Kathryn Sawyer1, Kathleen R Bell2, Dawn M Ehde3, Nancy Temkin4, Sureyya Dikmen5, Rhonda M Williams6, Tiara Dillworth3, Jeanne M Hoffman3. 1. Department of Rehabilitation Medicine, University of Washington, Seattle, WA. Electronic address: kasawyer@uw.edu. 2. Department of Physical Medicine and Rehabilitation, University of Texas Southwest Medical Center, Dallas, TX. 3. Department of Rehabilitation Medicine, University of Washington, Seattle, WA. 4. Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Department of Neurological Surgery, University of Washington, Seattle, WA; Department of Biostatistics, University of Washington, Seattle, WA. 5. Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Department of Neurological Surgery, University of Washington, Seattle, WA; Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA. 6. Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Veterans Affairs Puget Sound Healthcare System, Seattle, WA.
Abstract
OBJECTIVE: To examine headache trajectories among persons with mild traumatic brain injury (MTBI) in the year after injury and the relation of headache trajectory to posttraumatic stress disorder (PTSD) at 1 year postinjury. DESIGN: Prospective, longitudinal study. SETTING: Participants were recruited through a university medical center and participated in follow-up assessments by telephone. PARTICIPANTS: Prospectively enrolled individuals (N=212) within 1 week of MTBI who were hospitalized for observation or other system injuries. Participants were assessed at baseline and 3, 6, and 12 months postinjury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants rated average headache pain intensity using the 0 to 10 numerical rating scale at each assessment period. The PTSD Checklist-Civilian Version was completed at 12 months postinjury. RESULTS: Latent class growth analysis produced a 4-trajectory group model, with groups labeled resolved, worsening, improving, and chronic. Multivariate regression modeling revealed that younger age and premorbid headache correlated with membership in the worse trajectory groups (worsening and chronic; P<.001). Univariate regression revealed a significant association between PTSD and membership in the worse trajectory groups (P<.001). CONCLUSIONS: Headache is common in the year after MTBI, with younger people, persons who previously had headaches, and persons with PTSD more likely to report chronic or worsening headache. Further research is needed to examine whether PTSD symptoms exacerbate headaches or whether problematic headache symptoms exacerbate PTSD.
OBJECTIVE: To examine headache trajectories among persons with mild traumatic brain injury (MTBI) in the year after injury and the relation of headache trajectory to posttraumatic stress disorder (PTSD) at 1 year postinjury. DESIGN: Prospective, longitudinal study. SETTING:Participants were recruited through a university medical center and participated in follow-up assessments by telephone. PARTICIPANTS: Prospectively enrolled individuals (N=212) within 1 week of MTBI who were hospitalized for observation or other system injuries. Participants were assessed at baseline and 3, 6, and 12 months postinjury. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participants rated average headache pain intensity using the 0 to 10 numerical rating scale at each assessment period. The PTSD Checklist-Civilian Version was completed at 12 months postinjury. RESULTS: Latent class growth analysis produced a 4-trajectory group model, with groups labeled resolved, worsening, improving, and chronic. Multivariate regression modeling revealed that younger age and premorbid headache correlated with membership in the worse trajectory groups (worsening and chronic; P<.001). Univariate regression revealed a significant association between PTSD and membership in the worse trajectory groups (P<.001). CONCLUSIONS:Headache is common in the year after MTBI, with younger people, persons who previously had headaches, and persons with PTSD more likely to report chronic or worsening headache. Further research is needed to examine whether PTSD symptoms exacerbate headaches or whether problematic headache symptoms exacerbate PTSD.
Authors: Raquel C Gardner; Jing Cheng; Adam R Ferguson; Ross Boylan; John Boscardin; Ross D Zafonte; Geoffrey T Manley Journal: J Neurotrauma Date: 2019-05-24 Impact factor: 5.269
Authors: Laura Kathleen Langer; Mark Theodore Bayley; David Wyndham Lawrence; Paul Comper; Alice Kam; Alan Tam; Cristina Saverino; Catherine Wiseman-Hakes; Lesley Ruttan; Tharshini Chandra; Evan Foster; Jonathan Gladstone Journal: Cephalalgia Date: 2022-05-11 Impact factor: 6.075