CoQ10 linked to symptom resolution in children with New Daily Persistent Headache - Children's National

A new study from neurology experts at Children's National Hospital suggests that Coenzyme Q10 (CoQ10) may play a meaningful role in the resolution of new daily persistent headache (NDPH), a rare, debilitating and historically treatment-resistant condition in children. This study analyzed 182 pediatric patients evaluated over six years, making it the largest single-center study of NDPH ever conducted.

The research was led by pediatric neurologist Mrinmayee Takle, MD, along with co-authors Jeffrey Strelzik, MD, Raquel Langdon, MD, Abigail Turner, MD, William McClintock, MD, John Barber, MS, Armelle Dejoie, MS, Emily McCracken, BS, Olivia Goucher, BS, and senior author Marc DiSabella, DO.

Why it matters

Progress in NDPH research has been slow, particularly in the pediatric population. The condition is both rare and highly heterogeneous, making research and controlled trials challenging. Many patients present only after experiencing long-standing symptoms and multiple unsuccessful treatments, complicating efforts to isolate which interventions are truly effective. Additionally, most pediatric headache studies and all industry-sponsored clinical trials specifically exclude children with continuous daily headaches like NDPH.

These obstacles have left clinicians with little evidence-based guidance and families with a trial-and-error approach that can feel discouraging. This new analysis offers hope, highlighting potential treatment avenues and underscoring the need for prospective, controlled studies.

What the study found

Among the 182 patients studied, researchers found that CoQ10 supplementation was significantly more common among children whose headaches ultimately resolved. While other interventions including magnesium, topiramate, onabotulinum toxin A and regular aerobic exercise showed encouraging trends, CoQ10 was the only treatment associated with statistically significant improvement.

"This is the first potential treatment signal we've seen in pediatric NDPH," Dr. Takle explained. "Very few therapies have shown measurable impact in this population, so identifying an association with Coenzyme Q10 is particularly exciting." The consistency of positive trends across other migraine-related treatments also suggests that NDPH may share more therapeutic overlap with migraine than previously assumed, an insight that could help reshape how clinicians think about the disorder.

Impact on patients and care

For families, the findings offer something the field has long lacked: a more informed starting point. NDPH is notoriously treatment-resistant, and many patients cycle through medications and lifestyle adjustments with little clarity on what may help. The study's results provide clinicians with data-backed options to guide therapy, hopefully bringing relief to patients sooner.

Emphasizing lifestyle factors such as regular aerobic exercise also gives families accessible, proactive strategies that may support symptom improvement.

Children's National leads the way

Children's National houses one of the largest and most systematically characterized pediatric headache registries, enabling the type of robust analysis rarely possible in NDPH research. The hospital's multidisciplinary Headache Program, led by Dr. Marc DiSabella, has developed standardized evaluations and long-term follow-up that support high-quality data collection and clinical insight.

This study is the first to identify CoQ10 as a potential contributor to symptom resolution in pediatric NDPH, highlighting the unique role Children's National plays in advancing both scientific understanding and patient care for this challenging disorder.

Read the full study, Coenzyme Q10 Supplementation May Be Correlated With Resolution of New Daily Persistent Headache, in The Journal of Pediatric Neurology.