Abstract
Objective This study aimed to investigate the effect of prior mTBI on the clinical features and disability in patients presenting with migraine.
Background Head injury is a risk factor for chronic migraine (CM) and migraine is a risk factor for persistent headache after mild traumatic brain injury (mTBI).
Design/Methods Of 2,161 migraine patients without a diagnosis of post-traumatic headache (PTH) who participated in the American Registry for Migraine Research (ARMR) between February 2016 and March 2020, 1,120 answered questions about a history of mTBI. After controlling for age, gender, and having CM, demographics, headache characteristics, Patient Health Questionnaire-2 (PHQ-2) score, General Anxiety Disorder-7 (GAD-7) grade, and Migraine Disability Assessment Scale (MIDAS) scores were compared between those with a history of mTBI to those without.
Results Among 1,098 migraine patients, 37.6% (n = 413) had a history of mTBI. The patients with mTBI were more likely to have CM (p = 0.004), dizziness (p = 0.003), vertigo (p = 0.009), and difficulty finding words (p < 0.001). Patients with mTBI had significantly greater scores on the MIDAS (58.6 ± 52.6 vs 50.0 ± 47.8, p = 0.034) and PHQ-2 (1.6 ± 1.8 vs 1.3 ± 1.6, p = 0.012), and had significantly higher proportion of moderate to severe GAD-7 grade (21.7% vs 17.1%, p = 0.017) compared to those without mTBI.
Conclusions In patients presenting with migraine, a prior history of mTBI was associated with a diagnosis of chronic migraine, disability, anxiety and depression severity, as well as dizziness, vertigo, and word finding difficulty. A history of mTBI should be assessed in patients presenting with migraine, and people with migraine who have a high exposure risk to mTBI, should be aware of the potential for migraine progression and psychiatric symptoms after mTBI.
Footnotes
Disclosure: Dr. Ishii has nothing to disclose. Dr. Dodick has received personal compensation for serving as an employee of Mayo Clinic. Dr. Dodick has received personal compensation in the range of $50,000–$99,999 for serving as a Consultant for Amgen. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Allergan/Abbvie. Dr. Dodick has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for AEON. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Clexio. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Cerecin. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Biohaven. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Linpharma. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Lundbeck. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Promius. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Eli Lilly. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Novartis. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Impel. Dr. Dodick has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for Theranica. Dr. Dodick has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for WL Gore. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Zosano. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for XoC. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Upjohn. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Pieris. Dr. Dodick has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for Revance. Dr. Dodick has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for Equinox. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Praxis. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Cooltech. Dr. Dodick has received personal compensation in the range of $100,000–$499,999 for serving on a Scientific Advisory or Data Safety Monitoring board for All companies listed as consultant also apply to advisory board. . Dr. Dodick has received personal compensation in the range of $0–$499 for serving as an officer or member of the Board of Directors for Epien. Dr. Dodick has received personal compensation in the range of $0–$499 for serving as an officer or member of the Board of Directors for KingDevick Technologies. Dr. Dodick has received personal compensation in the range of $0–$499 for serving as an officer or member of the Board of Directors for Precon Health. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as an officer or member of the Board of Directors for Ontologics. Dr. Dodick has received personal compensation in the range of $0–$499 for serving as an officer or member of the Board of Directors for Matterhorn. Dr. Dodick has received stock or an ownership interest from Healint. Dr. Dodick has received stock or an ownership interest from Theranica. Dr. Dodick has received stock or an ownership interest from Aural Analytics. Dr. Dodick has received stock or an ownership interest from Epien. Dr. Dodick has received stock or an ownership interest from Matterhorn. Dr. Dodick has received stock or an ownership interest from Ontologics. Dr. Dodick has received stock or an ownership interest from Precon Health. Dr. Dodick has received stock or an ownership interest from King Devick Technologies. Dr. Dodick has received stock or an ownership interest from Nocira. Dr. Dodick has received stock or an ownership interest from Exsano. Dr. Dodick has received stock or an ownership interest from Palion. Dr. Dodick has received stock or an ownership interest from Second opinion/mobile health. The institution of Dr. Dodick has received research support from Department of Defense. The institution of Dr. Dodick has received research support from American Migraine Foundation. The institution of Dr. Dodick has received research support from Patient Centered Outcomes Research Institute. The institution of Dr. Dodick has received research support from Henry Jackson Foundation. Dr. Dodick has received intellectual property interests from a discovery or technology relating to health care. Dr. Dodick has received intellectual property interests from a discovery or technology relating to health care. Dr. Dodick has received publishing royalties from a publication relating to health care. Dr. Dodick has received publishing royalties from a publication relating to health care. Dr. Dodick has received publishing royalties from a publication relating to health care. Dr. Dodick has received personal compensation in the range of $5,000–$9,999 for serving as a CME symposia with CME Outfitters. Dr. Dodick has received personal compensation in the range of $10,000–$49,999 for serving as a CME symposia speaker with WebMD/Medscape. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consulting with KLJ Associates. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consulting with Curry Rockefeller Group. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consulting with DeepBench. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a CME symposia speaker with Medlogix Communications. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a CME symposia speaker with Miller Medical Communications. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a speaker at annual meeting with Southern Headache Society. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a consulting with Majallin LLC. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a Consulting/Advisory board with Satsuma. Dr. Dodick has received personal compensation in the range of $500–$4,999 for serving as a CME symposia speakers with Global Access Meetings. Dr. Dodick has a non-compensated relationship as a Chair with American Brain Foundation that is relevant to AAN interests or activities. Dr. Dodick has a non-compensated relationship as a Committee member/Course Director with American Academy of Neurology that is relevant to AAN interests or activities. Dr. Dodick has a non-compensated relationship as a Chair/Immediate Past Chair with American Migraine Foundation that is relevant to AAN interests or activities. Dr. Dodick has a non-compensated relationship as a Chair Global Patient Advocacy Coalition with International Headache Society that is relevant to AAN interests or activities. Ms. Trivedi has nothing to disclose. Gina Dumkrieger has received personal compensation for serving as an employee of Mayo Clinic. The institution of Gina Dumkrieger has received research support from NIH. The institution of Gina Dumkrieger has received research support from DOD. The institution of Gina Dumkrieger has received research support from AMGEN. Dr. Schwedt has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Alder. Dr. Schwedt has received personal compensation in the range of $50,000–$99,999 for serving as a Consultant for Allergan. Dr. Schwedt has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for Biohaven. Dr. Schwedt has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Cipla. Dr. Schwedt has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Click Therapeutics. Dr. Schwedt has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Eli Lilly. Dr. Schwedt has received personal compensation in the range of $10,000–$49,999 for serving as a Consultant for Equinox. Dr. Schwedt has received personal compensation in the range of $5,000–$9,999 for serving as a Consultant for Lundbeck. Dr. Schwedt has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Novartis. Dr. Schwedt has received personal compensation in the range of $500–$4,999 for serving as a Consultant for XoC Pharmaceuticals. Dr. Schwedt has received personal compensation in the range of $500–$4,999 for serving as a Consultant for Weber & Weber. Dr. Schwedt has received personal compensation in the range of $10,000–$49,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for American Headache Society. Dr. Schwedt has received stock or an ownership interest from Aural Analytics. Dr. Schwedt has received stock or an ownership interest from Nocira. The institution of Dr. Schwedt has received research support from Amgen. Dr. Schwedt has received publishing royalties from a publication relating to health care.
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