# Specific pre-injury migraine characteristics associated with worse concussion outcomes

## TL;DR

People with a history of migraines before injury tend to report worse outcomes after concussions, including longer recovery times and lower quality of life.

## Contribution

This study identifies specific pre-injury migraine characteristics linked to worse post-concussion outcomes using retrospective self-report data.

## Key findings

- Individuals with pre-injury migrines reported worse post-concussion symptoms and delayed return to activities.
- Migraine-related functional impairment and severity were strongly correlated with worse post-concussion outcomes and lower quality of life.
- The findings suggest that pre-injury migraine history should be considered in concussion evaluation and management.

## Abstract

We examined retrospectively recalled characteristics of pre-injury migraine and their association with retrospectively reported post-concussion outcomes.

Data for this study was collected based on self-reported recall from a cross-sectional survey design, distributed online via the Prolific platform. Eligible participants (N = 271) completed the Migraine Disability Assessment Test, Rivermead Post-Concussion Symptoms Questionnaire, Quality of Life in Neurological Disorders short-form, and self-reported return to activities. A MANCOVA compared retrospectively reported concussion outcomes between individuals with and without a self-reported pre-injury migraine diagnosis. Partial correlations assessed associations between retrospectively recalled migraine characteristics and post-concussion outcomes.

Compared to those without a self-reported history of migraine (n = 208), individuals with a self-reported pre-injury migraine diagnosis (n = 61) retrospectively reported significantly greater severity of earlier (p = .007) and later (p = .032) cluster post-concussion symptoms, delayed return to work/school (p = .050) and sports (p < .001), and lower quality of life in the stigma (p < .001) subdomain. Retrospectively reported pre-injury migraine-related functional impairment was significantly correlated with recalled severity of earlier (r = .37) and later (r = .31) cluster post-concussion symptoms, return to sports (r = .29), and quality of life in the social role 1 subdomain (r = −.35). Retrospective reports of pre-injury migraine severity were significantly correlated with both earlier (r = .43) and later (r = .34) cluster post-concussion symptom severity, and lower quality of life in the anxiety (r = .45), depression (r = .46), dyscontrol (r = .38), fatigue (r = .32), wellbeing (r = −.32), sleep (r = .35), social role 1 (r = −.48), and cognition 2 (r = −.37) subdomains.

Individuals with a retrospectively reported history of migraine recalled worse concussion outcomes than those without a migraine history. Additionally, more unfavourable recalled pre-injury migraine characteristics were associated with reports of more adverse post-concussion outcomes. These findings highlight the potential value of assessing individuals’ experience with pre-injury migraine when evaluating post-concussion challenges, and the need for future research to examine these relationships using longitudinal designs and objective clinical measures.