학술논문
Frequency and predictors of headache in the first 12 months after traumatic brain injury: results from CENTER-TBI.
Document Type
Academic Journal
Author
Howe EI; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway. emilie.howe@medisin.uio.no.; Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway. emilie.howe@medisin.uio.no.; Andelic N; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.; Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway.; Brunborg C; Oslo Centre for Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway.; Zeldovich M; Institute of Psychology, University of Innsbruck, Innsbruck, Austria.; Helseth E; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.; Department of Neurosurgery, Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway.; Skandsen T; Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway.; Olsen A; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway.; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.; Fure SCR; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.; Theadom A; TBI Network, Department of Psychology, Faculty of Health and Environmental Sciences, Auckland University of Technology, Auckland, New Zealand.; Rauen K; Neurological Rehabilitation Center Godeshöhe, Bonn, Germany.; Department of Traumatology & Department of Psychiatry, Psychotherapy, and Psychosomatics, Neuroscience Center Zurich, University of Zurich, University Hospital Zurich, Zürich, Switzerland.; Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig Maximilian University of Munich, Munich, Germany.; Madsen BÅ; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.; Jacobs B; Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; van der Naalt J; Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.; Tartaglia MC; Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, ON, Canada.; Canadian Concussion Centre, Krembil Brain Institute, Toronto, ON, Canada.; Memory Clinic, Toronto Western Hospital, Toronto, ON, Canada.; Einarsen CE; Department of Neuromedicine and Movement Science, NTNU - Norwegian University of Science and Technology, Trondheim, Norway.; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; Storvig G; Clinic of Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.; NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway.; Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.; Tronvik E; NorHEAD - Norwegian Centre for Headache Research, Trondheim, Norway.; Department of Neurology, St. Olav University Hospital, Trondheim, Norway.; Tverdal C; Department of Neurosurgery, Division of Emergencies and Critical Care, Department of Research and Development, Oslo University Hospital, Oslo, Norway.; von Steinbüchel N; Institute of Psychology, University of Innsbruck, Innsbruck, Austria.; Røe C; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.; Center for Habilitation and Rehabilitation Models and Services (CHARM), Institute of Health and Society, University of Oslo, Oslo, Norway.; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.; Hellstrøm T; Department of Physical Medicine and Rehabilitation, Oslo University Hospital, Oslo, Norway.
Source
Publisher: BioMed Central Country of Publication: England NLM ID: 100940562 Publication Model: Electronic Cited Medium: Internet ISSN: 1129-2377 (Electronic) Linking ISSN: 11292369 NLM ISO Abbreviation: J Headache Pain Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Headache is a prevalent and debilitating symptom following traumatic brain injury (TBI). Large-scale, prospective cohort studies are needed to establish long-term headache prevalence and associated factors after TBI. This study aimed to assess the frequency and severity of headache after TBI and determine whether sociodemographic factors, injury severity characteristics, and pre- and post-injury comorbidities predicted changes in headache frequency and severity during the first 12 months after injury.
Methods: A large patient sample from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study was used. Patients were stratified based on their clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU) in the acute phase. Headache was assessed using a single item from the Rivermead Post-Concussion Symptoms Questionnaire measured at baseline, 3, 6 and 12 months after injury. Mixed-effect logistic regression analyses were applied to investigate changes in headache frequency and associated predictors.
Results: A total of 2,291 patients responded to the headache item at baseline. At study enrolment, 59.3% of patients reported acute headache, with similar frequencies across all strata. Female patients and those aged up to 40 years reported a higher frequency of headache at baseline compared to males and older adults. The frequency of severe headache was highest in patients admitted to the ICU. The frequency of headache in the ER stratum decreased substantially from baseline to 3 months and remained from 3 to 6 months. Similar trajectory trends were observed in the ICU and ADM strata across 12 months. Younger age, more severe TBI, fatigue, neck pain and vision problems were among the predictors of more severe headache over time. More than 25% of patients experienced headache at 12 months after injury.
Conclusions: Headache is a common symptom after TBI, especially in female and younger patients. It typically decreases in the first 3 months before stabilising. However, more than a quarter of patients still experienced headache at 12 months after injury. Translational research is needed to advance the clinical decision-making process and improve targeted medical treatment for headache.
Trial Registration: ClinicalTrials.gov NCT02210221.
(© 2024. The Author(s).)
Methods: A large patient sample from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study was used. Patients were stratified based on their clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU) in the acute phase. Headache was assessed using a single item from the Rivermead Post-Concussion Symptoms Questionnaire measured at baseline, 3, 6 and 12 months after injury. Mixed-effect logistic regression analyses were applied to investigate changes in headache frequency and associated predictors.
Results: A total of 2,291 patients responded to the headache item at baseline. At study enrolment, 59.3% of patients reported acute headache, with similar frequencies across all strata. Female patients and those aged up to 40 years reported a higher frequency of headache at baseline compared to males and older adults. The frequency of severe headache was highest in patients admitted to the ICU. The frequency of headache in the ER stratum decreased substantially from baseline to 3 months and remained from 3 to 6 months. Similar trajectory trends were observed in the ICU and ADM strata across 12 months. Younger age, more severe TBI, fatigue, neck pain and vision problems were among the predictors of more severe headache over time. More than 25% of patients experienced headache at 12 months after injury.
Conclusions: Headache is a common symptom after TBI, especially in female and younger patients. It typically decreases in the first 3 months before stabilising. However, more than a quarter of patients still experienced headache at 12 months after injury. Translational research is needed to advance the clinical decision-making process and improve targeted medical treatment for headache.
Trial Registration: ClinicalTrials.gov NCT02210221.
(© 2024. The Author(s).)