Persistent post-traumatic headache attributed to mild traumatic brain injury: Deep phenotyping and treatment patterns
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Persistent post-traumatic headache attributed to mild traumatic brain injury : Deep phenotyping and treatment patterns. / Ashina, Håkan; Iljazi, Afrim; Al-Khazali, Haidar Muhsen; Ashina, Sait; Jensen, Rigmor Højland; Amin, Faisal Mohammad; Ashina, Messoud; Schytz, Henrik Winther.
I: Cephalalgia, Bind 40, Nr. 6, 2020, s. 554-564.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Persistent post-traumatic headache attributed to mild traumatic brain injury
T2 - Deep phenotyping and treatment patterns
AU - Ashina, Håkan
AU - Iljazi, Afrim
AU - Al-Khazali, Haidar Muhsen
AU - Ashina, Sait
AU - Jensen, Rigmor Højland
AU - Amin, Faisal Mohammad
AU - Ashina, Messoud
AU - Schytz, Henrik Winther
PY - 2020
Y1 - 2020
N2 - OBJECTIVE: To investigate clinical characteristics and treatment patterns in persistent post-traumatic headache attributed to mild traumatic brain injury.METHODS: A total of 100 individuals with persistent post-traumatic headache attributed to mild traumatic brain injury were enrolled between July 2018 and June 2019. Deep phenotyping was performed using a semi-structured interview while allodynia was assessed using the 12-item Allodynia Symptom Checklist.RESULTS: In 100 subjects with persistent post-traumatic headache, the mean headache frequency was 25.4 ± 7.1 days per month. The most common headache phenotype was chronic migraine-like headache (n = 61) followed by combined episodic migraine-like and tension-type-like headache (n = 29) while nine subjects reported "pure" chronic tension-type-like headache. The most frequent trigger factors were stress, lack of sleep, and bright lights. A history of preventive medication use was reported by 63 subjects, of which 79% reported failure of at least one preventive drug, while 19% reported failure of at least four preventive drugs. Cutaneous allodynia was absent in 54% of the subjects, mild in 23%, moderate in 17%, and severe in 6%.CONCLUSIONS: The headache profile of individuals with persistent post-traumatic headache most often resembled a chronic migraine-like phenotype or a combined episodic migraine-like and tension-type-like headache phenotype. Migraine-specific preventive medications were largely reported to be ineffective. Therefore, there is a pressing need for pathophysiological insights and disease-specific therapies.
AB - OBJECTIVE: To investigate clinical characteristics and treatment patterns in persistent post-traumatic headache attributed to mild traumatic brain injury.METHODS: A total of 100 individuals with persistent post-traumatic headache attributed to mild traumatic brain injury were enrolled between July 2018 and June 2019. Deep phenotyping was performed using a semi-structured interview while allodynia was assessed using the 12-item Allodynia Symptom Checklist.RESULTS: In 100 subjects with persistent post-traumatic headache, the mean headache frequency was 25.4 ± 7.1 days per month. The most common headache phenotype was chronic migraine-like headache (n = 61) followed by combined episodic migraine-like and tension-type-like headache (n = 29) while nine subjects reported "pure" chronic tension-type-like headache. The most frequent trigger factors were stress, lack of sleep, and bright lights. A history of preventive medication use was reported by 63 subjects, of which 79% reported failure of at least one preventive drug, while 19% reported failure of at least four preventive drugs. Cutaneous allodynia was absent in 54% of the subjects, mild in 23%, moderate in 17%, and severe in 6%.CONCLUSIONS: The headache profile of individuals with persistent post-traumatic headache most often resembled a chronic migraine-like phenotype or a combined episodic migraine-like and tension-type-like headache phenotype. Migraine-specific preventive medications were largely reported to be ineffective. Therefore, there is a pressing need for pathophysiological insights and disease-specific therapies.
U2 - 10.1177/0333102420909865
DO - 10.1177/0333102420909865
M3 - Journal article
C2 - 32102546
VL - 40
SP - 554
EP - 564
JO - Cephalalgia
JF - Cephalalgia
SN - 0800-1952
IS - 6
ER -
ID: 261235739