@article{ref1,
title="Associations between traumatic brain injury history and future headache severity in Veterans: a longitudinal study",
journal="Archives of physical medicine and rehabilitation",
year="2017",
author="Suri, Pradeep and Stolzmann, Kelly and Iverson, Katherine M. and Williams, Rhonda and Meterko, Mark and Yan, Kun and Gormley, Katelyn and Pogoda, Terri K.",
volume="98",
number="11",
pages="2118-2125.e1",
abstract="OBJECTIVE: To determine whether traumatic brain injury (TBI) history is associated with worse headache severity outcomes. <br><br>DESIGN: Prospective cohort study. SETTING: Department of Veterans Affairs (VA) outpatient clinics. PARTICIPANTS: 2566 Veterans who completed a mail follow-up survey an average of 3 years after a comprehensive TBI evaluation (CTBIE). MAIN OUTCOME MEASURES: The presence or absence of TBI, and TBI severity, were evaluated by a trained clinician and classified according to VA/Department of Defense clinical practice guidelines. Headache severity was evaluated at both the baseline CTBIE assessment and 3-year follow-up using a 5-level headache score ranging from 0 ('none') to 4 ('very severe') based on headache-associated activity interference in the past 30 days. We examined associations of mild and moderate/severe TBI history, as compared to no TBI history, with headache severity in cross-sectional and longitudinal analyses, with and without adjustment for potential confounders. <br><br>RESULTS: Mean headache severity scores were 2.4 at baseline and 2.3 at 3-year follow-up. Mild TBI was associated with greater headache severity in multivariate-adjusted cross-sectional analyses (ß [SE]= 0.61[0.07], p<0.001), as compared to no TBI, but not in longitudinal analyses (ß [SE]= 0.09[0.07], p=0.20). Moderate/severe TBI was significantly associated with greater headache severity in both cross-sectional (ß [SE]= 0.66[0.09], p<0.001) and longitudinal analyses (ß [SE]= 0.18[0.09], p=0.04). <br><br>CONCLUSIONS: Headache outcomes are poor in Veterans who receive VA TBI evaluations, irrespective of past TBI exposure, but significantly worse in those with a history of moderate/severe TBI. This study found no association between mild TBI and future headache severity in Veterans. Veterans with headache presenting for TBI evaluations, and particularly those with moderate/severe TBI, may benefit from further evaluation and treatment of headache.<br><br>Copyright © 2017. Published by Elsevier Inc.<p /> <p>Language: en</p>",
language="en",
issn="0003-9993",
doi="10.1016/j.apmr.2017.04.008",
url="http://dx.doi.org/10.1016/j.apmr.2017.04.008"
}