title: Longitudinal Study of Headache Trajectories in the Year After Mild Traumatic Brain Injury: Relation to Posttraumatic Stress Disorder Symptoms.
abstract: OBJECTIVE
  To examine headache trajectories among persons with mild traumatic brain injury (MTBI) in the year after injury and the relation of headache trajectory to posttraumatic stress disorder (PTSD) at 1 year postinjury.
  
  
  METHODS
  Prospective, longitudinal study.
  
  
  METHODS
  Participants were recruited through a university medical center and participated in follow-up assessments by telephone.
  
  
  METHODS
  Prospectively enrolled individuals (N=212) within 1 week of MTBI who were hospitalized for observation or other system injuries. Participants were assessed at baseline and 3, 6, and 12 months postinjury.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Participants rated average headache pain intensity using the 0 to 10 numerical rating scale at each assessment period. The PTSD Checklist-Civilian Version was completed at 12 months postinjury.
  
  
  RESULTS
  Latent class growth analysis produced a 4-trajectory group model, with groups labeled resolved, worsening, improving, and chronic. Multivariate regression modeling revealed that younger age and premorbid headache correlated with membership in the worse trajectory groups (worsening and chronic; P<.001). Univariate regression revealed a significant association between PTSD and membership in the worse trajectory groups (P<.001).
  
  
  CONCLUSIONS
  Headache is common in the year after MTBI, with younger people, persons who previously had headaches, and persons with PTSD more likely to report chronic or worsening headache. Further research is needed to examine whether PTSD symptoms exacerbate headaches or whether problematic headache symptoms exacerbate PTSD.
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA. Electronic address: kasawyer@uw.edu.
authors.forename: Kathryn
authors.initials: K
authors.lastname: Sawyer
authors.affiliation: Department of Physical Medicine and Rehabilitation, University of Texas Southwest Medical Center, Dallas, TX.
authors.forename: Kathleen R
authors.initials: KR
authors.lastname: Bell
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Ehde
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Department of Neurological Surgery, University of Washington, Seattle, WA; Department of Biostatistics, University of Washington, Seattle, WA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Temkin
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Department of Neurological Surgery, University of Washington, Seattle, WA; Department of Psychiatry and Behavioral Medicine, University of Washington, Seattle, WA.
authors.forename: Sureyya
authors.initials: S
authors.lastname: Dikmen
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA; Veterans Affairs Puget Sound Healthcare System, Seattle, WA.
authors.forename: Rhonda M
authors.initials: RM
authors.lastname: Williams
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Tiara
authors.initials: T
authors.lastname: Dillworth
authors.affiliation: Department of Rehabilitation Medicine, University of Washington, Seattle, WA.
authors.forename: Jeanne M
authors.initials: JM
authors.lastname: Hoffman
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000453:epidemiology*; D005260:Female; D006261:Headache / Q000453:epidemiology*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D011446:Prospective Studies; D013313:Stress Disorders, Post-Traumatic / Q000453:epidemiology*; D014193:Trauma Centers; D055815:Young Adult
keywords: Headache; Rehabilitation; Stress disorders; post-traumatic