Sufrinko Alicia, McAllister-Deitrick Jamie, Elbin R J, Collins Michael W, Kontos Anthony P
UPMC Sports Medicine Concussion Program, Department of Orthopaedic Surgery, University of Pittsburgh, Pennsylvania (Drs Sufrinko, McAllister-Deitrick, Collins, and Kontos); and Department of Health, Human Performance and Recreation/Office for Sport Concussion Research, University of Arkansas, Fayetteville (Dr Elbin).
J Head Trauma Rehabil. 2018 Jan/Feb;33(1):7-14. doi: 10.1097/HTR.0000000000000315.
To determine whether family history of migraine increased the likelihood of posttraumatic migraine (PTM) symptom presentation in adolescents following concussion, and examine the influence of family history of migraine and PTM on postinjury outcomes.
Outpatient concussion clinic.
A total of 153 patients with concussion (103 males and 50 females) aged 15.72 ± 1.48 years (range 12-18 years).
Cross-sectional, observational study of patients presenting for initial evaluation 4.72 ± 3.05 days (range 1-14) postinjury.
Computerized neurocognitive testing, symptom report, and vestibular/oculomotor screening.
Patients with a family history of migraine were 2.6 times (odds ratio = 2.60, confidence interval = 1.35-5.02, P = .003) more likely to present with PTM compared with patients without a family history. Results of multivariate analyses of covariance, controlling for concussion history, revealed significant main effects for PTM on (1) Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT)/Post-Concussion Symptom Scale (PCSS) (F = 15.43, P <.001) and (2) Vestibular/Ocular Motor Screening (VOMS) (F = 8.52, P < .001). There was no main effect for family history of migraine on ImPACT/PCSS (P = .22) and VOMS (P = .83) or interaction between family history of migraine and PTM on ImPACT/PCSS (P = .84) and VOMS (P = .52).
Family history of migraine is associated with PTM symptoms following sport-related concussion, suggesting a genetic predisposition for migraine may serve as a catalyst or trigger for onset of PTM. However, only presence of PTM, rather than family history of migraine, was related to worse neurocognitive and vestibular/oculomotor outcomes.
确定偏头痛家族史是否会增加青少年脑震荡后创伤后偏头痛(PTM)症状出现的可能性,并研究偏头痛家族史和PTM对伤后结局的影响。
门诊脑震荡诊所。
共153例脑震荡患者(103例男性和50例女性),年龄15.72±1.48岁(范围12 - 18岁)。
对伤后4.72±3.05天(范围1 - 14天)前来进行初始评估的患者进行横断面观察性研究。
计算机神经认知测试、症状报告以及前庭/动眼筛查。
与无偏头痛家族史的患者相比,有偏头痛家族史的患者出现PTM的可能性高2.6倍(比值比 = 2.60,置信区间 = 1.35 - 5.02,P = .003)。在控制脑震荡病史的协方差多变量分析结果中,PTM对以下方面有显著的主效应:(1)脑震荡后即刻评估和认知测试(ImPACT)/脑震荡后症状量表(PCSS)(F = 15.43,P <.001)以及(2)前庭/动眼筛查(VOMS)(F = 8.52,P <.001)。偏头痛家族史对ImPACT/PCSS(P = .22)和VOMS(P = .83)没有主效应,偏头痛家族史与PTM之间在ImPACT/PCSS(P = .84)和VOMS(P = .52)上也没有交互作用。
偏头痛家族史与运动相关脑震荡后的PTM症状相关,表明偏头痛的遗传易感性可能是PTM发病的催化剂或触发因素。然而,只有PTM的存在,而非偏头痛家族史,与更差的神经认知和前庭/动眼结局相关。