Samantha Glover

Background/Objectives: Omega-3 polyunsaturated fatty acids (PUFAs) influence lipid-mediated inflammatory pathways implicated in migraine, yet randomized trial data evaluating biologic effects of omega-3 supplementation in youth with migraine remain limited. This pilot quasi-randomized clinical trial aimed to determine whether 12 weeks of omega-3 PUFA supplementation produces measurable changes in whole-blood EPA and DHA levels in children and adolescents with migraine, and to characterize changes in patient-reported measures of pain, migraine-related disability, and psychological distress. Methods: We conducted a parallel-group, quasi-randomized, double-blind, placebo-controlled trial in children and adolescents (ages 10–17) with migraine diagnosed per International Classification of Headache Disorders, 3rd edition criteria, recruited from pediatric neurology clinics at two academic medical centers. Of 57 participants allocated 1:1 to daily omega-3 PUFA supplementation (340 mg EPA + 510 mg DHA) or coconut oil placebo for 12 weeks, 44 completed the study and were analyzed. The primary outcome was change in whole-blood omega-3 PUFA index. Secondary outcomes included patient-reported measures of pain intensity, pain interference, migraine-related disability, and psychological distress. Exploratory outcomes included changes in omega-6/omega-3 and arachidonic acid/eicosapentaenoic acid (AA/EPA) ratios. Between-group differences were evaluated using ANCOVA adjusting for baseline values. Results: Omega-3 supplementation significantly altered lipid biomarker profiles. Compared with placebo, the intervention group demonstrated greater increases in omega-3 PUFA index (adjusted mean difference 1.64; 95% CI 0.94–2.35; p < 0.001) and greater reductions in omega-6/omega-3 ratio (−2.57; 95% CI −4.25 to −0.90; p = 0.003) and AA/EPA ratio (−13.52; 95% CI −21.55 to −5.49; p = 0.002), consistent with the increase in whole-blood omega-3 levels. No significant between-group differences were observed in patient-reported outcomes. Conclusions: Omega-3 PUFA supplementation significantly altered lipid biomarker profiles in youth with migraine over 12 weeks, supporting a measurable whole-blood EPA + DHA response in this proof-of-concept trial. Future larger-scale trials with longer duration are needed to evaluate clinical effects.

Background/Objectives: Migraine affects approximately 3–10% of school-aged children and up to 28% of adolescents, with prevalence increasing during adolescence. For pediatric specialty providers, increased awareness of this condition may influence patient care. This study examined pediatric dentists’ education, clinical exposure, and perceived knowledge gaps related to pediatric migraine, with the goal of identifying barriers to recognition and referral, as well as informing future training to support accurate diagnosis and interdisciplinary care. Methods: A 28-item electronic questionnaire was distributed to all members of the American Academy of Pediatric Dentistry, including pediatric dentists and postgraduate pediatric dental residents, assessing knowledge, beliefs, clinical experience, and interest in further training regarding pediatric headache/migraine management. Respondents with and without previous training were compared in terms of general understanding using t-tests; a linear regression model analyzed predictors of provider awareness regarding links between oral conditions and headache/migraine. Results: Among 315 respondents, the mean self-perceived awareness score was 2.7 ± 1.3 (on a 0–5 scale). The most frequently identified contributing factors were clenching (73.7%), bruxism (72.4%), and temporomandibular disorders (65.7%). Nearly all respondents (95.2%) reported no formal education on headache/migraine prevention, yet 78.1% agreed on the importance of understanding the relationship between oral health and headache/migraine. Respondents with prior training were significantly more aware (p < 0.001) than those without prior training. Educating families (p < 0.001), frequency of patient encounters with headache (p = 0.032), coordination with healthcare providers (p = 0.002), and access to appropriate management resources (p < 0.001) were significant predictors of providers’ awareness. Conclusions: Pediatric dental providers expressed strong interest in enhancing their knowledge of headache/migraine management, highlighting the value of integrating headache/migraine-related education into training programs and promoting greater interdisciplinary collaboration.