{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T09:59:35Z","timestamp":1785319175393,"version":"3.55.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/100009997","name":"International Headache Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009997","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Cephalalgia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>New daily persistent headache (NDPH) is a primary headache disorder that often presents in adolescence. Presently, there is no effective treatment for NDPH and a paucity of clinical trials exploring therapeutic options. In this study, we explored the relative benefit of currently used treatments to help inform future trials and clinical decision-making.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this retrospective chart review study, patients aged 5\u201317 years with abrupt onset continuous headache and headache duration of at least one month (constituting NDPH or probable NDPH) were identified based on responses to a Headache Questionnaire in child neurology clinic and confirmed with chart review. We included all treatments (transitional therapy, preventive supplement, preventive medication and preventive non-medication therapy) started during continuous headache until both break in continuous headache and sustained improvement in headache were achieved. For treatments tried by at least 10 patients and for the first treatment tried in each category, we calculated proportions of any documented benefit, including \u201cSignificant\u201d (\u226530% improvement lasting \u22654 weeks) and \u201cSome improvement\u201d (all other improvement) and proportions of negative outcome (those with worsened headaches or side effects warranting discontinuation), as well as median time to treatment. We used multivariable regression modeling to examine for factors associated with headache outcomes. Treatments may have overlapped.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 165 patients, the largest proportion of patients experienced benefit with the first transitional therapy (62\/108; 57%), which was usually intravenous medications \u00b1 oral corticosteroids. The first supplement tried, usually riboflavin \u00b1 magnesium, offered benefit in (36\/118; 31%), with few negative outcomes (3\/118; 3%). The first prescription preventive tried, usually amitriptyline or topiramate, offered similar benefit (37\/106; 35%) as the first supplement, but with more negative outcomes (25\/106; 24%). Despite being tried after oral preventives, onabotulinumtoxinA injections offered benefit to the largest proportion of patients (14\/20; 70%) without negative outcomes (0%). Overall, the time to first therapy was weeks to months into continuous headache: shortest for transitional therapies (median = 49 days, interquartile range = 17\u201392 days), and longest for non-medication therapies (median = 144 days, interquartile range = 61\u2013381 days). Increased time to any first treatment was associated with decreased odds of headache improvement at one-year follow-up (odds ratio = 0.823, 95% confidence interval = 0.715\u20130.946,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Children and adolescents with new onset continuous headache experience treatment delays which are associated with worse outcomes. Clinicians should consider use of transitional therapies in combination with preventive treatments as early as possible. Prospective natural history studies and trials are needed to improve treatment outcomes for pediatric patients with NDPH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03331024261426562","type":"journal-article","created":{"date-parts":[[2026,6,19]],"date-time":"2026-06-19T09:32:07Z","timestamp":1781861527000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment outcomes in new daily persistent headache in children and adolescents"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0009-0002-2544-9958","authenticated-orcid":false,"given":"Nassim","family":"Abuhalaweh","sequence":"first","affiliation":[{"name":"University of Pennsylvania"},{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0911-7905","authenticated-orcid":false,"given":"Amy A.","family":"Gelfand","sequence":"additional","affiliation":[{"name":"Department of Neurology, Child &amp; Adolescent Headache Program, University of California San Francisco, San Francisco, CA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-3541-4680","authenticated-orcid":false,"given":"Morgan","family":"Evans","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5350-3853","authenticated-orcid":false,"given":"Blanca","family":"Marquez de Prado","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4996-2457","authenticated-orcid":false,"given":"Carlyn","family":"Patterson Gentile","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"},{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nichelle","family":"Raj","sequence":"additional","affiliation":[{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1598-7536","authenticated-orcid":false,"given":"Andrew D.","family":"Hershey","sequence":"additional","affiliation":[{"name":"Division of Neurology, Cincinnatti Children's Hospital & Medical Center"},{"name":"Department of Pediatrics, University of Cincinnati School of Medicine, San Cincinnatti, OH, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4786-8889","authenticated-orcid":false,"given":"Christina L.","family":"Szperka","sequence":"additional","affiliation":[{"name":"University of Pennsylvania"},{"name":"Children's Hospital of Philadelphia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,6,19]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102417738202"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.1727"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-019-1022-z"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000137039.08724.18"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.15050"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0b013e3181dad5de"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-022-01011-3"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/03331024221131331"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420920644"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.3390\/diagnostics11030385"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1177\/03331024241282803"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.14643"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.13810"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2020.09.014"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/head.12939"},{"key":"e_1_3_2_18_2","volume-title":"R: a language and environment for statistical computing","author":"R Core Team","year":"2020","unstructured":"R Core Team. 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Onset, characteristics, treatments, and burden of new daily persistent headache: initial data from the NDPH Patient Experience Survey. 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