Kiersten I Mangold, Tapasya Katta, Vu Do, R Davis Moore, Chen Lin, X Michelle Androulakis
{"title":"美国轻度创伤性脑损伤退伍军人的白质高强度和头痛。","authors":"Kiersten I Mangold, Tapasya Katta, Vu Do, R Davis Moore, Chen Lin, X Michelle Androulakis","doi":"10.1111/head.14873","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>The objective of this study was to examine the association between white matter hyperintensities and migraine-like headache in United States military veterans with a history of mild traumatic brain injury.</p><p><strong>Background: </strong>White matter hyperintensities on magnetic resonance imaging (MRI) may be associated with migraine; however, little is currently known about the relationship between white matter hyperintensities and headache following mild traumatic brain injury in military veterans.</p><p><strong>Methods: </strong>This cross-sectional study consisted of a retrospective chart review of veterans from a Southeastern Department of Veterans Affairs polytrauma clinic who had a verified history of mild traumatic brain injury. Participants were included if they had undergone an MRI of the brain. Images were reviewed for the presence and severity of periventricular and deep white matter hyperintensities. Headache and migraine-like headache were defined based on responses from the Neurobehavioral Symptom Inventory.</p><p><strong>Results: </strong>This cohort included 83 veterans, mostly consisting of males (78/83 [94%]) with a median (interquartile range [IQR]) age of 36 (13) years, who were a median (IQR) of 9 (8) years since their most recent mild traumatic brain injury. Most of the veterans reported experiencing migraine-like headache (67/83 [81%]). Periventricular white matter hyperintensities were identified on MRI among 35% (29/83) of the cohort, and deep white matter hyperintensities were identified on MRI of 25% (21/83) of the cohort. There was no association between the odds of displaying white matter hyperintensities and the presence of migraine-like headache (periventricular: unadjusted odds ratio [OR] 2.75, 95% confidence interval [CI] 0.71-10.6; deep white matter: OR 0.69, 95% CI 0.208-2.29; all p > 0.05), nor headache severity (periventricular: moderate headache OR 2.92, 95% CI 0.67-12.8; severe headache OR 3.11, 95% CI 0.77-12.6; deep white matter: moderate headache OR 1.44, 95% CI 0.358-5.8; severe headache OR 0.94, 95% CI 0.246-3.62; all p > 0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that neither migraine-like headache nor severity of headache is associated with increased prevalence of white matter hyperintensities in veterans with a history of mild traumatic brain injury.</p>","PeriodicalId":12844,"journal":{"name":"Headache","volume":" ","pages":"206-215"},"PeriodicalIF":5.4000,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"White matter hyperintensities and headache in United States military veterans with mild traumatic brain injury.\",\"authors\":\"Kiersten I Mangold, Tapasya Katta, Vu Do, R Davis Moore, Chen Lin, X Michelle Androulakis\",\"doi\":\"10.1111/head.14873\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>The objective of this study was to examine the association between white matter hyperintensities and migraine-like headache in United States military veterans with a history of mild traumatic brain injury.</p><p><strong>Background: </strong>White matter hyperintensities on magnetic resonance imaging (MRI) may be associated with migraine; however, little is currently known about the relationship between white matter hyperintensities and headache following mild traumatic brain injury in military veterans.</p><p><strong>Methods: </strong>This cross-sectional study consisted of a retrospective chart review of veterans from a Southeastern Department of Veterans Affairs polytrauma clinic who had a verified history of mild traumatic brain injury. Participants were included if they had undergone an MRI of the brain. Images were reviewed for the presence and severity of periventricular and deep white matter hyperintensities. Headache and migraine-like headache were defined based on responses from the Neurobehavioral Symptom Inventory.</p><p><strong>Results: </strong>This cohort included 83 veterans, mostly consisting of males (78/83 [94%]) with a median (interquartile range [IQR]) age of 36 (13) years, who were a median (IQR) of 9 (8) years since their most recent mild traumatic brain injury. Most of the veterans reported experiencing migraine-like headache (67/83 [81%]). Periventricular white matter hyperintensities were identified on MRI among 35% (29/83) of the cohort, and deep white matter hyperintensities were identified on MRI of 25% (21/83) of the cohort. There was no association between the odds of displaying white matter hyperintensities and the presence of migraine-like headache (periventricular: unadjusted odds ratio [OR] 2.75, 95% confidence interval [CI] 0.71-10.6; deep white matter: OR 0.69, 95% CI 0.208-2.29; all p > 0.05), nor headache severity (periventricular: moderate headache OR 2.92, 95% CI 0.67-12.8; severe headache OR 3.11, 95% CI 0.77-12.6; deep white matter: moderate headache OR 1.44, 95% CI 0.358-5.8; severe headache OR 0.94, 95% CI 0.246-3.62; all p > 0.05).</p><p><strong>Conclusions: </strong>Our findings suggest that neither migraine-like headache nor severity of headache is associated with increased prevalence of white matter hyperintensities in veterans with a history of mild traumatic brain injury.</p>\",\"PeriodicalId\":12844,\"journal\":{\"name\":\"Headache\",\"volume\":\" \",\"pages\":\"206-215\"},\"PeriodicalIF\":5.4000,\"publicationDate\":\"2025-02-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Headache\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/head.14873\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/12/3 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Headache","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/head.14873","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/3 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
摘要
目的:本研究的目的是研究有轻度创伤性脑损伤史的美国退伍军人白质高强度与偏头痛样头痛之间的关系。背景:磁共振成像(MRI)上的白质高信号可能与偏头痛有关;然而,目前对退伍军人轻度创伤性脑损伤后白质高强度与头痛之间的关系知之甚少。方法:本横断面研究包括对来自东南部退伍军人事务部多创伤诊所的退伍军人进行回顾性图表回顾,这些退伍军人有轻度创伤性脑损伤的病史。如果参与者接受了大脑核磁共振成像,他们就被包括在内。检查图像是否存在脑室周围和深部白质高信号及其严重程度。头痛和偏头痛样头痛是根据神经行为症状量表的反应来定义的。结果:该队列包括83名退伍军人,主要由男性组成(78/83[94%]),中位年龄(四分位数间距[IQR])为36(13)岁,距最近一次轻度创伤性脑损伤的中位年龄(IQR)为9(8)岁。大多数退伍军人报告有偏头痛样头痛(67/83[81%])。35%(29/83)的患者在MRI上发现心室周围白质高信号,25%(21/83)的患者在MRI上发现深部白质高信号。显示白质高信号的几率与偏头痛样头痛的存在之间没有关联(心室周围:未调整的优势比[OR] 2.75, 95%可信区间[CI] 0.71-10.6;深部白质:OR 0.69, 95% CI 0.208-2.29;所有p < 0.05),与头痛严重程度无关(脑室周围:中度头痛OR 2.92, 95% CI 0.67-12.8;严重头痛OR 3.11, 95% CI 0.77-12.6;深部白质:中度头痛OR 1.44, 95% CI 0.358-5.8;严重头痛OR 0.94, 95% CI 0.246-3.62;p < 0.05)。结论:我们的研究结果表明,在有轻度创伤性脑损伤史的退伍军人中,偏头痛样头痛和头痛的严重程度与白质高信号的患病率增加无关。
White matter hyperintensities and headache in United States military veterans with mild traumatic brain injury.
Objective: The objective of this study was to examine the association between white matter hyperintensities and migraine-like headache in United States military veterans with a history of mild traumatic brain injury.
Background: White matter hyperintensities on magnetic resonance imaging (MRI) may be associated with migraine; however, little is currently known about the relationship between white matter hyperintensities and headache following mild traumatic brain injury in military veterans.
Methods: This cross-sectional study consisted of a retrospective chart review of veterans from a Southeastern Department of Veterans Affairs polytrauma clinic who had a verified history of mild traumatic brain injury. Participants were included if they had undergone an MRI of the brain. Images were reviewed for the presence and severity of periventricular and deep white matter hyperintensities. Headache and migraine-like headache were defined based on responses from the Neurobehavioral Symptom Inventory.
Results: This cohort included 83 veterans, mostly consisting of males (78/83 [94%]) with a median (interquartile range [IQR]) age of 36 (13) years, who were a median (IQR) of 9 (8) years since their most recent mild traumatic brain injury. Most of the veterans reported experiencing migraine-like headache (67/83 [81%]). Periventricular white matter hyperintensities were identified on MRI among 35% (29/83) of the cohort, and deep white matter hyperintensities were identified on MRI of 25% (21/83) of the cohort. There was no association between the odds of displaying white matter hyperintensities and the presence of migraine-like headache (periventricular: unadjusted odds ratio [OR] 2.75, 95% confidence interval [CI] 0.71-10.6; deep white matter: OR 0.69, 95% CI 0.208-2.29; all p > 0.05), nor headache severity (periventricular: moderate headache OR 2.92, 95% CI 0.67-12.8; severe headache OR 3.11, 95% CI 0.77-12.6; deep white matter: moderate headache OR 1.44, 95% CI 0.358-5.8; severe headache OR 0.94, 95% CI 0.246-3.62; all p > 0.05).
Conclusions: Our findings suggest that neither migraine-like headache nor severity of headache is associated with increased prevalence of white matter hyperintensities in veterans with a history of mild traumatic brain injury.
期刊介绍:
Headache publishes original articles on all aspects of head and face pain including communications on clinical and basic research, diagnosis and management, epidemiology, genetics, and pathophysiology of primary and secondary headaches, cranial neuralgias, and pains referred to the head and face. Monthly issues feature case reports, short communications, review articles, letters to the editor, and news items regarding AHS plus medicolegal and socioeconomic aspects of head pain. This is the official journal of the American Headache Society.