Migraine History Linked To Concussion Severity

A study from the Toronto Rehabilitation Institute of University Health Network has found concussion patients with a pre-injury lifetime history of migraines have significantly more concussion symptoms and higher symptom severity than people without migraine history.
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Toronto Rehabilitation Institute, Laura Langer, said concussion symptoms and severity scores, which were determined using the Sports Concussion Assessment Tool (SCAT), were higher among people who had pre-injury migraines more frequently than once a month, and remained elevated through the entire 16-week study.

“This study is one of the few studies that have linked symptomatic recovery to pre-injury baselines,” Langer told MedPage Today.

“This information is important for physicians treating patients with a concussion and pre-concussion history of migraine.

“It may flag that a patient is at risk for a prolonged recovery, which could influence treatment plan, lifestyle modifications, appropriate pharmacological treatment considerations, etc., especially if the migraines were more than one per month before injury.

“22% of migraineurs with more than one migraine a month before their concussion still had not recovered to their pre-concussion baseline at week 16.

“Further analysis of the migraine cohort is needed to identify any mediating factors for increased concussion symptom severity and prolonged recover that may be present, such as sex, pre-injury mental health, injury coping strategies, or sleep quality,” she said.

Toronto Rehabilitation Institute MD, and co-author of the study, Jonathan Gladstone, said a total of 302 concussion patients completed questionnaires about their history of migraines and headaches pre-injury, followed by questionnaires about concussion symptoms and severity weekly during the first 8 weeks, then at week 12, and week 16.

“Recognising that a pre-concussion history of migraines more than once monthly may place individuals at increased risk for greater number, greater intensity, and longer-lasting concussion-related symptoms suggests that this subgroup of patients may be a population worthy of evaluation to determine whether treatment with the new CGRP monoclonal antibodies may result in meaningfully improved recovery trajectory,” Gladstone said.

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