Evidence map›Paper›PMID 35470141›Full record

ArticleNeurology2022

Relationship Between Headache Characteristics and a Remote History of TBI in Veterans: A 10-Year Retrospective Chart Review.

Colt Coffman, Deborah Reyes, Mary Catherine Hess, Alec M Giakas, Melinda Thiam, Jason Jonathon Sico, Elizabeth Seng, William Renthal, Charles Rhoades, Guoshuai Cai and 1 more

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
3.3field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. History of Traumatic Brain Injury with Loss of Consciousness and APOEbioRxiv : the preprint server for biology · 2026
    Article
  3. Review
  4. Observational
  5. Article
  6. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 1 institution in 1 country.

Colt CoffmanFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
Deborah ReyesFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
Mary Catherine HessFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
Alec M GiakasFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.ORCID 0000-0002-0082-1648
Melinda ThiamFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
Jason Jonathon SicoFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
Elizabeth SengFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.ORCID 0000-0002-8938-4949
William RenthalFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.ORCID 0000-0003-0206-2101
Charles RhoadesFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
Guoshuai CaiFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC.
X Michelle AndroulakisFrom the Department of Kinesiology (C.C.), Michigan State University, East Lansing; Department of Physical Medicine and Rehabilitation Services (D.R., C.R.), Departments of Neurology (M.C.H., X.M.A.), and Psychiatry (M.T.), Columbia VA Healthcare System; University of South Carolina School of Medicine (A.M.G.), Columbia; Yale School of Medicine (J.J.S.), New Haven; Headache Centers of Excellence Program (J.J.S.), US Department of Veterans Affairs, West Haven, CT; Montefiore Headache Center (E.S.), Montefiore Medical Center, Bronx, NY; Department of Neurology (W.R.), Brigham and Women's Hospital and Harvard Medical School, Boston; Department of Neurobiology (W.R.), Harvard Medical School, Boston, MA; Department of Environmental Health Science (G.C.), Arnold School of Public Health, University of South Carolina, Columbia; and Headache Centers of Excellence Program (X.M.A.), US Department of Veterans Affairs, Columbia, SC. michelle.androulakis@uscmed.sc.edu.ORCID 0000-0002-1833-3474
Department of Veterans Affairs · AU

Funding

Yale Clinical and Translational Science Award (U Component)UL1TR001863 · NCATS · YALE UNIVERSITY · PI John H. Krystal, LUCILA OHNO-MACHADO · 2016 to 2026
$102.9M
NCATS NIH HHS UL1 TR001863
6 · The paper itself

Abstract

BACKGROUND AND

objectivesThe objective of this work was to examine the association between deployment-related traumatic brain injury (TBI) severity, frequency, and other injury characteristics with headache outcomes in veterans evaluated at a Veterans Administration (VA) polytrauma support clinic.

methodsWe conducted a retrospective chart review of 594 comprehensive TBI evaluations between 2011 and 2021. Diagnostic criteria were based on the Department of Defense/VA Consensus-Based Classification of Closed TBI. Adjusted odds ratios (AORs) and 95% CIs were estimated for headache prevalence (logistic), headache severity (ordinal), and prevalence of migraine-like features (logistic) with multiple regression analysis. Regression models were adjusted for age, sex, race/ethnicity, time since injury, and mental health diagnoses.

resultsTBI severity groups were classified as sub concussive exposure (n = 189) and mild (n = 377), moderate (n = 28), and severe TBI (n = 0). Increased headache severity was reported in veterans with mild TBI (AOR 1.72 [95% CI 1.15, 2.57]) and moderate TBI (AOR 3.89 [1.64, 9.15]) compared to those with subconcussive exposure. A history of multiple mild TBIs was associated with more severe headache (AOR 2.47 [1.34, 4.59]) and migraine-like features (AOR 5.95 [2.55, 13.77]). No differences were observed between blast and nonblast injuries; however, greater headache severity was reported in veterans with both primary and tertiary blast effects (AOR 2.56 [1.47, 4.49]). Alteration of consciousness (AOC) and posttraumatic amnesia (PTA) >30 minutes were associated with more severe headache (AOR 3.37 [1.26, 9.17] and 5.40 [2.21, 13.42], respectively). The length of time between the onset of last TBI and the TBI evaluation was associated with headache severity (AOR 1.09 [1.02, 1.17]) and prevalence of migraine-like features (AOR 1.27 [1.15, 1.40]). Last, helmet use was associated with less severe headache (AOR 0.42 [0.23, 0.75]) and lower odds of migraine-like features (AOR 0.45 [0.21, 0.98]). DISCUSSION: Our data support the notion of a dose-response relationship between TBI severity and headache outcomes. A history of multiple mild TBIs and longer duration of AOC and PTA are unique risk factors for poor headache outcomes in veterans. Furthermore, this study sheds light on the poor headache outcomes associated with subconcussive exposure. Past TBI characteristics should be considered when developing headache management plans for veterans.

Indexed as

Brain ConcussionBrain Injuries, TraumaticMigraine DisordersVeteransHeadacheHumansIraq War, 2003-2011Retrospective StudiesSeverity of Illness Index

Identifiers

PMID35470141
PMCPMC9280992
OpenAlexW4224923076

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.