TY - JOUR
PY - 2021//
TI - Persistent posttraumatic headaches and functioning in veterans: injury type can matter
JO - Headache
A1 - Nabity, Paul S.
A1 - Jaramillo, Carlos A.
A1 - Resick, Patricia A.
A1 - McGeary, Cindy A.
A1 - Eapen, Blessen C.
A1 - Straud, Casey L.
A1 - Hale, Willie J.
A1 - Houle, Timothy T.
A1 - Litz, Brett T.
A1 - Mintz, Jim
A1 - Penzien, Donald B.
A1 - Young-McCaughan, Stacey
A1 - Keane, Terence M.
A1 - Peterson, Alan L.
A1 - McGeary, Donald D.
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - 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.
Language: en
LA - en SN - 0017-8748 UR - http://dx.doi.org/10.1111/head.14210 ID - ref1 ER -