Family History of Migraine Associated With Posttraumatic Migraine Symptoms Following Sport-Related Concussion

Sufrinko, Alicia; McAllister-Deitrick, Jamie; Elbin, R.J.; Collins, Michael W.; Kontos, Anthony P.

doi:10.1097/htr.0000000000000315

Cited by 55 publications

(25 citation statements)

References 50 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similarly, in a study of 120 young athletes with sports-related concussion, Morgan et al. found that a family history of migraine was more prevalent in the children with persistent post-concussive symptoms compared to those without persistent symptoms (37). In contrast, in a study of 3063 children presenting with an acute head injury at a pediatric emergency department, Zemek et al.…”

Section: Discussionmentioning

confidence: 97%

Headache complexity (number of symptom features) differentiates post-traumatic from non-traumatic headaches

et al. 2020

View full text Add to dashboard Cite

Background Post-traumatic headaches are a common sequela of mild traumatic brain injury (concussion). It is unclear whether or how these headaches differ phenotypically from primary headaches. Objective Determine whether there is an overarching unobserved latent trait that drives the expression of observed features of post-traumatic headache and other headaches. Methods Data from this post-hoc analysis come from the Warrior Strong Cohort Study conducted from 2010 through 2015. Approximately 25,000 soldiers were screened for concussion history at routine post-deployment health assessments. A random sample was invited to participate, enrolling 1567. Twelve observed headache phenotypic features were used to measure “headache complexity”, the latent trait of clinical interest, using single factor confirmatory factor analysis. We compared headache complexity between groups and determined whether headache complexity predicted accessing medical care for headache. Results Of 1094 soldiers with headaches, 198 were classified as having post-traumatic headache. These headaches were compared to those in the other soldiers (647 without concussion history and 249 with concussion history). Soldiers with post-traumatic headache had greater endorsement of all 12 headache features compared to the soldiers with non-concussive headaches. The confirmatory factor analysis showed good model fit (χ2 (51) = 95.59, p = 0.0002, RMSEA = 0.03, comparative fit index = 0.99, and Tucker-Lewis index = 0.99), providing empirical support for the headache complexity construct. Soldier groups differed in their mean headache complexity level ( p < 0.001) such that post-traumatic headache soldiers had greater headache complexity compared to non-concussed soldiers (standardized mean difference = 0.91, 95% confidence interval: 0.72–1.09, p < 0.001 and to concussed soldiers with coincidental headaches standardized mean difference = 0.75, 95% confidence interval: 0.53–0.96, p < 0.001). Increasing headache complexity predicted medical encounters for headache (odds ratio = 1.87, 95% confidence interval: 1.49–2.35, p < 0.001) and migraine (odds ratio = 3.74, 95% confidence interval: 2.33–5.98, p < 0.001) during the year following deployment. Conclusions and relevance: The current study provided support for a single latent trait, characterized by observed headache symptoms, that differentiates between concussive and non-concussive headaches and predicts use of medical care for headache. The single trait confirmatory factor analysis suggests that post-traumatic headaches differ from non-concussive headaches by severity more than kind, based on the symptoms assessed. ClinicalTrials.gov identifier NCT01847040

show abstract

Section: Discussionmentioning

confidence: 97%

Headache complexity (number of symptom features) differentiates post-traumatic from non-traumatic headaches

et al. 2020

View full text Add to dashboard Cite

show abstract

“…11 Migraine is a headache type characterized by a prodrome and/or aura with associated symptoms including nausea, vomiting, and sensitivity to light, sound, or smell. 12 Pre-existing headache types place individuals at greater risk for headache following a concussion 12,13 or may be worsened following concussion with increasing frequency or severity. Patients with the headache/migraine subtype of concussion have self-reported history of headaches that differs from their pre-existing history and/or changes in their headache assessments demonstrated on validated headache scales with levels of severities.…”

Section: Methodsmentioning

confidence: 99%

Concussion Guidelines Step 2: Evidence for Subtype Classification

et al. 2019

View full text Add to dashboard Cite

BACKGROUND Concussion is a heterogeneous mild traumatic brain injury (mTBI) characterized by a variety of symptoms, clinical presentations, and recovery trajectories. By thematically classifying the most common concussive clinical presentations into concussion subtypes (cognitive, ocular-motor, headache/migraine, vestibular, and anxiety/mood) and associated conditions (cervical strain and sleep disturbance), we derive useful definitions amenable to future targeted treatments. OBJECTIVE To use evidence-based methodology to characterize the 5 concussion subtypes and 2 associated conditions and report their prevalence in acute concussion patients as compared to baseline or controls within 3 d of injury. METHODS A multidisciplinary expert workgroup was established to define the most common concussion subtypes and their associated conditions and select clinical questions related to prevalence and recovery. A literature search was conducted from January 1, 1990 to November 1, 2017. Two experts abstracted study characteristics and results independently for each article selected for inclusion. A third expert adjudicated disagreements. Separate meta-analyses were conducted to do the following: 1) examine the prevalence of each subtype/associated condition in concussion patients using a proportion, 2) assess subtype/associated conditions in concussion compared to baseline/uninjured controls using a prevalence ratio, and 3) compare the differences in symptom scores between concussion subtypes and uninjured/baseline controls using a standardized mean difference (SMD). RESULTS The most prevalent concussion subtypes for pediatric and adult populations were headache/migraine (0.52; 95% CI = 0.37, 0.67) and cognitive (0.40; 95% CI = 0.25, 0.55), respectively. In pediatric patients, the prevalence of the vestibular subtype was also high (0.50; 95% CI = 0.40, 0.60). Adult patients were 4.4, 2.9, and 1.7 times more likely to demonstrate cognitive, vestibular, and anxiety/mood subtypes, respectively, as compared with their controls (P < .05). Children and adults with concussion showed significantly more cognitive symptoms than their respective controls (SMD = 0.66 and 0.24; P < .001). Furthermore, ocular-motor in adult patients (SMD = 0.72; P < .001) and vestibular symptoms in both pediatric and adult patients (SMD = 0.18 and 0.36; P < .05) were significantly worse in concussion patients than in controls. CONCLUSION Five concussion subtypes with varying prevalence within 3 d following injury are commonly seen clinically and identifiable upon systematic literature review. Sleep disturbance, a concussion-associated condition, is also common. There was insufficient information available for analysis of cervical strain. A comprehensive acute concussion assessment defines and characterizes the injury and, therefore, should incorporate evaluations of all 5 subtypes and associated conditions.

show abstract

“…24 This suggests that head trauma may trigger migraine in those with a genetic predisposition. 24 This suggests that head trauma may trigger migraine in those with a genetic predisposition.…”

Section: Genetic and Phenotypic Backgroundmentioning

confidence: 99%

“…Genetic Influences.-A study of adolescents found that those with a family history of migraine were significantly more likely to have posttraumatic headache with a migraine phenotype following sport-related concussion compared with those without a family history. 24 This suggests that head trauma may trigger migraine in those with a genetic predisposition. Although migraine is clearly familial in many cases, the genetic basis of migraine remains poorly understood.…”

Section: Genetic and Phenotypic Backgroundmentioning

confidence: 99%

Posttraumatic Headache: Basic Mechanisms and Therapeutic Targets

Kamins

Charles²

2018

Headache

View full text Add to dashboard Cite

Frequent or continuous headache, often refractory to medical therapy, is a common occurrence after head trauma. In addition to being the most common acute symptom after traumatic brain injury (TBI), headache is also one of the most persistent and disabling symptoms. Different studies indicate that 18-58% of those suffering a TBI will have significant headache at 1 year following the trauma. In addition to being disabling on its own, posttraumatic headache (PTH) is a predictor of overall outcome after concussion. Despite its remarkable prevalence and associated social and economic costs, many fundamental and important questions about PTH remain unanswered. The purpose of this review is to identify key questions regarding the clinical characteristics of posttraumatic headache, its basic mechanisms, and its optimal management. We discuss phenotypic features of PTH, pathophysiological mechanisms of TBI including potential overlaps with those of migraine and other primary headache disorders, and potential novel targets for treatment. We suggest different strategies to finding answers to the questions regarding PTH in order to advance the understanding of the disorder and develop more effective therapies.

show abstract

Family History of Migraine Associated With Posttraumatic Migraine Symptoms Following Sport-Related Concussion

Cited by 55 publications

References 50 publications

Headache complexity (number of symptom features) differentiates post-traumatic from non-traumatic headaches

Headache complexity (number of symptom features) differentiates post-traumatic from non-traumatic headaches

Concussion Guidelines Step 2: Evidence for Subtype Classification

Posttraumatic Headache: Basic Mechanisms and Therapeutic Targets

Contact Info

Product

Resources

About