Objective: The purpose of this study was to investigate the association between migraine headache and concussion in athletes.
Design: Case–control observational study.
Setting: A university-associated combined sports neurology and orthopedic sports medicine clinic.
Participants: A total of 221 male (n = 140) and female (n = 81) athletes aged 12 to 24 years, including 115 concussion cases (52%) and 106 orthopedic controls (48%), were included in this study.
Interventions: Participants completed a one-page questionnaire that recorded their age, sex, reason for visit (concussion vs any other injury), concussion history, and self/immediate family member migraine headache history.
Main Outcome Measures: The odds of having a previous history of migraine headache were compared in the concussion group versus orthopedic controls.
Results: Controlling for between-group differences in age and sex, there was a significant positive association between concussion group status and history of migraine headache [adjusted odds ratio (OR), 1.90; 95% confidence interval (CI), 1.03-3.50. P = 0.039]. However, when including a previous concussion history in the statistical model, this relationship failed to reach significance [adjusted OR, 1.68; 95% CI, 0.89-3.16. P = 0.107].
Conclusions: These results suggest that there is an association between migraine headache and concussion in athletes, but the cause–effect nature of this relationship cannot be determined. Migraine headache should be considered a modifying factor when caring for concussed athletes.
*Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan;
†Michigan NeuroSport, University of Michigan, Ann Arbor, Michigan;
‡Department of Neurology, Norton Healthcare, Louisville, Kentucky;
§Department of Neurology, University of Kentucky, Lexington, Kentucky; and
¶Department of Neurology, University of Michigan, Ann Arbor, Michigan. A. Pescovitz is now with Department of General Surgery, Maimonides Medical Center, Brooklyn, New York; M. Zeiger is now with Division of Pediatric Neurology, University of California, Los Angeles, California; and J. S. Kutcher is now with The Sports Neurology Clinic, Ann Arbor, Michigan.
Corresponding Author: James T. Eckner, MD, MS, Department of PM & R, University of Michigan, 325 E. Eisenhower Pkwy, Ann Arbor, MI 48108 (email@example.com).
Dr Eckner received partial effort support during this project from the Rehabilitation Medicine Scientist Training Program and the National Institutes of Health (1 K23 HD078502). His active research funding includes the National Institutes of Health (1 K23 HD078502), the National Collegiate Athletics Association, the United States Department of Defense (14132004), the University of Michigan Injury Center, and the Foundation for Physical Medicine and Rehabilitation. Dr Seifert is a member of the Kentucky State Boxing Commission and has served as a consultant for the United States Department of Defense. He has received personal compensation as a speaker for the National Headache Foundation and the American Headache Society. Dr Kutcher is a consultant for the National Basketball Association and ElmindA, Ltd. The other authors report no conflicts of interest.
Received October 16, 2015
Accepted April 01, 2016