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In the Chronic Headache Program, we’re committed to expanding our understanding of chronic headaches in children and teenagers. We do this by conducting research that explores the many factors that can contribute to the development, exacerbation, maintenance, and effective management of pediatric headaches.

Our team collaborates with our colleagues in the Pain Treatment Center and other departments within Boston Children’s, as well as with other institutions and organizations across the country and around the world. Several of our current studies are funded by the National Institutes of Health and other grants. Many involve patient and family input through focus groups and other patient-led initiatives. Collectively, we are focused on novel and meaningful ways to evolve the field of chronic pain medicine.

Our investigators are currently engaged in research projects that aim to:

  • Understand how various forms of pediatric headache differ from each other based on psychological and physiological properties
  • Understand what leads to the development of chronic headaches and why some patients respond better to headache interventions than others
  • Understand the psychological and social risk factors and protective factors that can influence chronic headache presentation, persistence, and response to treatment
  • Establish the safety and effectiveness of various interventional approaches offered by our program for headache management (e.g., Botox injections for migraine, lidocaine infusions for new daily persistent headache)
  • Explore the unique experiences of LGBTQ+ and gender-diverse youth as they relate to their chronic pain as well as their experiences with our providers in the Pain Treatment Center
  • Understand the experience of headaches in youth with Chiari malformation, both pre-operatively and post-operatively, gathering directly through patient and family interviews
  • Develop and validate new measurement tools for assessing aspects of chronic headaches that were previously unexamined. These can help providers to measure improvement in symptoms with treatment. For example, our team recently designed surveys measuring avoidance behavior in youth who have headache-related light and sound sensitivities.

Email our research assistant, Hannah Rogan, at hannah.rogan@childrens.harvard.edu if you are interested in participating in any of our ongoing research studies or have additional questions.

If you are interested in learning more about other clinical research throughout Boston Children’s, you can search for studies here.

Recent publications

  • Atinuke, O.G., Heavner, K., Mangano, K.M., Morse, B., El Ghaziri, M., Thind, H. (2024). Prolonged social media use and its association with perceived stress in female college students. American Journal of Health Education. 55(3), 189-198. 
  • Clementi, M. A., Chang, Y. H., Gambhir, R., Lebel, A., & Logan, D. E. (2020). The Impact of Sleep on Disability and School Functioning: Results From a Tertiary Pediatric Headache Center. Journal of child neurology, 35(3), 221–227. https://doi.org/10.1177/0883073819887597. 
  • Faria, V., Talbert, C., Goturi, N., Borsook, D., Lebel, A., Kaptchuk, T. J., Kirsch, I., Kelley, J. M., & Moulton, E. A. (2023). Placebos in pediatrics: A cross-sectional survey investigating physicians' perspectives. Journal of Psychosomatic Research, 172, 111421. https://doi.org/10.1016/j.jpsychores.2023.111421. 
  • Flynn, H., Mote, S., Morse, B. (2022). Social media and adolescent mental health: Sounding the alarm. NASN School Nurse. 37(5), 271-276. 
  • Holmes, S. A., Mar'i, J., Lemme, J., Maallo, A. M., Lebel, A., Simons, L., O'Brien, M. J., Zurakowski, D., Burnstein, R., & Borsook, D. (2022). Evidence of Chronic Complement Activation in Asymptomatic Pediatric Brain Injury Patients: A Pilot Study. Children (Basel, Switzerland), 10(1), 45. https://doi.org/10.3390/children10010045. 
  • Holmes, S., Mar'i, J., Simons, L. E., Zurakowski, D., LeBel, A. A., O'Brien, M., & Borsook, D. (2022). Integrated Features for Optimizing Machine Learning Classifiers of Pediatric and Young Adults With a Post-Traumatic Headache From Healthy Controls. Frontiers in pain research (Lausanne, Switzerland), 3, 859881. https://doi.org/10.3389/fpain.2022.859881. 
  • Holmes, S., Mar'i, J., Simons, L. E., Zurakowski, D., LeBel, A. A., O'Brien, M., & Borsook, D. (2022). Integrated Features for Optimizing Machine Learning Classifiers of Pediatric and Young Adults With a Post-Traumatic Headache From Healthy Controls. Frontiers in pain research (Lausanne, Switzerland), 3, 859881. https://doi.org/10.3389/fpain.2022.859881. 
  • Holmes SA, Staffa SJ, Karapanagou A, Lopez N, Karian VE, Borra R, Zurakowski D, Lebel A, Borsook D. Biological laterality and peripheral nerve DTI metrics. PLoS One. 2021 Dec 16;16(12).
  • Kaczynski, K., Gambhir, R., Caruso, A., & Lebel, A. (2016). Depression as a mediator of the relation between family functioning and functional disability in youth with chronic headaches. Headache, 56(3), 491–500. https://doi.org/10.1111/head.12709. 
  • Karian VE. Getting Ahead of Your Child’s Headaches, a guide for families. 2024. Damianos Publishing. In press.
  • Karian, V.K., Morton, H., Schefter, Z.J., Smith, A., Rogan, H., Morse, B., Lebel, A. (2023). OnabotulinumtoxinA for Pediatric Migraine. Pain Management Nursing. ISSN 1524-9042, https://doi.org/10.1016/j.pmn.2023.04.006.
  • Karian VE, Yu-Hsing Chang C, Schefter ZJ, Lebel A (2022) Can Botox reduce self-injurious behavior in young patients with chronic head pain and autism/developmental delay? Autism Open Access. 12:333.
  • Karian, V.E. Getting Ahead of Pediatric Headaches, a comprehensive guide for nurse practitioners to manage headaches in children and adolescents. Damianos Publishing.
  • Kendrick, A., Fantasia, H.C., Morse, B., Willis, D. (In Press). Experiences of food insecure college students during the Covid-19 pandemic: A qualitative descriptive study. Journal of Hunger and Environmental Nutrition. 
  • Kendrick, A., Fantasia, H.C., Morse, B., Willis, D. (2022). Food insecurity among college students: A concept analysis. Nursing Forum. 57(5), 898-904. 
  • Kieran, K., Morse B., Margolis, A. (In Press). Dissociative identity disorders in schools: Part II. NASN School Nurse. 
  • Kieran, K., Morse B., Margolis, A. (In Press). Dissociative identity disorders in schools: Part I. ASN School Nurse.
  • Morse, BL, and Karian, VE, 2023. Supporting the Young Adulthood Transitions in Women With Migraine. Nursing for Women's Health.
  • Rogan H, Kim AJ, Bento SP, Smith AM, & Nelson S. Investigating depressive symptoms, stress, and basal cortisol risk in pediatric chronic pain patients. Psychoneuroendocrinology, 153, 106204. 
  • Salguero, R., Morse, B. (2024). Fostering belonging beyond the health office through inclusive language. NASN School Nurse. 39(2), 89-95. 
  • Schefter, Z., & Smith, A. M. (2024). Exploring downstream effects of gender roles in healthcare decision-making and relationships within systems: A cross-sectional analysis of openness to treatment in pediatric headache. Journal of psychosomatic research, 179, 111611. https://doi.org/10.1016/j.jpsychores.2024.111611. 
  • Smith, A.M., Silvia, M., Rogan, H., & LeBel, A.A. The Photo- and Phono-Sensitivity Avoidance Behavior Scales: Evaluating Clinical Utility in Pediatric Primary Headache. Under review. 
  • Smith, A. M., Silvia, M., Rogan, H., & Schefter, Z. J. (2024). Avoiding lights and sounds: validation of the PhotoSensitivity and PhonoSensitivity Avoidance Behavior Scales (PHOTO-SABS & PHONO-SABS) in pediatric headache. Children’s Health Care, 53(1), 76–95. https://doi.org/10.1080/02739615.2023.2189117.
  • Smith, A. M., Schefter, Z. J., & Rogan, H. (2022). Aligning with Patients and Families: Exploring Youth and Caregiver Openness to Pediatric Headache Interventions. Children (Basel, Switzerland), 9(12), 1956. https://doi.org/10.3390/children9121956. 
  • Smith, A. M., & Logan, D. E. (2021). Promoting readiness and engagement in pain rehabilitation for youth and families: Developing a pediatric telehealth motivational interviewing protocol. Paediatric & neonatal pain, 4(3), 125–135. https://doi.org/10.1002/pne2.12063. 
  • Szabo, E., Chang, Y. C., Shulman, J., Sieberg, C. B., Sethna, N. F., Borsook, D., Holmes, S. A., & Lebel, A. A. (2022). Alterations in the structure and function of the brain in adolescents with new daily persistent headache: A pilot MRI study. Headache, 62(7), 858–869. https://doi.org/10.1111/head.14360. 
  • Szabo, E., Chang, Yu-Hsing C., Shulman, J., Sieberg, C., Sethna, N., Borsook, D., Holmes, S., Lebel, A. (2022) Structural Brain Changes Are Associated with Pain Sensitivity in New Daily Persistent Headache. The Journal of Pain, Vol 23 (5). 
  • Wilcox, S.L., Nelson, S., Ludwick, A., Youssef, A. M., Lebel, A., Beccera, L., Burstein, R., Borsook, D. (2023). Hippocampal volume changes across developmental periods in female migraineurs. Neurobiology of Pain. Volume 14, 2023, 100137, ISSN 2452-073X,  https://doi.org/10.1016/j.ynpai.2023.100137.
  • Williams, M., Morse, B.L., McAuliffe, D., Degraffenried, W. (2022). Addressing stress in high school students during COVID. NASN School Nurse. 36(4), 226-232.
  • Wilson, O., Morse, B., Mote, S. (2023). Addressing vaccine hesitancy among students and families. NASN School Nurse. 38(3), 146-154.