Cognitive symptoms in veterans with migraine or traumatic brain injury: A Million Veteran Program study.

IF 5.4 2区医学 Q1 CLINICAL NEUROLOGY Headache Pub Date : 2024-08-28 DOI:10.1111/head.14815

Matthew S Herbert, Victoria C Merritt, Niloofar Afari, Marianna Gasperi

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Abstract

Objective: To examine the spectrum and severity of cognitive symptoms in veterans with migraine, traumatic brain injury (TBI), or both; and to evaluate the extent to which psychiatric conditions contribute to the relationship of migraine and TBI with cognitive symptoms.

Background: Migraine contributes significantly to global disability, with veterans facing additional burdens due to high comorbidity of TBI and psychiatric conditions. Understanding the intersection of these conditions is crucial for improving veterans' health-care outcomes.

Methods: This observational study used self-reported data from 338,217 veterans enrolled in the Million Veteran Program (MVP) to assess cognitive symptoms using the Medical Outcomes Study Cognitive Functioning Scale Revised (MOS-Cog-R) and psychiatric conditions in veterans with migraine only, TBI only, both, or neither.

Results: Of the participants, 30,080/338,217 (8.9%) veterans reported migraine, 31,906/338,217 (9.4%) reported TBI, and 7828/338,217 (2.3%) reported both migraine and TBI. Veterans with only migraine or only TBI reported similar levels of cognitive symptoms (M = 74.19, standard deviation [SD] = 25.18; M = 73.87, SD = 24.98, respectively), which were substantially higher than veterans without these conditions (M = 62.52, SD = 27.90). Veterans with both conditions reported the most cognitive symptoms (M = 83.01, SD = 22.13) and psychiatric conditions (depression = 5041/7828 [64.4%], anxiety = 3735/7828 [47.7%], post-traumatic stress disorder = 4243/7828 [54.2%]). The association of migraine and TBI with cognitive symptoms persisted beyond the influence of psychiatric conditions (B = -2.20, standard error = -0.36, p < 0.001).

Conclusion: Veterans with migraine reported cognitive challenges analogous to veterans with TBI, indicating a need for careful attention to cognitive symptoms in veterans with migraine. Further, the associations of migraine and TBI with cognitive symptoms in veterans were not explained by psychiatric conditions. These findings encourage future research to elucidate the association between self-reported and objective cognitive symptoms and to identify factors, including environmental exposure and genetic influences, contributing to cognitive impairment to optimize the assessment and treatment of veterans with migraine.

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患有偏头痛或脑外伤的退伍军人的认知症状：百万退伍军人计划研究。

目的：研究患有偏头痛、创伤性脑损伤（TBI）或同时患有这两种疾病的退伍军人的认知症状的范围和严重程度；评估精神疾病在多大程度上导致偏头痛和创伤性脑损伤与认知症状之间的关系：背景：偏头痛是导致全球残疾的重要原因，而退伍军人由于同时患有创伤性脑损伤和精神疾病而面临着额外的负担。了解这些疾病的交叉点对于改善退伍军人的医疗保健效果至关重要：这项观察性研究利用 338,217 名参加 "百万退伍军人计划"（Million Veteran Program，MVP）的退伍军人的自我报告数据，使用医学结果研究认知功能量表修订版（MOS-Cog-R）评估认知症状，并评估仅患有偏头痛、仅患有创伤性脑损伤、同时患有偏头痛或两者均不患有创伤性脑损伤的退伍军人的精神状况：在参与者中，30,080/338,217（8.9%）名退伍军人患有偏头痛，31,906/338,217（9.4%）名退伍军人患有创伤性脑损伤，7828/338,217（2.3%）名退伍军人同时患有偏头痛和创伤性脑损伤。仅患有偏头痛或仅患有创伤性脑损伤的退伍军人报告的认知症状水平相似（分别为：M = 74.19，标准差 [SD] = 25.18；M = 73.87，标准差 = 24.98），均远高于未患有偏头痛或创伤性脑损伤的退伍军人（M = 62.52，标准差 = 27.90）。患有这两种疾病的退伍军人报告的认知症状（M = 83.01，SD = 22.13）和精神状况（抑郁 = 5041/7828 [64.4%]，焦虑 = 3735/7828 [47.7%]，创伤后应激障碍 = 4243/7828 [54.2%]）最多。患有偏头痛的退伍军人报告了与患有创伤性脑损伤的退伍军人类似的认知挑战，这表明需要仔细关注患有偏头痛的退伍军人的认知症状。此外，偏头痛和创伤性脑损伤与退伍军人认知症状之间的关联无法用精神状况来解释。这些发现鼓励未来的研究阐明自我报告的认知症状与客观认知症状之间的关联，并确定导致认知障碍的因素，包括环境暴露和遗传影响，以优化对偏头痛退伍军人的评估和治疗。

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来源期刊

Headache 医学-临床神经学

CiteScore

9.40

自引率

10.00%

发文量

172

审稿时长

3-8 weeks

期刊介绍： Headache publishes original articles on all aspects of head and face pain including communications on clinical and basic research, diagnosis and management, epidemiology, genetics, and pathophysiology of primary and secondary headaches, cranial neuralgias, and pains referred to the head and face. Monthly issues feature case reports, short communications, review articles, letters to the editor, and news items regarding AHS plus medicolegal and socioeconomic aspects of head pain. This is the official journal of the American Headache Society.