Clinical comparisons between post-traumatic headache and migraine: A cross-sectional study.

Abstract

ObjectiveTo compare clinical characteristics, treatment patterns, and patient-reported outcome measures (PROMs) in persons with persistent post-traumatic headache (PTH) and those with episodic or chronic migraine (with and without medication-overuse headache).MethodsThis cross-sectional study included adults with persistent PTH following mild traumatic brain injury and adults with episodic or chronic migraine. Information on headache features, treatment patterns, and PROMs were collected via semi-structured interviews and standardized questionnaires, including the HIT-6, MIDAS, HADS, ASC-12, CSI, WHODAS-2.0, NDI, and ODI.ResultsA total of 132 participants with persistent PTH and 751 with migraine were enrolled. On average, participants with persistent PTH reported 27.2 ± 9.3 monthly headache days, and 93.9% had a migraine-like phenotype. Compared with episodic migraine, the persistent PTH group had higher MIDAS scores (72.5 [IQR, 28.0-156.0] vs. 40.0 [IQR, 20.0-62.8]; P < 0.001), HADS-Anxiety (6.0 [IQR, 3.3-9.0] vs. 5.0 [IQR, 3.0-7.0]; P = 0.003), higher HADS-Depression scores (6.0 [IQR, 3.0-9.0] vs. 3.0 [IQR, 1.0-5.0]; P < 0.001), CSI (67.2 [SD, 15.0] vs. 57.4 [SD, 12.5]; P = 0.002), WHODAS-2.0 (41.0 [IQR, 15.5-68.5] vs. 22.0 [IQR, 10.0-35.0]; P < 0.001), and NDI (21.0 [IQR, 16.0-27.0] vs. 14.5 [IQR, 8.0-22.0]; P = 0.007). No marked differences were noted between the PTH group and chronic migraine groups.ConclusionsPersons with persistent PTH show similar disability and headache profiles to those with chronic migraine. These findings underscore the need for targeted management strategies, similar to those used in chronic migraine care.