Evidence map›Paper›PMID 37808506›Full record

ArticleFrontiers in neurology2023

Headache among combat-exposed veterans and service members and its relation to mild traumatic brain injury history and other factors: a LIMBIC-CENC study.

William C Walker, Sarah W Clark, Kaleb Eppich, Elisabeth A Wilde, Aaron M Martin, Chelsea M Allen, Melissa M Cortez, Mary Jo Pugh, Samuel R Walton, Kimbra Kenney

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in Frontiers in neurology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
1.3field-weighted citation impact, top 20% 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

4 citing papers in PubMed, 6 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

10 authors at 5 institutions in 1 country.

William C WalkerDepartment of Physical Medicine and Rehabilitation (PM&R), School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.
Sarah W ClarkRichmond Veterans Affairs (VA) Medical Center, Central Virginia VA Health Care System, Richmond, VA, United States.
Kaleb EppichDivision of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States.
Elisabeth A WildeGeorge E. Wahlen VA Salt Lake City Healthcare System, Salt Lake City, UT, United States.
Aaron M MartinMental Health and Behavioral Science Service, James A. Haley Veterans' Hospital, Tampa, FL, United States.
Chelsea M AllenDivision of Epidemiology, Department of Internal Medicine, University of Utah, Salt Lake City, UT, United States.
Melissa M CortezDepartment of Neurology, University of Utah, Salt Lake City, UT, United States.
Mary Jo PughInformatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center, Salt Lake City, UT, United States.
Samuel R WaltonDepartment of Physical Medicine and Rehabilitation (PM&R), School of Medicine, Virginia Commonwealth University, Richmond, VA, United States.
Kimbra KenneyDepartment of Neurology, Uniformed Services University of the Health Sciences, Bethesda, MD, United States.
University of Utah · USVirginia Commonwealth University · USJames A. Haley Veterans' Hospital · USUniformed Services University of the Health Sciences · USVA Salt Lake City Healthcare System · US

Funding

Utah Center for Clinical and Translational ScienceUL1TR002538 · NCATS · UNIVERSITY OF UTAH · PI HESS, RACHEL, MAJERSIK, JENNIFER JUHL · 2018 to 2022
$26.0M
University of Utah Center for Clinical and Translational ScienceUL1TR001067 · NCATS · UNIVERSITY OF UTAH · PI DERE, WILLARD H., HESS, RACHEL · 2013 to 2017
$19.8M
UNIVERSITY OF UTAH CENTER FOR CLINICAL AND TRANSLATIONAL SCIENCE-UL1: BPCAUL1RR025764 · NCRR · UNIVERSITY OF UTAH · PI MCCLAIN, DONALD A. · 2008 to 2011
$19.4M
CSRD VA I01 CX001135CSRD VA I01 CX001246CSRD VA I01 CX001820CSRD VA I01 CX002096CSRD VA I01 CX002097HSRD VA I01 HX003155NCATS NIH HHS UL1 TR001067NCATS NIH HHS UL1 TR002538NCRR NIH HHS UL1 RR025764RRD VA I01 RX001135RRD VA I01 RX001774RRD VA I01 RX001880RRD VA I01 RX002076RRD VA I01 RX002170RRD VA I01 RX002171RRD VA I01 RX002172RRD VA I01 RX002173RRD VA I01 RX002174RRD VA I01 RX003442RRD VA I01 RX003443RRD VA I01 RX003444
6 · The paper itself

Abstract

Background: Headache (HA) is a common persistent complaint following mild traumatic brain injury (mTBI), but the association with remote mTBI is not well established, and risk factors are understudied. Objective: Determine the relationship of mTBI history and other factors with HA prevalence and impact among combat-exposed current and former service members (SMs). Design: Secondary cross-sectional data analysis from the Long-Term Impact of Military-Relevant Brain Injury Consortium-Chronic Effects of Neurotrauma Consortium prospective longitudinal study. Methods: We examined the association of lifetime mTBI history, demographic, military, medical and psychosocial factors with (1) HA prevalence ("lately, have you experienced headaches?") using logistic regression and (2) HA burden via the Headache Impact Test-6 (HIT-6) using linear regression. Each lifetime mTBI was categorized by mechanism (blast-related or not) and setting (combat deployed or not). Participants with non-credible symptom reporting were excluded, leaving Results: At a median 10 years since last mTBI, mTBI positive participants had higher HA prevalence (69% overall, 78% if 3 or more mTBIs) and greater HA burden (67% substantial/severe impact) than non-TBI controls (46% prevalence, 54% substantial/severe impact). In covariate-adjusted analysis, HA prevalence was higher with greater number of blast-related mTBIs (OR 1.81; 95% CI 1.48, 2.23), non-blast mTBIs while deployed (OR 1.42; 95% CI 1.14, 1.79), or non-blast mTBIs when not deployed (OR 1.23; 95% CI 1.02, 1.49). HA impact was only higher with blast-related mTBIs. Female identity, younger age, PTSD symptoms, and subjective sleep quality showed effects in both prevalence and impact models, with the largest mean HIT-6 elevation for PTSD symptoms. Additionally, combat deployment duration and depression symptoms were factors for HA prevalence, and Black race and Hispanic/Latino ethnicity were factors for HA impact. In sensitivity analyses, time since last mTBI and early HA onset were both non-significant. Conclusion: The prevalence of HA symptoms among formerly combat-deployed veterans and SMs is higher with more lifetime mTBIs regardless of how remote. Blast-related mTBI raises the risk the most and is uniquely associated with elevated HA burden. Other demographic and potentially modifiable risk factors were identified that may inform clinical care.

Indexed as

blast injuriesconcussionheadachemilitary medicinepostconcussive headachepredictiontraumatic brain injuryveterans

Identifiers

PMID37808506
PMCPMC10552781
OpenAlexW4386933302

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.