Skip to main content
Top
Published in: The Journal of Headache and Pain 1/2021

Open Access 01-12-2021 | Central Nervous System Trauma | Research article

Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury

Authors: Håkan Ashina, Haidar Muhsen Al-Khazali, Afrim Iljazi, Sait Ashina, Faisal Mohammad Amin, Richard B. Lipton, Henrik Winther Schytz

Published in: The Journal of Headache and Pain | Issue 1/2021

Login to get access

Abstract

Objective

To investigate the association of psychiatric and cognitive comorbidities with persistent post-traumatic headache (PTH) attributed to mild traumatic brain injury (TBI).

Methods

A total of 100 patients with persistent PTH attributed to mild TBI and 100 age- and gender-matched healthy controls free of mild TBI were enrolled between July 2018 and June 2019. Quality of sleep was evaluated using the Pittsburgh Sleep Quality Index, while symptoms of anxiety and depression were assessed using the Hospital Anxiety and Depression Scale. Cognitive impairment was evaluated using the Montreal Cognitive Assessment questionnaire, while post-traumatic stress disorder (PTSD) was assessed using the Harvard Trauma Questionnaire.

Results

In 100 patients with persistent PTH, 85% reported poor quality sleep, compared with 42% of healthy controls (P < 0.01). The relative frequency of probable to high risk of anxiety was 52% in the persistent PTH group vs. 8% in healthy controls (P < 0.01), while the relative frequency of probable to high risk of depression was 42% in the persistent PTH group vs. 2% in healthy controls (P < 0.01). Furthermore, 27% of the patients with persistent PTH had mild cognitive impairment while 10% had probable PTSD.

Conclusions

Poor quality of sleep as well as symptoms suggestive of anxiety and depression were more common in patients with persistent PTH than healthy controls. Clinicians should screen patients with persistent PTH for these comorbidities and develop treatment plans that account for their presence.
Literature
8.
go back to reference Headache Classification Committee of the International Headache Society (IHS) (2018) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38(1):1–211CrossRef Headache Classification Committee of the International Headache Society (IHS) (2018) The International Classification of Headache Disorders, 3rd edition. Cephalalgia 38(1):1–211CrossRef
10.
go back to reference World Medical A (2013) World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 310(20):2191–2194CrossRef World Medical A (2013) World medical association declaration of Helsinki: ethical principles for medical research involving human subjects. JAMA. 310(20):2191–2194CrossRef
12.
go back to reference Ashina H, Iljazi A, Al-Khazali HM, Christensen CE, Amin FM, Ashina M et al (2020) Hypersensitivity to Calcitonin Gene-Related Peptide in Post-Traumatic Headache. Ann Neurol 88(6):1220–1228CrossRefPubMed Ashina H, Iljazi A, Al-Khazali HM, Christensen CE, Amin FM, Ashina M et al (2020) Hypersensitivity to Calcitonin Gene-Related Peptide in Post-Traumatic Headache. Ann Neurol 88(6):1220–1228CrossRefPubMed
22.
go back to reference Stein MB, Jain S, Giacino JT, Levin H, Dikmen S, Nelson LD, Vassar MJ, Okonkwo DO, Diaz-Arrastia R, Robertson CS, Mukherjee P, McCrea M, Mac Donald CL, Yue JK, Yuh E, Sun X, Campbell-Sills L, Temkin N, Manley GT, and the TRACK-TBI Investigators, Adeoye O, Badjatia N, Boase K, Bodien Y, Bullock MR, Chesnut R, Corrigan JD, Crawford K, Diaz-Arrastia R, Dikmen S, Duhaime AC, Ellenbogen R, Feeser VR, Ferguson A, Foreman B, Gardner R, Gaudette E, Giacino JT, Gonzalez L, Gopinath S, Gullapalli R, Hemphill JC, Hotz G, Jain S, Korley F, Kramer J, Kreitzer N, Levin H, Lindsell C, Machamer J, Madden C, Martin A, McAllister T, McCrea M, Merchant R, Mukherjee P, Nelson LD, Noel F, Okonkwo DO, Palacios E, Perl D, Puccio A, Rabinowitz M, Robertson CS, Rosand J, Sander A, Satris G, Schnyer D, Seabury S, Sherer M, Stein MB, Taylor S, Toga A, Temkin N, Valadka A, Vassar MJ, Vespa P, Wang K, Yue JK, Yuh E, Zafonte R (2019) Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: a TRACK-TBI study. JAMA Psychiatry 76(3):249–258. https://doi.org/10.1001/jamapsychiatry.2018.4288CrossRefPubMedPubMedCentral Stein MB, Jain S, Giacino JT, Levin H, Dikmen S, Nelson LD, Vassar MJ, Okonkwo DO, Diaz-Arrastia R, Robertson CS, Mukherjee P, McCrea M, Mac Donald CL, Yue JK, Yuh E, Sun X, Campbell-Sills L, Temkin N, Manley GT, and the TRACK-TBI Investigators, Adeoye O, Badjatia N, Boase K, Bodien Y, Bullock MR, Chesnut R, Corrigan JD, Crawford K, Diaz-Arrastia R, Dikmen S, Duhaime AC, Ellenbogen R, Feeser VR, Ferguson A, Foreman B, Gardner R, Gaudette E, Giacino JT, Gonzalez L, Gopinath S, Gullapalli R, Hemphill JC, Hotz G, Jain S, Korley F, Kramer J, Kreitzer N, Levin H, Lindsell C, Machamer J, Madden C, Martin A, McAllister T, McCrea M, Merchant R, Mukherjee P, Nelson LD, Noel F, Okonkwo DO, Palacios E, Perl D, Puccio A, Rabinowitz M, Robertson CS, Rosand J, Sander A, Satris G, Schnyer D, Seabury S, Sherer M, Stein MB, Taylor S, Toga A, Temkin N, Valadka A, Vassar MJ, Vespa P, Wang K, Yue JK, Yuh E, Zafonte R (2019) Risk of posttraumatic stress disorder and major depression in civilian patients after mild traumatic brain injury: a TRACK-TBI study. JAMA Psychiatry 76(3):249–258. https://​doi.​org/​10.​1001/​jamapsychiatry.​2018.​4288CrossRefPubMedPubMedCentral
25.
go back to reference Frenette LC, Tinawi S, Correa JA, Alturki AY, LeBlanc J, Feyz M et al (2018) Early detection of cognitive impairments with the Montreal cognitive assessment in patients with uncomplicated and complicated mild traumatic brain injury. Brain Inj:1–9 Frenette LC, Tinawi S, Correa JA, Alturki AY, LeBlanc J, Feyz M et al (2018) Early detection of cognitive impairments with the Montreal cognitive assessment in patients with uncomplicated and complicated mild traumatic brain injury. Brain Inj:1–9
Metadata
Title
Psychiatric and cognitive comorbidities of persistent post-traumatic headache attributed to mild traumatic brain injury
Authors
Håkan Ashina
Haidar Muhsen Al-Khazali
Afrim Iljazi
Sait Ashina
Faisal Mohammad Amin
Richard B. Lipton
Henrik Winther Schytz
Publication date
01-12-2021
Publisher
Springer Milan
Published in
The Journal of Headache and Pain / Issue 1/2021
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI
https://doi.org/10.1186/s10194-021-01287-7

Other articles of this Issue 1/2021

The Journal of Headache and Pain 1/2021 Go to the issue