Terry Douglas P, Huebschmann Nathan A, Maxwell Bruce A, Cook Nathan E, Mannix Rebekah, Zafonte Ross, Seifert Tad, Berkner Paul D, Iverson Grant L
1 Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital, Brigham and Women's Hospital , Harvard Medical School, Boston Massachusetts.
2 Home Base, A Red Sox Foundation and Massachusetts General Hospital Program , Boston, Massachusetts.
J Neurotrauma. 2018 Aug 2. doi: 10.1089/neu.2017.5443.
Having a preexisting migraine disorder might be a risk factor for a prolonged recovery following a sport-related concussion. We examined whether having a migraine history was associated with a prolonged return to academics and athletics following a concussion. High school and collegiate athletes (n = 1265; 42% female) who sustained a sport-related concussion were monitored by athletic trainers using a web-based surveillance system that collects information about concussion recovery. Nonparametric Kolmogorov-Smirnov tests (KS) were used to compare days to return to academics/athletics across groups due to non-normally distributed outcome variables and unequal distributions of scores between groups. Chi-squared tests were used to examine the proportion of players who had not returned to academics/athletics at 7, 14, and 21 days post-injury stratified by self-reported migraine history. There were 117 athletes (9.2%) who reported a preinjury migraine history. Athletes with a history of migraine took a median of 6 days to return to academics (mean [M] = 10.6, standard deviation [SD] = 14.2) and 15.5 days to return to athletics (M = 23.8, SD = 30.8), while those with no migraine history took a median of 5 days to return to academics (M = 7.5, SD = 10.9) and 14 days to return to athletics (M = 19.4, SD = 19.4). There were no statistically significant differences in days to return to school or athletics between the groups (KS p > 0.05). However, a lower percentage of athletes with a history of migraine had returned to school after 7 days (57% vs. 68%, χ = 5.53, p = 0.02), 14 days (75% vs. 88%, χ = 14.21, p < 0.001), and 21 days post-injury (89% vs. 94%, χ = 4.90, p = 0.03). Stratifying the analyses by sex showed that this effect was significant in girls and women with preexisting migraines, but not boys and men with preexisting migraines. There were no group differences in recovery rates when examining return to athletics. Athletes with a preinjury migraine history may be at an elevated risk for a protracted return to school after concussion, especially girls and women.
患有偏头痛疾病史可能是运动相关脑震荡后恢复时间延长的一个风险因素。我们研究了偏头痛病史是否与脑震荡后学业和运动恢复时间延长有关。高中和大学运动员（n = 1265；42%为女性）发生运动相关脑震荡后，由运动训练师使用基于网络的监测系统进行监测，该系统收集有关脑震荡恢复的信息。由于结果变量呈非正态分布且组间分数分布不均，因此使用非参数柯尔莫哥洛夫-斯米尔诺夫检验（KS）来比较不同组恢复学业/运动的天数。卡方检验用于检查按自我报告的偏头痛病史分层的受伤后7天、14天和21天未恢复学业/运动的运动员比例。有117名运动员（9.2%）报告有受伤前偏头痛病史。有偏头痛病史的运动员恢复学业的中位数为6天（均值[M]=10.6，标准差[SD]=14.2），恢复运动的中位数为15.5天（M = 23.8，SD = 30.8），而无偏头痛病史的运动员恢复学业的中位数为5天（M = 7.5，SD = 10.9）,恢复运动为14天（M = 19.4，SD = 19.4）。两组间恢复学校学习或运动的天数无统计学显著差异（KS p>0.05）。然而，有偏头痛病史的运动员在受伤后7天（57%对68%，χ = 5.53，p = 0.02）、14天（75%对88% ,χ = 14.21，p<0.001）和21天（89%对94%，χ = 4.90，p = 0.03）后恢复上学的比例较低。按性别分层分析表明，这种影响在患有偏头痛的女孩和女性中显著，但在患有偏头痛的男孩和男性中不显著。在检查恢复运动情况时，各组恢复率无差异。有受伤前偏头痛病史的运动员在脑震荡后恢复上学的时间可能会延长，尤其是女孩和女性。
