Mangold Kiersten I, Katta Tapasya, Do Vu, Moore R Davis, Lin Chen, Androulakis X Michelle
Department of Exercise Science, University of South Carolina, Columbia, South Carolina, USA.
College of Arts and Sciences, The University of Alabama at Birmingham, Birmingham, Alabama, USA.
Headache. 2025 Feb;65(2):206-215. doi: 10.1111/head.14873. Epub 2024 Dec 3.
The objective of this study was to examine the association between white matter hyperintensities and migraine-like headache in United States military veterans with a history of mild traumatic brain injury.
White matter hyperintensities on magnetic resonance imaging (MRI) may be associated with migraine; however, little is currently known about the relationship between white matter hyperintensities and headache following mild traumatic brain injury in military veterans.
This cross-sectional study consisted of a retrospective chart review of veterans from a Southeastern Department of Veterans Affairs polytrauma clinic who had a verified history of mild traumatic brain injury. Participants were included if they had undergone an MRI of the brain. Images were reviewed for the presence and severity of periventricular and deep white matter hyperintensities. Headache and migraine-like headache were defined based on responses from the Neurobehavioral Symptom Inventory.
This cohort included 83 veterans, mostly consisting of males (78/83 [94%]) with a median (interquartile range [IQR]) age of 36 (13) years, who were a median (IQR) of 9 (8) years since their most recent mild traumatic brain injury. Most of the veterans reported experiencing migraine-like headache (67/83 [81%]). Periventricular white matter hyperintensities were identified on MRI among 35% (29/83) of the cohort, and deep white matter hyperintensities were identified on MRI of 25% (21/83) of the cohort. There was no association between the odds of displaying white matter hyperintensities and the presence of migraine-like headache (periventricular: unadjusted odds ratio [OR] 2.75, 95% confidence interval [CI] 0.71-10.6; deep white matter: OR 0.69, 95% CI 0.208-2.29; all p > 0.05), nor headache severity (periventricular: moderate headache OR 2.92, 95% CI 0.67-12.8; severe headache OR 3.11, 95% CI 0.77-12.6; deep white matter: moderate headache OR 1.44, 95% CI 0.358-5.8; severe headache OR 0.94, 95% CI 0.246-3.62; all p > 0.05).
Our findings suggest that neither migraine-like headache nor severity of headache is associated with increased prevalence of white matter hyperintensities in veterans with a history of mild traumatic brain injury.
本研究旨在探讨有轻度创伤性脑损伤病史的美国退伍军人中白质高信号与偏头痛样头痛之间的关联。
磁共振成像（MRI）上的白质高信号可能与偏头痛有关；然而，目前对于退伍军人轻度创伤性脑损伤后白质高信号与头痛之间的关系知之甚少。
这项横断面研究包括对东南部退伍军人事务部多创伤诊所中具有确诊轻度创伤性脑损伤病史的退伍军人进行回顾性病历审查。如果参与者接受过脑部MRI检查，则纳入研究。对图像进行审查，以确定脑室周围和深部白质高信号的存在和严重程度。头痛和偏头痛样头痛根据神经行为症状量表的回答来定义。
该队列包括83名退伍军人，大多数为男性（78/83 [94%]），中位（四分位间距[IQR]）年龄为36（13）岁，自最近一次轻度创伤性脑损伤以来的中位（IQR）时间为9（8）年。大多数退伍军人报告经历过偏头痛样头痛（67/83 [81%]）。队列中35%（29/83）的人在MRI上发现脑室周围白质高信号，25%（21/83）的人在MRI上发现深部白质高信号。出现白质高信号的几率与偏头痛样头痛的存在之间没有关联（脑室周围：未调整优势比[OR] 2.75，95%置信区间[CI] 0.71 - 10.6；深部白质：OR 0.69，95% CI 0.208 - 2.29；所有p > 0.05），与头痛严重程度也没有关联（脑室周围：中度头痛OR 2.92，95% CI 0.67 - 12.8；重度头痛OR 3.11，95% CI 0.77 - 12.6；深部白质：中度头痛OR 1.44，95% CI 0.358 - 5.8；重度头痛OR 0.94，95% CI 0.246 - 3.62；所有p > 0.05）。
我们的研究结果表明，有轻度创伤性脑损伤病史的退伍军人中，偏头痛样头痛及其严重程度均与白质高信号患病率增加无关。
