TY  - JOUR
PY  - 2017//
TI  - Associations between traumatic brain injury history and future headache severity in Veterans: a longitudinal study
JO  - Archives of physical medicine and rehabilitation
A1  - Suri, Pradeep
A1  - Stolzmann, Kelly
A1  - Iverson, Katherine M.
A1  - Williams, Rhonda
A1  - Meterko, Mark
A1  - Yan, Kun
A1  - Gormley, Katelyn
A1  - Pogoda, Terri K.
SP  - 2118
EP  - 2125.e1
VL  - 98
IS  - 11
N2  - 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>
LA  - en
SN  - 0003-9993
UR  - http://dx.doi.org/10.1016/j.apmr.2017.04.008
ID  - ref1
ER  -