence of pain associated with the diagnosis and treatment of childhood cancer, there is a limited understanding of how having cancer shapes children's experience and meaning of pain after treatment has ended. This study addresses this gap by exploring childhood cancer survivors' (CCS') experiences of pain from their perspective and the perspective of their parents. Read More

Neurogastroenterol Motil 2019 06;31 Suppl 2:e13604

Division of Gastroenterology, Department of Pediatrics, Medical College of Wisconsin, Milwaukee, Wisconsin.

The increasing recognition of cyclic vomiting syndrome (CVS) in adults prompted the development of these evidence-based guidelines on the management of CVS in adults, which was sponsored by the American Neurogastroenterology and Motility Society (ANMS) and the Cyclic Vomiting Syndrome Association (CVSA). GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) framework was used and a professional librarian performed the literature search. The expert committee included the President of the CVSA who brought a patient perspective into the deliberations. Read More

Urol Int 2019 22;103(2):202-210. Epub 2019 May 22.

Department Urology-Pediatric Urology, UZ Leuven, Leuven, Belgium,

Purpose: A low-pressure bladder in children with neuropathic bladder dysfunction can be achieved using anticholinergic medication. Due to the significant side effects of oral oxybutynin, our patients are treated with daily intravesical oxybutynin instillations. Newer oral anticholinergic medication, such as fesoterodine, claim to have fewer side effects in a once daily formulation. Read More

Front Neurol 2019 12;10:364. Epub 2019 Apr 12.

Dipartimento di Promozione della Salute, Materno-Infantile, di Medicina Interna e Specialistica di Eccellenza "G. D'Alessandro", University of Palermo, Palermo, Italy.

Pediatric migraine remains still a challenge for the headache specialists as concerns both diagnostic and therapeutic aspects. The less ability of children to describe the exact features of their migraines and the lack of reliable biomarker for migraine contribute to complicate the diagnostic process. Therefore, there's need for new effective tools for supporting diagnostic and therapeutic approach in children with migraine. Read More

Pain Rep 2018 Sep 11;3(Suppl 1):e680. Epub 2018 Sep 11.

Department of Clinical Child and Adolescent Psychology and Psychotherapy, University of Trier, Trier, Germany.

Introduction: Fear of pain seems to be a key factor in the development and maintenance of chronic pain and pain-related disability. Interoceptive fear conditioning is assumed to constitute an important mechanism in the origins and maintenance of fear of pain. If conditioned stimuli such as internal bodily sensations are repeatedly paired with pain (unconditioned stimulus), they in turn elicit a conditioned fear response, including defence mobilization such as startle modulation and changes in heart rate and electrodermal activity. Read More

Headache 2018 Apr 22;58(4):512-524. Epub 2018 Jan 22.

Montefiore Medical Center, Bronx, NY, USA.

Objective: To assess the impact of parental migraine on adolescents (aged 13-21 years) living within the parental home from the adolescent's perspective.

Background: Family members are affected by their parent's migraine. We surveyed adolescents on the social, academic, and emotional effects of their parent's migraine. Read More

Pediatr Emerg Care 2020 Jun;36(6):e310-e317

From the Children's Hospital of Eastern Ontario.

Objective: The aim of this study was to explore the perspectives of families regarding their expectations and experience of visiting the emergency department (ED) for migraine.

Methods: This was a qualitative study involving the families of 25 patients aged 10 to 18 years receiving ED care for acute migraine. Following their visit, independent semistructured telephone interviews were conducted with both the patient and parent or guardian. Read More

Case Rep Radiol 2017 31;2017:2467085. Epub 2017 Jan 31.

French Medical Institute for Children (FMIC), Kabul, Afghanistan.

A 10-year-old boy with the history of headache, anorexia, and vomiting was referred to our department to undergo a brain CT scan. CT images demonstrated a well-defined, rounded, hyperdense lesion at the level of the foramen of Monro causing moderate dilatation of the lateral ventricles. An 11-year-old girl with a long history of a headache was also referred to undergoing a brain MRI. Read More

J Pain 2017 06 18;18(6):637-644. Epub 2017 Jan 18.

Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Headache Center, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio. Electronic address:

We compared headache frequency trajectories between clinical trial participants who received cognitive-behavioral therapy (CBT) and amitriptyline (CBT+A) or headache education (HE) and amitriptyline (HE+A) to determine if there was a differential time course of treatment response between the groups. One hundred thirty-five patients (age 10-17 years) diagnosed with chronic migraine participated, attending 8 one-hour one-on-one CBT or HE sessions with a trained psychologist for 8 weekly sessions, 2 sessions at weeks 12 and 16, and a post-treatment visit at week 20. Participants kept daily headache diaries and completed take-home assignments between visits. Read More

J Pain 2017 04 3;18(4):366-375. Epub 2016 Dec 3.

Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues, Barcelona, Catalonia, Spain. Electronic address:

Migraine with aura is a subtype of migraine characterized by transient neurological disturbances that usually precede headache. Cortical spreading depression (CSD) is the likely pathophysiological correlate of the aura phase of migraine, found in common and rare forms of migraine, such as familial hemiplegic migraine. CSD is a depolarization wave that propagates across the cerebral gray matter transiently suppressing neuronal activity. Read More

Acad Med 2016 11;91(11):1509-1515

R.E. Hawkins is vice president, Medical Education Outcomes, American Medical Association, Chicago, Illinois. M.B. Irons is senior vice president, Academic Affairs, American Board of Medical Specialties, Chicago, Illinois. C.M. Welcher is senior policy analyst, Medical Education Outcomes, American Medical Association, Chicago, Illinois. M.V. Pouwels is director, Medical Education Collaborations, American Medical Association, Chicago, Illinois. E.S. Holmboe is senior vice president, Milestone Development and Evaluation, Accreditation Council for Graduate Medical Education, Chicago, Illinois. E.J. Reisdorff is executive director, American Board of Emergency Medicine, East Lansing, Michigan. J.M. Cohen is director, Education, Department of Neurology, Mount Sinai Continuum; Headache Fellowship program director, Headache Institute and Adolescent Headache Center, Mount Sinai Roosevelt Hospital; and assistant professor of neurology, Icahn School of Medicine at Mount Sinai, New York, New York. S. Dentzer is senior policy adviser, Robert Wood Johnson Foundation, Washington, DC. D.G. Nichols is president and chief executive officer, American Board of Pediatrics, Chapel Hill, North Carolina. C.A. Lien is professor and vice chair for academic affairs, Department of Anesthesiology, Weill Cornell Medical Center, New York, New York. T.D. Horn is executive director, American Board of Dermatology, Newton, Massachusetts. R.B. Noone is executive director, American Board of Plastic Surgery, Philadelphia, Pennsylvania. R.S. Lipner is senior vice president, Evaluation, Research and Development, American Board of Internal Medicine, Philadelphia, Pennsylvania. K.W. Eva is associate director and senior scientist, Centre for Health Education Scholarship, and professor and director of education research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. J.J. Norcini is president and chief executive officer, Foundation for Advancement of International Medical Education and Research, Philadelphia, Pennsylvania. L.M. Nora is president and chief executive officer, American Board of Medical Specialties, Chicago, Illinois. J.P. Gold is chancellor, University of Nebraska Medical Center, Omaha, Nebraska.

This article describes the presentations and discussions at a conference co-convened by the Council on Medical Education of the American Medical Association (AMA) and by the American Board of Medical Specialties (ABMS). The conference focused on the ABMS Maintenance of Certification (MOC) Part III Examination. This article, reflecting the conference agenda, covers the value of and evidence supporting the examination, as well as concerns about the cost of the examination, and-given the current format-its relevance. Read More

J Pain 2016 08 19;17(8):855-873.e8. Epub 2016 Apr 19.

IWK Health Centre, Halifax, Nova Scotia, Canada.

Unlabelled: Little is known about childhood and adolescent risk and prognostic factors for recurrent headaches. This systematic review 1) examined longitudinal evidence about factors associated with onset and course of recurrent headaches in childhood or adolescence, using meta-analysis where possible, and 2) evaluated the quality of this evidence using a modified Grading of Recommendations Assessment, Development and Evaluation framework. Through searching electronic databases, reference lists of included studies, and an electronic mail list we identified and included 23 articles reporting 19 cohorts. Read More

J Pain 2016 06 10;17(6):694-706. Epub 2016 Mar 10.

MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati, College of Medicine, Cincinnati, Ohio.

Unlabelled: To investigate the spatial heterogeneity of cortical excitability in adolescents with migraine, magnetoencephalography (MEG) recordings at a sampling rate of 6,000 Hz were obtained from 35 adolescents with an acute migraine and 35 age- and sex-matched healthy control participants during an auditory-motor task. Neuromagnetic activation from low- to high-frequency ranges (5-1,000 Hz) was measured at sensor and source levels. The heterogeneity of cortical excitability was quantified within each functional modality (auditory vs motor) and hemispherical lateralization. Read More

Acta Neurochir (Wien) 2015 Sep 30;157(9):1587-93. Epub 2015 Jul 30.

Department of Neurosurgery, Hacettepe University School of Medicine, Ankara, Turkey,

Purpose: Chordoma is a rare neoplasm that arises from embryonic notochordal remnants along the axial skeleton (i.e., clivus, sacrum) and the vertebral bodies. Read More

J Headache Pain 2014 Mar 18;15:15. Epub 2014 Mar 18.

Headache Center, C, Mondino National Institute of Neurology Foundation, IRCCS, University of Pavia, Pavia, Italy.

Headache is one of the most common disorders in childhood, with an estimated 75% of children reporting significant headache by the age of 15 years. Pediatric migraine is the most frequent recurrent headache disorder, occurring in up to 28% of older teenagers. Headaches rank third among the illness-related causes of school absenteeism and result in substantial psychosocial impairment among pediatric patients. Read More

J Pain 2013 Oct 19;14(10):1196-207. Epub 2013 Jul 19.

School of Therapeutic Sciences, SRH University Heidelberg, Heidelberg, Germany. Electronic address:

Unlabelled: Migraine and tension-type headache have a high prevalence in children and adolescents. In addition to common pharmacologic and nonpharmacologic interventions, music therapy has been shown to be efficient in the prophylaxis of pediatric migraine. This study aimed to assess the efficacy of specific music therapy techniques in the treatment of adolescents with primary headache (tension-type headache and migraine). Read More

J Pain 2013 Dec 21;14(12):1553-63. Epub 2013 Jun 21.

Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio; Department of Neurology, University of Cincinnati, College of Medicine, Cincinnati, Ohio. Electronic address:

Unlabelled: To quantitatively assess cortical dysfunction in pediatric migraine, 31 adolescents with acute migraine and age- and gender-matched controls were studied using a magnetoencephalography (MEG) system at a sampling rate of 6,000 Hz. Neuromagnetic brain activation was elicited by a finger-tapping task. The spectral and spatial signatures of magnetoencephalography data in 5 to 2,884 Hz were analyzed using Morlet wavelet and beamformers. Read More

Neuropsychiatr Dis Treat 2013 6;9:351-5. Epub 2013 Mar 6.

Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Department of Mental Health, Physical, and Preventive Medicine, Second University of Naples, Naples.

Background: Migraine without aura is a primary headache which is frequent and disabling in the developmental age group. No reports are available concerning the prevalence and impact of migraine in children on the degree of stress experienced by parents. The aim of this study was to evaluate the prevalence of maternal stress in a large pediatric sample of individuals affected by migraine without aura. Read More

Neuropsychiatr Dis Treat 2012 1;8:509-13. Epub 2012 Nov 1.

Center for Childhood Headache, Clinic of Child and Adolescent Neuropsychiatry, Second University of Naples, Naples.

Background: The purpose of this study was to assess the cognitive functioning of children affected by headache, pinpointing the differences in intelligence style between subjects affected by migraine without aura and subjects with tension-type headache.

Methods: The study population consisted of 147 children (mean age 10.82 ± 2. Read More

Cogn Behav Pract 2012 Feb;19(1):56-67

Pediatric Pain Program, David Geffen School of Medicine at UCLA.

Chronic pain disorders represent a significant public health concern, particularly for children and adolescents. High rates of comorbid anxiety and unipolar mood disorders often complicate psychological interventions for chronic pain. Unified treatment approaches, based on emotion regulation skills, are applicable to a broad range of emotional disorders and suggest the possibility of extending these interventions to chronic pain and pain-related dysfunction. Read More

Paediatr Drugs 2009 ;11(3):203-26

Wolters Kluwer Health mid R: Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Philadelphia, Pennsylvania, USA.

Atomoxetine (Strattera(R)) is a selective norepinephrine (noradrenaline) reuptake inhibitor that is not classified as a stimulant, and is indicated for use in patients with attention-deficit hyperactivity disorder (ADHD). Atomoxetine is effective and generally well tolerated. It is significantly more effective than placebo and standard current therapy and does not differ significantly from or is noninferior to immediate-release methylphenidate; however, it is significantly less effective than the extended-release methylphenidate formulation OROS(R) methylphenidate (hereafter referred to as osmotically released methylphenidate) and extended-release mixed amfetamine salts. Read More

Pediatr Transplant 2010 Nov 5;14(7):E83-5. Epub 2010 Aug 5.

Department of Pediatric Nephrology, Hacettepe University School of Medicine, Ankara, Turkey.

IIH is a syndrome of increased intracranial pressure characterized by headache, visual disturbance, papilledema with normal cranial neuroimaging. It is associated with many factors in childhood. From the renal perspective renal insufficiency, chronic dialysis, steroid treatment, and recombinant human growth hormone have been associated with IIH. Read More

J Altern Complement Med 2009 Feb;15(2):197-200

M. Modern TCM Clinic, Melbourne, Victoria, Australia.

Background: A 13-year-old girl who suffered from basilar invagination managed with electroacupuncture and Chinese Herbal medicine is presented in this report. This is a rare disease. The condition was misdiagnosed by many biomedical specialists over a period of 5 years. Read More

Clin J Pain 2009 Jan;25(1):58-64

Department of Clinical Psychology and Psychotherapy, Georg-Elias-Müller-Institute of Psychology, University of Göttingen, Göttingen, Germany.

Background: The objective of the present study was to assess the concordance between parent and child report regarding different domains of pediatric health, headache in particular. In addition, the influence of potential moderator variables on the agreement between parents and children was examined.

Methodology: In an epidemiologic study on a randomly drawn sample of households with at least 1 child in the family between 7 and 14 years of age (community registries), various pediatric health disturbances (headache, other pains, somatic symptoms, and depression/anxiety) were assessed via both child (from the age of 9 y on) and parent report (n=3461). Read More

Headache 2008 Jul;48(7):994-1004

The Research Institute at Nationwide Children's Hospital and The Ohio State University, Columbus, OH 43205-2696, USA.

Objective: To use a case-control design to evaluate the emotional and behavioral functioning of children with migraine.

Background: Research has indicated that children with migraine are at increased risk for emotional and behavioral problems such as depression and anxiety; however, methodological limitations in sample definitions, measurement strategies, and comparison groups remain problematic.

Method: Forty-seven participants diagnosed with migraine at a pediatric headache center participated in a home-based study of child functioning using standardized measures. Read More

Paediatr Anaesth 2008 Oct 30;18(10):957-66. Epub 2008 Jul 30.

Department of Anaesthesia and Pain Management, Addenbrooke's Hospital NHS Trust, Cambridge, UK.

Background: There is a lack of information about the prevalence, manifestations, and management of chronic pain in children in the UK. We surveyed consultants with an interest in chronic pain management and general practitioners (GPs) in the UK in order to understand their perspective on chronic pain in children.

Methods: We conducted a postal survey of clinicians with an interest in chronic pain management and GPs in the UK. Read More

Dev Med Child Neurol 2008 Jul;50(7):541-5

Department of Pediatrics, Royal University Hospital and University of Saskatchewan, Saskatoon, Canada.

The aim of our observational study was to highlight some clinical observations on chronic daily headache (CDH) in children and adolescents. Data on patients < or =18 years aged presenting with CDH to the Pediatric Headache Clinic at the Royal University Hospital, Saskatoon, Canada, were collected prospectively and sequentially from February 2004 to July 2006. Standardized data sheets and definitions were used. Read More

Dev Med Child Neurol 2008 Jul;50(7):484

Department of Neurology, Royal Manchester Children's Hospital, Manchester, UK.

Annu Rev Nurs Res 2003 ;21:95-121

Theresa A. Thomas Faculty, School of Nursing, University of Virginia, Charlottesville, VA, USA.

This chapter summarizes and critiques research on physical symptoms in children and adolescents from a developmental science perspective. Studies conducted by researchers from various disciplines, primarily after 1990, were identified through searches of MEDLINE, CINAHL, and Psyc INFO. This review focuses on two areas: the prevalence of common physical symptoms--headache, abdominal pain or discomfort, musculoskeletal pain and fatigue--in pediatric populations and the developmental issues associated with these symptom experiences. Read More

J Pediatr Nurs 2001 Dec;16(6):392-401

School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

Functional headache, by definition, is a headache not associated with organic diseases. It is a common symptom in school children and can cause potentially serious health problems, affecting their growth and development. Therefore, this report synthesizes the literature about functional headaches in schoolchildren from a psychosocial perspective. Read More

Headache 2000 Mar;40(3):200-3

Department of Pediatrics, Children's Hospital of the King's Daughters, Eastern Virginia Medical School, Norfolk, USA.

Objectives: Our goals were (1) to investigate the causes of acute headache in childhood from the emergency department perspective and (2) to search for clinical clues that might distinguish headache associated with serious underlying disease.

Background: The clinical presentation of headache in children and adolescents can be separated into 5 temporal patterns: acute, acute-recurrent, chronic progressive, chronic nonprogressive, and mixed. Few data exist regarding acute headache in children. Read More

Pediatrics 1999 Sep;104(3 Pt 2):623-6

Departments of Pediatrics and Pharmacology, Children's Hospital, University of Helsinki, Helsinki, Finland.

A considerable number of patients have to be recruited in a clinical trial to obtain solid results. In pediatric studies, patient recruitment is frequently problematic. In the simple common childhood illnesses, the number of recruitable patients is certainly large, but they may be hard to reach, and the imbalance between potential benefit and inconvenience of participation may reduce motivation to enroll. Read More

Semin Pediatr Neurol 1995 Jun;2(2):119-26

Pediatric Headache Clinic, University of Maryland School of Medicine, Baltimore 21201, USA.

The primary care physician is often the first professional to evaluate the child with headaches. This article reviews the most common causes of headache, including infections, trauma, hypertension, pseudotumor cerebri, postlumbar puncture headaches, and ocular disorders. Most children with headache can be evaluated and treated by their primary care physician. Read More

Mayo Clin Proc 1994 Nov;69(11):1098-107

Division of Nephrology, Childrens Hospital of Los Angeles, California.

Objective: To provide an overview of clinical aspects of hypertension in pediatric patients.

Design: The recommended diagnostic studies and the management options for increased blood pressure levels in prepubertal and adolescent patients are reviewed.

Results: In pediatric patients with three consecutive blood pressure measurements that exceed the 95th percentile, a hypertension-oriented personal and family history should be elicited, and a focused physical examination should be conducted for evidence of target organ damage, left ventricular hypertrophy, and potential causes of secondary hypertension. Read More

Pediatr Rev 1992 Jul;13(7):248-55

Department of Pediatrics, University of Arizona Health Sciences Center, Tucson 85724.

Clin Pediatr (Phila) 1992 May;31(5):279-82

Division of Pediatric Neurology, University of Connecticut Health Center, Farmington 06030.

One hundred eight out of 256 (42%) surveys were completed by registered school nurses (SNs) working in the Connecticut public school system. Of the 108 respondents, 99% were RNs and 1% were LPNs. Each SN spent an average of 19 working days a month at school, in elementary (71%) and/or preschool (40%) settings. Read More

Headache 1990 Sep;30(9):586-92

Davidson College.

Childhood headache is a common pediatric problem. Clinical researchers have evaluated several behavioral treatment, such as biofeedback and relaxation training, that may be viable interventions. Adding a developmental perspective to the evaluation and treatment of childhood headache is a likely way to increase the effectiveness of these strategies. Read More

Psychiatry Res 1988 Jul;25(1):59-63

Child Psychiatry Branch, National Institute of Mental Health, Bethesda, MD 20892.

Lumbar punctures are a common clinical procedure in pediatric populations, yet little systematic information about side effects or the child's perspective of the procedure is available. In a subset (n = 20) of a sample of children and adolescents with disruptive behavior disorders, we recorded children's ratings of research lumbar puncture in comparison to other hospital experiences of blood sampling, electroencephalography, and going to school. Lumbar puncture did not differ from the other procedures in terms of preference. Read More

Clin Pediatr (Phila) 1976 Dec;15(12):1114-9