title: Coenzyme Q10 deficiency and response to supplementation in pediatric and adolescent migraine.
abstract: BACKGROUND
  Coenzyme Q10 (CoQ10) has been suggested to be effective in the prevention of migraine, and levels can be quantified with standardized reference ranges.
  
  
  OBJECTIVE
  This study documents the prevalence of CoQ10 deficiency in migraine headache and examines the potential effectiveness of supplementation.
  
  
  METHODS
  We assessed patients attending a tertiary care center with frequent headaches for CoQ10 deficiency. We recommended patients with low CoQ10 levels begin supplementation with CoQ10 as part of their multidisciplinary treatment plan. We assessed response to treatment including correction of CoQ10 deficiency, overall headache improvement, and headache disability.
  
  
  RESULTS
  CoQ10 was measured in 1550 patients (mean age 13.3 +/- 3.5, range 3 to 22 years). The mean total CoQ10 level was 0.60 +/- 0.20 microg/mL (range 0.21 to 1.77 microg/mL). Of these patients, 32.9% were below the reference range. Patients with low CoQ10 were recommended to start 1 to 3 mg/kg per day of CoQ10 in liquid gel capsule formulation. In a subset of patients who returned for timely follow-up (mean, 97 days), the total CoQ10 level improved to 1.20 +/- 0.59 microg/mL (P < .0001), while the headache frequency improved from 19.2 +/- 10.0 to 12.5 +/- 10.8 (P < .001) and headache disability assessed with PedMIDAS improved from 47.4 +/- 50.6 to 22.8 +/- 30.6 (P < .001).
  
  
  CONCLUSIONS
  Deficiency of CoQ10 may be common in pediatric and adolescent migraine. Determination of deficiency and consequent supplementation may result in clinical improvement. Further analysis involving more scientifically rigorous methodology will be required to confirm this observation.
authors.affiliation: Division of Neurology, Cincinnati Children's Hospital Medical Center, 3333 Burnet Avenue, Cincinnati, OH 45229, USA.
authors.forename: Andrew D
authors.initials: AD
authors.lastname: Hershey
authors.forename: Scott W
authors.initials: SW
authors.lastname: Powers
authors.forename: Anna-Liisa B
authors.initials: AL
authors.lastname: Vockell
authors.forename: Susan L
authors.initials: SL
authors.lastname: Lecates
authors.forename: Priscilla L
authors.initials: PL
authors.lastname: Ellinor
authors.forename: Ann
authors.initials: A
authors.lastname: Segers
authors.forename: Danny
authors.initials: D
authors.lastname: Burdine
authors.forename: Paula
authors.initials: P
authors.lastname: Manning
authors.forename: Marielle A
authors.initials: MA
authors.lastname: Kabbouche
mesh_terms: D000293:Adolescent; D002648:Child; D003067:Coenzymes; D019587:Dietary Supplements; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008881:Migraine Disorders / Q000188:drug therapy* / Q000517:prevention & control; D016896:Treatment Outcome; D014451:Ubiquinone / Q000031:analogs & derivatives* / Q000097:blood / Q000172:deficiency / Q000627:therapeutic use
chemical_list: D003067:Coenzymes; D014451:Ubiquinone; C024989:coenzyme Q10