Persistent posttraumatic headaches and functioning in veterans: Injury type can matter
| Autor: | Blessen C. Eapen, Timothy T. Houle, Donald D. McGeary, Willie J. Hale, Alan L. Peterson, Donald B. Penzien, Brett T. Litz, Terence M. Keane, Stacey Young-McCaughan, Casey L Straud, Patricia A. Resick, Jim Mintz, Cindy A. McGeary, Paul S Nabity, Carlos A. Jaramillo |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Traumatic brain injury Migraine Disorders Blast injury Head trauma Cohort Studies Stress Disorders Post-Traumatic Young Adult Blast Injuries Head Injuries Closed Brain Injuries Traumatic medicine Humans Disabled Persons Depression (differential diagnoses) Veterans Depression business.industry Head injury medicine.disease Neurology Migraine Blunt trauma Chronic Disease Post-Traumatic Headache Neurology (clinical) Headaches medicine.symptom business |
| Zdroj: | Headache: The Journal of Head and Face Pain. 61:1334-1341 |
| ISSN: | 1526-4610 0017-8748 |
| DOI: | 10.1111/head.14210 |
| Popis: | Objective To characterize the relationship between head trauma types (blast injury, blunt injury, combined blast+blunt injury) with subsequent headache presentations and functioning. Background Posttraumatic headaches (PTHs), the most common sequelae of traumatic brain injury (TBI), are painful and disabling. More than 400,000 veterans report having experienced a TBI, and understanding the predictors of PTHs may guide treatment developments. Methods This study used a nested-cohort design analyzing baseline data from a randomized clinical trial of cognitive behavioral therapy for PTH (N = 190). Participants had PTH (from blast and/or blunt head trauma) and symptoms of posttraumatic stress disorder (PTSD). The Structured Diagnostic Interview for Headache-Revised and Ohio State University Traumatic Brain Injury Identification Method were used to phenotype headaches and head injury histories, respectively. Results Individuals with persistent PTHs after a combined blast and blunt head trauma were more likely (OR =3.45; 95% CI [1.41, 8.4]) to experience chronic (vs. episodic) PTHs compared with the blunt trauma only group (23/33, 70% vs. 26/65, 40%, respectively); and they were more likely (OR =2.51; 95% CI [1.07, 5.9]) to experience chronic PTH compared with the blast trauma only group (44/92, 48%). There were no differences between head injury type on headache-related disability, depression symptoms, or severity of PTSD symptoms. Conclusion The combination of blast and blunt injuries was associated with headache chronicity, but not headache disability. Considering the refractory nature of chronic headaches, the potential added and synergistic effects of distinct head injuries warrant further study. |
| Databáze: | OpenAIRE |
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