Pre-Injury headache and post-traumatic headache in patients with mild traumatic brain injury: neuropsychological, psychiatric, and post-concussion symptom outcomes

Justin E. Karr; Michael W. Williams; Grant L. Iverson; Sheng Jean Huang; Chi Cheng Yang

doi:10.1080/02699052.2022.2043440

Pre-Injury headache and post-traumatic headache in patients with mild traumatic brain injury: neuropsychological, psychiatric, and post-concussion symptom outcomes

Justin E. Karr, Michael W. Williams, Grant L. Iverson, Sheng Jean Huang, Chi Cheng Yang

Research output: Contribution to journal › Article › peer-review

Abstract

Primary Objective: Headache, both before and after injury, has been associated with worse outcome following mild traumatic brain injury (MTBI). This study examined whether three MTBI patient groups–no headache (reported no pre-/post-injury headache), pre-injury headache (reported pre-injury headache, nearly all of whom also reported post-injury headache), and post-traumatic headache only (denied pre-injury headache and reported post-injury headache)–differed in acute-to-subacute outcomes. Research Design: Cross-sectional observational study. Methods and Procedures: Patients within 21 days of a MTBI (n = 291) completed neuropsychological tests and questionnaires evaluating depression, anxiety, and post-concussion symptoms. Main Outcomes and Results: Neuropsychological test performances did not differ between headache groups. Participants with pre-injury headache and participants with post-traumatic headache only reported greater change in self-reported physical and cognitive symptoms than participants with no headache. Participants with pre-injury headache reported worse post-injury anxiety symptoms than participants with post-traumatic headache only. Conclusions: The pre-injury headache and post-traumatic headache only groups did not meaningfully differ in outcome within 21 days of MTBI, but they had worse physical and cognitive symptoms than participants with no headache. Future research should assess whether differences in outcome emerge further from injury and whether specific headache subtypes are differentially associated with outcome.

Original language	English
Pages (from-to)	175-182
Number of pages	8
Journal	Brain Injury
Volume	36
Issue number	2
DOIs	https://doi.org/10.1080/02699052.2022.2043440
State	Published - 2022

Bibliographical note

Funding Information:
Dr. Iverson acknowledges unrestricted philanthropic support from the Heinz Family Foundation and the Spaulding Research Institute.

Funding Information:
Grant Iverson, Ph.D. has been reimbursed by the government, professional scientific bodies, and commercial organizations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs. He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.), and the National Football League. He serves as a scientific advisor for Sway Operations, LLC, Highmark, Inc., and NanoDx™. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, Boston Bolts, and National Rugby League.

Funding Information:
This work was supported by the Ministry of Science and Technology in Taiwan [MOST 108-2410-H-004-087- and MOST 108-2918-I-004-0]. Dr. Iverson acknowledges unrestricted philanthropic support from the Heinz Family Foundation and the Spaulding Research Institute.

Publisher Copyright:
© 2022 Taylor & Francis Group, LLC.

Keywords

Brain concussion
anxiety
depression
neuropsychological tests
post-concussion syndrome
post-traumatic headache

ASJC Scopus subject areas

Neuroscience (miscellaneous)
Developmental and Educational Psychology
Clinical Neurology

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10.1080/02699052.2022.2043440

Cite this

@article{7e53f429330f4b70909c2eed9b89729a,

title = "Pre-Injury headache and post-traumatic headache in patients with mild traumatic brain injury: neuropsychological, psychiatric, and post-concussion symptom outcomes",

abstract = "Primary Objective: Headache, both before and after injury, has been associated with worse outcome following mild traumatic brain injury (MTBI). This study examined whether three MTBI patient groups–no headache (reported no pre-/post-injury headache), pre-injury headache (reported pre-injury headache, nearly all of whom also reported post-injury headache), and post-traumatic headache only (denied pre-injury headache and reported post-injury headache)–differed in acute-to-subacute outcomes. Research Design: Cross-sectional observational study. Methods and Procedures: Patients within 21 days of a MTBI (n = 291) completed neuropsychological tests and questionnaires evaluating depression, anxiety, and post-concussion symptoms. Main Outcomes and Results: Neuropsychological test performances did not differ between headache groups. Participants with pre-injury headache and participants with post-traumatic headache only reported greater change in self-reported physical and cognitive symptoms than participants with no headache. Participants with pre-injury headache reported worse post-injury anxiety symptoms than participants with post-traumatic headache only. Conclusions: The pre-injury headache and post-traumatic headache only groups did not meaningfully differ in outcome within 21 days of MTBI, but they had worse physical and cognitive symptoms than participants with no headache. Future research should assess whether differences in outcome emerge further from injury and whether specific headache subtypes are differentially associated with outcome.",

keywords = "Brain concussion, anxiety, depression, neuropsychological tests, post-concussion syndrome, post-traumatic headache",

author = "Karr, {Justin E.} and Williams, {Michael W.} and Iverson, {Grant L.} and Huang, {Sheng Jean} and Yang, {Chi Cheng}",

note = "Funding Information: Dr. Iverson acknowledges unrestricted philanthropic support from the Heinz Family Foundation and the Spaulding Research Institute. Funding Information: Grant Iverson, Ph.D. has been reimbursed by the government, professional scientific bodies, and commercial organizations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs. He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.), and the National Football League. He serves as a scientific advisor for Sway Operations, LLC, Highmark, Inc., and NanoDx{\texttrademark}. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, Boston Bolts, and National Rugby League. Funding Information: This work was supported by the Ministry of Science and Technology in Taiwan [MOST 108-2410-H-004-087- and MOST 108-2918-I-004-0]. Dr. Iverson acknowledges unrestricted philanthropic support from the Heinz Family Foundation and the Spaulding Research Institute. Publisher Copyright: {\textcopyright} 2022 Taylor & Francis Group, LLC.",

year = "2022",

doi = "10.1080/02699052.2022.2043440",

language = "English",

volume = "36",

pages = "175--182",

number = "2",

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TY - JOUR

T1 - Pre-Injury headache and post-traumatic headache in patients with mild traumatic brain injury

T2 - neuropsychological, psychiatric, and post-concussion symptom outcomes

AU - Karr, Justin E.

AU - Williams, Michael W.

AU - Iverson, Grant L.

AU - Huang, Sheng Jean

AU - Yang, Chi Cheng

N1 - Funding Information: Dr. Iverson acknowledges unrestricted philanthropic support from the Heinz Family Foundation and the Spaulding Research Institute. Funding Information: Grant Iverson, Ph.D. has been reimbursed by the government, professional scientific bodies, and commercial organizations for discussing or presenting research relating to mild TBI and sport-related concussion at meetings, scientific conferences, and symposiums. He has a clinical and consulting practice in forensic neuropsychology, including expert testimony, involving individuals who have sustained mild TBIs. He has received research funding from several test publishing companies, including ImPACT Applications, Inc., CNS Vital Signs, and Psychological Assessment Resources (PAR, Inc.), and the National Football League. He serves as a scientific advisor for Sway Operations, LLC, Highmark, Inc., and NanoDx™. He acknowledges unrestricted philanthropic support from ImPACT Applications, Inc., the Mooney-Reed Charitable Foundation, Boston Bolts, and National Rugby League. Funding Information: This work was supported by the Ministry of Science and Technology in Taiwan [MOST 108-2410-H-004-087- and MOST 108-2918-I-004-0]. Dr. Iverson acknowledges unrestricted philanthropic support from the Heinz Family Foundation and the Spaulding Research Institute. Publisher Copyright: © 2022 Taylor & Francis Group, LLC.

PY - 2022

Y1 - 2022

N2 - Primary Objective: Headache, both before and after injury, has been associated with worse outcome following mild traumatic brain injury (MTBI). This study examined whether three MTBI patient groups–no headache (reported no pre-/post-injury headache), pre-injury headache (reported pre-injury headache, nearly all of whom also reported post-injury headache), and post-traumatic headache only (denied pre-injury headache and reported post-injury headache)–differed in acute-to-subacute outcomes. Research Design: Cross-sectional observational study. Methods and Procedures: Patients within 21 days of a MTBI (n = 291) completed neuropsychological tests and questionnaires evaluating depression, anxiety, and post-concussion symptoms. Main Outcomes and Results: Neuropsychological test performances did not differ between headache groups. Participants with pre-injury headache and participants with post-traumatic headache only reported greater change in self-reported physical and cognitive symptoms than participants with no headache. Participants with pre-injury headache reported worse post-injury anxiety symptoms than participants with post-traumatic headache only. Conclusions: The pre-injury headache and post-traumatic headache only groups did not meaningfully differ in outcome within 21 days of MTBI, but they had worse physical and cognitive symptoms than participants with no headache. Future research should assess whether differences in outcome emerge further from injury and whether specific headache subtypes are differentially associated with outcome.

AB - Primary Objective: Headache, both before and after injury, has been associated with worse outcome following mild traumatic brain injury (MTBI). This study examined whether three MTBI patient groups–no headache (reported no pre-/post-injury headache), pre-injury headache (reported pre-injury headache, nearly all of whom also reported post-injury headache), and post-traumatic headache only (denied pre-injury headache and reported post-injury headache)–differed in acute-to-subacute outcomes. Research Design: Cross-sectional observational study. Methods and Procedures: Patients within 21 days of a MTBI (n = 291) completed neuropsychological tests and questionnaires evaluating depression, anxiety, and post-concussion symptoms. Main Outcomes and Results: Neuropsychological test performances did not differ between headache groups. Participants with pre-injury headache and participants with post-traumatic headache only reported greater change in self-reported physical and cognitive symptoms than participants with no headache. Participants with pre-injury headache reported worse post-injury anxiety symptoms than participants with post-traumatic headache only. Conclusions: The pre-injury headache and post-traumatic headache only groups did not meaningfully differ in outcome within 21 days of MTBI, but they had worse physical and cognitive symptoms than participants with no headache. Future research should assess whether differences in outcome emerge further from injury and whether specific headache subtypes are differentially associated with outcome.

KW - Brain concussion

KW - anxiety

KW - depression

KW - neuropsychological tests

KW - post-concussion syndrome

KW - post-traumatic headache

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JO - Brain Injury

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ER -

Pre-Injury headache and post-traumatic headache in patients with mild traumatic brain injury: neuropsychological, psychiatric, and post-concussion symptom outcomes

Abstract

Bibliographical note

Keywords

ASJC Scopus subject areas

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