Headache complexity (number of symptom features) differentiates post-traumatic from non-traumatic headaches

Area of Science:

• Neuroscience
• Epidemiology
• Clinical Medicine

Background:

• Post-traumatic headaches are a frequent outcome of mild traumatic brain injury (concussion).
• The phenotypic differences between post-traumatic headaches and primary headaches remain unclear.

Purpose of the Study:

• To investigate an underlying latent trait influencing the expression of observed features in post-traumatic headache and other headache types.
• To determine if headache complexity differs between post-traumatic headaches and other headache presentations.

Main Methods:

• Utilized data from the Warrior Strong Cohort Study (2010-2015) involving 1567 soldiers.
• Employed single-factor confirmatory factor analysis on 12 headache phenotypic features to measure 'headache complexity'.
• Compared headache complexity across groups: post-traumatic headache, concussion with coincidental headache, and no concussion history.

Main Results:

• Soldiers with post-traumatic headaches exhibited greater endorsement of all 12 headache features compared to non-concussive headache groups.
• Confirmatory factor analysis supported the 'headache complexity' construct with good model fit.
• Post-traumatic headache patients demonstrated significantly higher headache complexity than both non-concussed and concussed soldiers with coincidental headaches.
• Increased headache complexity was a predictor of medical encounters for headache and migraine within a year post-deployment.

Conclusions:

• The study provides evidence for a single latent trait, 'headache complexity,' differentiating concussive from non-concussive headaches.
• Findings suggest post-traumatic headaches are distinguished by severity rather than type, based on assessed symptoms.
• Headache complexity is a significant predictor of accessing medical care for headache conditions.