Detecting Migraine in Patients with Mild Traumatic Brain Injury Using Three Different Headache Measures.

Kirsten Anderson,Elaine De Guise,Mitra Feyz,Julie Lamoureux,Simon Tinawi

doi:10.1155/2015/693925

Kirsten Anderson, Elaine De Guise + Show 3 more

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https://doi.org/10.1155/2015/693925

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Abstract

Posttraumatic migraine may represent an important subtype of headache among the traumatic brain injury (TBI) population and is associated with increased recovery times. However, it is underdiagnosed in patients with mild traumatic brain injury (mTBI). This study examined the effectiveness of the self-administered Nine-Item Screener (Nine-Item Screener-SA), the Headache Impact Test- 6 (HIT-6), the 3-Item Migraine Screener, and the Rivermead Post-Concussion Questionnaire (RPQ) at discriminating between mTBI patients with (n = 23) and without (n = 20) migraines. The Nine-Item Screener demonstrated significant differences between migraine patients with and without migraine on nearly every question, especially on Question 9 (disability), sensitivity: 0.95 and specificity: 0.65 (95% CI, 0.64–0.90). The HIT-6 demonstrated significant differences between migraine and no-migraine patients on disability and pain severity, with disability having a sensitivity of 0.70 and specificity of 0.75 (95% CI, 0.54–0.83). Only Question 3 of the 3-Item ID Migraine Screener (photosensitivity) showed significant differences between migraine and no-migraine patients, sensitivity: 0.84 and specificity: 0.55 (CI, 0.52–0.82). The RPQ did not reveal greater symptoms in migraine patients compared with those without. Among headache measures, the Nine-Item Screener-SA best differentiated between mTBI patients with and without migraine. Disability may best identify migraine sufferers among the TBI population.

Highlights

Posttraumatic headaches (PTH) are common in the traumatic brain injury (TBI) population, with a prevalence ranging from 30 to 90% depending on the type of measurement instrument administered to patients [1]
The main purpose of this study was to determine which headache tests among the Nine-Item Screener-SA, the Headache Impact Test- 6 (HIT-6), and the 3Item ID Migraine Screener would best differentiate between mild TBI patients with and without migraines
The present study demonstrated that the Nine-Item Screener may be the best inventory at detecting migraine headaches in a mild TBI population

Summary

Introduction

Posttraumatic headaches (PTH) are common in the TBI population, with a prevalence ranging from 30 to 90% depending on the type of measurement instrument administered to patients [1]. 75% of the 1.7 million patients with traumatic head injuries in the United States (annual) are classified as mild [3]. Posttraumatic headaches in this population may be the major cause of persistent disability. The frequency of different headache types after TBI can be quite variable in different studies. An important reason underlying this variability may be differences in the measurement instruments used to classify them. Few studies have examined the efficacy of these tests in distinguishing between mild TBI patients with and without migraines

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