Do Neuropsychiatric Comorbidities Influence The Outcome of Goni For Headache Prevention In Children?

Objective: We aim to evaluate if the presence of neuropsychiatric comorbidities influences Greater occipital nerve injections (GONI) response for preventative childhood headaches. Methods: All paediatric patients with a primary headache diagnosis seen in the period April 2022- March 2023 in the Headache Service of Great Ormond Street Hospital for Children in London, UK. Patients were divided in a GONI cohort, for patients underwent GONI to manage headache, and NO GONI cohort for patients that used oral preventative treatment. Our primary outcome was response to treatment, considered as a >50% reduction in monthly headache days following twelve weeks from the preventative therapy initiation (GONI or oral treatments). Results: A total of n=343 patients were included, of which 141 with follow up data for GONI and 137 in the NO GONI cohor. The most frequent diagnoses were migraine without aura, migraine with aura and NDPH. 48% of the GONI cohort had previous neuropsychiatric diagnosis vs. 41% in the NO GONI. For our primary outcome, 59% (n=83) of the GONI population showed >50% reduction in monthly headache days vs. 55.5% (n= 76) of the NO GONI cohort. There was no significant difference in GONI response in patients with neuropsychiatric comorbidities respect to those without (χ2=0.1), while neuropsychiatric comorbidities influence oral prevention in the NO GONI population (χ2=0.04). Conclusion: In our sample the presence of psychiatric comorbidities did not influence the effe