{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T15:55:56Z","timestamp":1789660556387,"version":"4.0.1"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"3-4","funder":[{"name":"U.S. Army Medical Research and Material Command and from the U.S. Department of Veterans Affairs Chronic Effects of Neurotrauma Consortium","award":["W81XWH-13-2-0095"],"award-info":[{"award-number":["W81XWH-13-2-0095"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,2,26]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Chronic pain is a significant problem for service members and veterans with mild traumatic brain injury (mTBI). While the root cause of pain is not clearly understood, comorbidities may contribute to how their pain disrupts their functional status, a construct termed \u201cpain interference.\u201d The purpose of this study is to examine the associations between mTBI, other comorbidities, and pain interference.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Materials and Methods<\/jats:title>\n                  <jats:p>The sample comprised participants with mTBI(s) from The Chronic Effects of Neurotrauma Consortium multicenter observational study. Potential concussive events were identified using a modified Ohio State University traumatic brain injury (TBI) Identification interview and then further with a structured interview. Pain interference was measured with the TBI quality-of-life pain interference score, which was categorized into insignificant, moderate, and high pain interference. Comorbidities of interest included anxiety, depression, post-traumatic stress disorder, insomnia, and arthritis. Multivariable relationships were analyzed using logistic regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The analysis sample included 346 participants with mTBI(s). In adjusted analysis, those with high pain interference were more likely to have history of \u2265 3 TBIs (odds ratio (OR) 3.1, 95% confidence interval [CI] 1.4, 6.9) and to have clinical levels of post-traumatic stress disorder (OR 5.4, 95% CI 1.9, 15.7), depression (OR 2.5, 95% CI, 1.0, 6.1), anxiety (OR 4.9, 95% CI, 2.0, 11.7), and sleep disturbances (OR 6.1, 95% CI 2.0, 19.0) versus those with insignificant pain interference.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>These results identify clinical features of veterans and service members with mTBI(s) who are at highest risk for pain-related disability. These findings also demonstrate the need to consider mental health and sleep problems in their pain evaluation and treatment approach.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/milmed\/usaa249","type":"journal-article","created":{"date-parts":[[2020,10,2]],"date-time":"2020-10-02T19:33:36Z","timestamp":1601667216000},"page":"e293-e299","source":"Crossref","is-referenced-by-count":17,"title":["Post-mTBI Pain Interference in a U.S. Military Population: A Chronic Effects of Neurotrauma Consortium Study"],"prefix":"10.1093","volume":"186","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0143-1390","authenticated-orcid":false,"given":"Bilal R","family":"Khokhar","sequence":"first","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan A","family":"Lindberg","sequence":"additional","affiliation":[{"name":"Defense and Veterans Brain Injury Center, Silver Spring, MD 20910, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C","family":"Walker","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hunter Holmes McGuire Department of Veterans Affairs Medical Center, Richmond, VA 23249, USA"},{"name":"Defense and Veterans Brain Injury Center, Richmond, VA 23249, USA"},{"name":"Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA 23284, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,2,26]]},"reference":[{"issue":"6","key":"2021022616231350400_R1","doi-asserted-by":"crossref","first-page":"711","DOI":"10.1001\/jama.300.6.711","article-title":"Prevalence of chronic pain after traumatic brain injury: a systematic 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