Pain Neuroscience Education: A Pilot Trial in Pediatric Primary Headache

Background: Pain neuroscience education (PNE) improves the functional outcomes of adults with chronic pain, and may also benefit children with chronic pain. We assessed pediatric primary headache patients' baseline understanding of PNE through interviews and standardized questionnaires, and piloted an educational intervention using a 3D brain model. Methods: Seventeen patients, aged 12-18 with primary headaches, completed the interview, pre-intervention Concept of Pain Inventory (COPI), and an educational session. Twelve of these participants completed the post-intervention COPI. The patients completed the validated COPI at a regular clinic visit, and completed interviews focused on their concepts of and relation to their pain symptoms, used to tailor education to individual understanding. PNE included a presentation of a 3D-printed brain model (printed from a brain MRI) and a ten-minute discussion. The session concluded with a post-intervention COPI to gauge the intervention's impact on the subjects' views of primary headache. Results: Comparison of pre- and post- intervention COPI scores revealed an average 9.5 point score increase (p=0.002). Overall low pre-intervention scores suggested a low baseline alignment with the concepts of PNE, additionally supported by the interview answers. The participants were generally interested in learning more about PNE, and were teachable as indicated by the significant COPI score increase. Conclusions: Pediatric primary headache patients are typically not well-versed in central concepts of PNE, but interactive sessions can increase understanding. 3D brain models can be an effective vehicle for delivering PNE. These findings support further research on the efficacy of PNE in the setting of pediatric headache.