{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:10:51Z","timestamp":1787008251361,"version":"build-2736575974"},"reference-count":36,"publisher":"SAGE Publications","issue":"15-16","license":[{"start":{"date-parts":[[2024,8,1]],"date-time":"2024-08-01T00:00:00Z","timestamp":1722470400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:p>\n                    Pre-injury migraines might be a risk factor for prolonged recovery after sport-related concussion (SRC). We sought to examine whether a pre-injury history of migraines is associated with worse recovery following SRC in collegiate athletes. Data were collected through a prospective concussion surveillance system in 11 National Collegiate Athletic Association (NCAA) Division III college athletic programs between September 2014 and March 2020. Our primary independent variable, pre-injury migraines, were self-reported by the athletes. Between those with and without migraines, the outcomes of days to return-to-learn (RTL) without academic accommodations and return-to-play (RTP) were compared using Mann\u2013Whitney\n                    <jats:italic toggle=\"yes\">U<\/jats:italic>\n                    tests. Each athlete's RTL and RTP status was dichotomized (i.e., returned vs. not returned) at various time points for RTL (i.e., 7\/14\/21\/28 days) and RTP (i.e., 14\/21\/28\/56 days). Chi-squared tests were performed to compare the proportions of RTL and RTP status between groups. Multivariable regressions analyzed potential predictors of RTL and RTP adjusting for age, gender, prior concussions, other health conditions, and symptom severity. Of 1409 athletes with an SRC, 111 (7.9%) had a pre-injury history of migraines. Compared with those without migraines, those with migraines had longer median (interquartile range [IQR]) days to RTL (migraines\u2009=\u20097.0 [3.0\u201312.3] vs. no migraines\u2009=\u20095.0 [2.0\u201310.0],\n                    <jats:italic toggle=\"yes\">U<\/jats:italic>\n                    \u2009=\u200953,590.5,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.022). No differences were found in RTP between the two groups (migraines\u2009=\u200916.0 [10.0\u201333.0] vs. n\u03c7o migraines 15.0 [11.0\u201323.0],\n                    <jats:italic toggle=\"yes\">U<\/jats:italic>\n                    \u2009=\u200938,545.0,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.408). Regarding RTL, significantly lower proportions of athletes in the migraine group had fully RTL, without accommodations, at \u226414 days (77.5% vs. 85.2%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20094.33,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.037), \u226421 days (85.3% vs. 93.0%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20097.99,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.005), and \u226428 days (88.2% vs. 95.6%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u200910.60,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.001). Regarding RTP, a significantly lower proportion of athletes in the migraine group RTP at \u226428 days (72.0% vs. 82.7%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20095.40,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.020) and \u226456 days (84.0% vs. 93.0%, \u03c7\n                    <jats:sup>2<\/jats:sup>\n                    \u2009=\u20098.19,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.004). In a multivariable model predicting RTL that was adjusted for age, gender, acute concussion symptoms, and other health variables (e.g., attention-deficit\/hyperactivity disorder [ADHD], history of mental health difficulties), pre-injury history of migraine was associated with longer RTL (\u03b2\u2009=\u20090.06,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.030). In a multivariable model predicting RTP, pre-injury history of migraine was not associated with RTP (\u03b2\u2009=\u20090.04,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2009=\u20090.192). In collegiate athletes, pre-injury migraine history was independently associated with longer RTL but not RTP. When comparing the proportions of those with successful RTP by days, significantly lower proportions of those with migraines showed successful RTP at \u226428 days and \u226456 days. Futures studies should study the generalizability of our findings in other school levels.\n                  <\/jats:p>","DOI":"10.1089\/neu.2023.0475","type":"journal-article","created":{"date-parts":[[2024,3,22]],"date-time":"2024-03-22T08:01:54Z","timestamp":1711094514000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Recovery After Sport-Related Concussion in Collegiate Athletes With Self-Reported Pre-Injury Migraines"],"prefix":"10.1177","volume":"41","author":[{"given":"Douglas P.","family":"Terry","sequence":"first","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Jo","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristen L.","family":"Williams","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce A.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Khoury College of Computer Science, Northeastern University \u2013 Seattle, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul D.","family":"Berkner","sequence":"additional","affiliation":[{"name":"College of Osteopathic Medicine, University of New England, Biddeford, Maine, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA."},{"name":"Mass General for Children Sports Concussion Program, Waltham, Massachusetts, USA."},{"name":"Department of Physical Medicine and Rehabilitation, Spaulding Rehabilitation Hospital and the Schoen Adams Research Institute at Spaulding Rehabilitation, Charlestown, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott L.","family":"Zuckerman","sequence":"additional","affiliation":[{"name":"Vanderbilt Sports Concussion Center, Department of Neurological Surgery, Vanderbilt University Medical Center, Nashville, Tennessee, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2024,8,20]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/BSD.0000000000000451"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jadohealth.2018.08.023"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092313"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699052.2020.1740942"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097729"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1080\/00913847.2016.1142834"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.06.035"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512444554"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-51.3.05"},{"key":"e_1_3_2_11_2","unstructured":"Dick RW. Is there a gender difference in concussion incidence and outcomes? Vanderbilt University. n.d. Available from: https:\/\/catalog.library.vanderbilt.edu [Last accessed: 11\/23\/2021]"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617712001464"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1249\/JSR.0000000000000104"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.4085\/1062-6050-46.1.76"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2016.0073"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1177\/1941738116672184"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617713001288"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2022.915357"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102413485658"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0228284"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a116014"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-022-01528-3"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2017.5443"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000791"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2016.1203"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000000494"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2013-0432"},{"key":"e_1_3_2_28_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1355617719000286"},{"key":"e_1_3_2_29_2","doi-asserted-by":"publisher","DOI":"10.1080\/21622965.2017.1381099"},{"key":"e_1_3_2_30_2","unstructured":"Anonymous. H.I.T. PROJECT. n.d. Available from: https:\/\/www.maineconcussionmanagementinitiative.org\/hit-project [Last accessed: 10\/28\/2023]"},{"key":"e_1_3_2_31_2","doi-asserted-by":"publisher","DOI":"10.1177\/0363546512455400"},{"key":"e_1_3_2_32_2","unstructured":"Anonymous. Returning to Sports and Activities | HEADS UP | CDC Injury Center. 2023. 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