A - 39 Pre- and Post-Injury Factors Associated With Post-traumatic Migraine in Concussion Patients Without a Migraine History

Abstract Purpose To identify preinjury factors and clinical findings associated with post-traumatic migraine (PTM) in patients post-concussion without a migraine history. Method This was a retrospective study of patients (5–49 years) presenting to a specialty clinic <30 days after a diagnosed concussion who did not endorse personal migraine history. Participants completed the Concussion Clinical Profile Screen (CP Screen), Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT), and Vestibular/ Ocular Motor Screening (VOMS). Participants were categorized into PTM and No PTM groups based on CP Screen migraine items (e.g., headache with nausea). T-tests, chi-square tests, and ANCOVAs examined group differences/associations. Results 496 participants (age = 17.5 ± 8.0; 50.8% male) were included; 277 (55.9%) with PTM and 219 (44.1%) without PTM. Female sex (OR = 2.2, 95%CI = 1.6–3.2, p < 0.01), anxiety history (OR = 1.7, 95%CI = 1.2–2.6, p < 0.01), and depression history (OR = 1.6, 95%CI = 1.1–2.6, p = 0.04) were associated with PTM. In addition to migraine clinical profile (OR = 2.3, 95%CI = 1.3–4.2, p < 0.01), PTM was associated with anxiety/mood (OR = 1.9, 95%CI = 1.2–3.0, p = 0.01) and vestibular profiles (OR = 1.9, 95%CI = 1.2–3.1, p = 0.01). Controlling for sex and anxiety/depression history (F(1,470) = 145.6, p < 0.001), PTM exhibited a greater CP Screen Total than No PTM (30.6 vs. 14.4, p < 0.001). Adjusting for CP Screen Total as well, the PTM group exhibited worse ImPACT verbal memory (F(1,458) = 8.0, p < 0.01), processing speed (F(1,458) = 4.9, p = 0.03), and VOMS change score (F(1,462) = 32.0, p < 0.01). Conclusions Patients exhibiting PTM symptoms post-concussion without a migraine history were more likely to be female and have a history of anxiety/depression. PTM presentation was associated with vestibular and anxiety/mood profiles and worse overall concussion symptoms, verbal memory, processing speed, and vestibular/ocular motor functioning.