{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T18:13:20Z","timestamp":1793384000750,"version":"4.5.0"},"reference-count":64,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T00:00:00Z","timestamp":1655683200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Individuals with migraine disorders may be affected differently by concussions compared to individuals without migraine disorders. Prior studies on this topic have had mixed results. The purpose of this study was to systematically examine clinical outcomes following a sport-related concussion in athletes who have a pre-injury history of migraines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      All studies published prior to 15 May 2021 that examined pre-injury migraines as a possible predictor of clinical recovery from concussion were included. The search included (i) sport\/athlete-related terms, (ii) concussion-related terms, and (iii) diverse predictor\/modifier terms. After removing duplicates, 5,118 abstracts were screened, 538 full-text articles were reviewed, and 27 articles were included for narrative synthesis without meta-analysis (\n                      <jats:italic>n<\/jats:italic>\n                      = 25 with unique samples). Risk of bias was assessed using the domain-based Quality In Prognosis Studies (QUIPS) tool.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Most studies did not find pre-injury migraines to be associated with concussion outcome, but several of these studies had small or very small sample sizes, as well as other methodological weaknesses. Risk of bias varied greatly across studies. Some of the larger, better-designed studies suggested pre-injury migraines may be a risk factor for worse concussion outcome. Most articles examined pre-injury migraines as an exploratory\/secondary predictor of concussion outcome; very few were designed to examine migraine as the primary focus of the study. Migraine history was predominantly based on self-report and studies included minimal information about migraine (e.g., age of onset, frequency\/severity, past treatment). Effect sizes were usually not reported or able to be calculated from reported study data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is some evidence to suggest that pre-injury migraines may be a vulnerability factor for a worse outcome following concussion, with studies having the lowest risk of bias reporting a positive association. Future studies should focus on improving methodological quality when assessing the relationship between pre-injury migraines and concussion outcome and better characterizing pre-injury migraine status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Systematic Review Registration<\/jats:title>\n                    <jats:p>\n                      <jats:ext-link>https:\/\/www.crd.york.ac.uk\/prospero\/display_record.php?ID=CRD42019128292<\/jats:ext-link>\n                      , identifier: PROSPERO 2019 CRD42019128292.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2022.915357","type":"journal-article","created":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T03:15:05Z","timestamp":1655694905000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Systematic Review of Pre-injury Migraines as a Vulnerability Factor for Worse Outcome Following Sport-Related Concussion"],"prefix":"10.3389","volume":"13","author":[{"given":"Douglas P.","family":"Terry","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fionn","family":"B\u00fcttner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan A.","family":"Huebschmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Gardner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathan E.","family":"Cook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grant L.","family":"Iverson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,6,20]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"941","DOI":"10.1136\/bjsports-2017-097729","article-title":"Predictors of clinical recovery from concussion: a systematic review","volume":"51","author":"Iverson","year":"2017","journal-title":"Br J Sports Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"571","DOI":"10.1097\/DBP.0000000000000808","article-title":"Attention-deficit\/hyperactivity disorder and outcome after concussion: a systematic review","volume":"41","author":"Cook","year":"2020","journal-title":"J Dev Behav Pediatr."},{"key":"B3","doi-asserted-by":"publisher","first-page":"2325967120950682","DOI":"10.1177\/2325967120950682","article-title":"Systematic review of preinjury mental health problems as a vulnerability factor for worse outcome after sport-related concussion","volume":"8","author":"Iverson","year":"2020","journal-title":"Orthop J Sports Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"629","DOI":"10.1177\/0333102413485658","article-title":"The international classification of headache disorders","volume":"33","year":"2013","journal-title":"Cephalalgia"},{"key":"B5","doi-asserted-by":"publisher","first-page":"1088","DOI":"10.1111\/j.1469-8749.2010.03793.x","article-title":"Prevalence of headache and migraine in children and adolescents: a systematic review of population-based studies","volume":"52","author":"Abu-Arafeh","year":"2010","journal-title":"Dev Med Child Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"21","DOI":"10.1111\/head.12482","article-title":"The prevalence and burden of migraine and severe headache in the United States: updated statistics from government health surveillance studies","volume":"55","author":"Burch","year":"2015","journal-title":"Headache."},{"key":"B7","doi-asserted-by":"publisher","first-page":"S69","DOI":"10.1097\/JSM.0000000000000594","article-title":"Factors associated with self-reported concussion history in middle school athletes","volume":"30","author":"Terry","year":"2018","journal-title":"Clin J Sport Med."},{"key":"B8","doi-asserted-by":"publisher","first-page":"91","DOI":"10.1136\/bjsports-2013-092734","article-title":"Risk factors for sports concussion: an evidence-based systematic review","volume":"48","author":"Abrahams","year":"2014","journal-title":"Br J Sports Med."},{"key":"B9","doi-asserted-by":"publisher","first-page":"1132","DOI":"10.1001\/jamapediatrics.2015.2374","article-title":"Factors associated with concussion-like symptom reporting in high school athletes","volume":"169","author":"Iverson","year":"2015","journal-title":"JAMA Pediatr."},{"key":"B10","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1001\/jama.2016.1203","article-title":"Clinical risk score for persistent post-concussion symptoms among children with acute concussion in the ED","volume":"315","author":"Zemek","year":"2016","journal-title":"JAMA."},{"key":"B11","doi-asserted-by":"publisher","first-page":"465","DOI":"10.3171\/2018.10.PEDS18425","article-title":"Premorbid migraine history as a risk factor for vestibular and oculomotor baseline concussion assessment in pediatric athletes","volume":"23","author":"Moran","year":"2019","journal-title":"J Neurosurg Pediatr."},{"key":"B12","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1097\/JSM.0000000000000791","article-title":"Acute effects of concussion in youth with pre-existing migraines","volume":"31","author":"Terry","year":"2021","journal-title":"Clin J Sport Med."},{"key":"B13","doi-asserted-by":"publisher","first-page":"589","DOI":"10.3171\/2014.10.PEDS14356","article-title":"Predictors of post-concussion syndrome after sports-related concussion in young athletes: a matched case-control study","volume":"15","author":"Morgan","year":"2015","journal-title":"J Neurosurg Pediatr."},{"key":"B14","doi-asserted-by":"publisher","first-page":"491","DOI":"10.3171\/2015.8.PEDS14332","article-title":"Predictors of delayed recovery following pediatric sports-related concussion: a case-control study","volume":"17","author":"Miller","year":"2016","journal-title":"J Neurosurg Pediatr."},{"key":"B15","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1227\/NEU.0b013e31823150f0","article-title":"Cutoff scores in neurocognitive testing and symptom clusters that predict protracted recovery from concussions in high school athletes","volume":"70","author":"Lau","year":"2012","journal-title":"Neurosurgery."},{"key":"B16","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1542\/peds.2013-0432","article-title":"Time interval between concussions and symptom duration","volume":"132","author":"Eisenberg","year":"2013","journal-title":"Pediatrics."},{"key":"B17","doi-asserted-by":"publisher","first-page":"709","DOI":"10.3171\/2015.5.PEDS15220","article-title":"Psychiatric outcome after pediatric sports-related concussion","volume":"16","author":"Ellis","year":"2015","journal-title":"J Neurosurg Pediatr."},{"key":"B18","doi-asserted-by":"publisher","first-page":"1674","DOI":"10.3109\/02699052.2015.1075252","article-title":"Association between GRIN2A promoter polymorphism and recovery from concussion","volume":"29","author":"McDevitt","year":"2015","journal-title":"Brain Injury."},{"key":"B19","doi-asserted-by":"publisher","first-page":"721","DOI":"10.1016\/j.jpeds.2013.03.012","article-title":"Symptom severity predicts prolonged recovery after sport-related concussion, but age and amnesia do not","volume":"163","author":"Meehan","year":"2013","journal-title":"J Pediatr."},{"key":"B20","doi-asserted-by":"publisher","first-page":"2204","DOI":"10.1212\/WNL.0000000000001073","article-title":"Early symptom burden predicts recovery after sport-related concussion","volume":"83","author":"Meehan","year":"2014","journal-title":"Neurology."},{"key":"B21","doi-asserted-by":"publisher","first-page":"1856","DOI":"10.1212\/WNL.0000000000002679","article-title":"Preinjury somatization symptoms contribute to clinical recovery after sport-related concussion","volume":"86","author":"Nelson","year":"2016","journal-title":"Neurology."},{"key":"B22","doi-asserted-by":"publisher","first-page":"e1000097","DOI":"10.1371\/journal.pmed.1000097","article-title":"PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement","volume":"6","author":"Moher","year":"2009","journal-title":"PloS Med."},{"key":"B23","doi-asserted-by":"publisher","first-page":"280","DOI":"10.7326\/0003-4819-158-4-201302190-00009","article-title":"Assessing bias in studies of prognostic factors","volume":"158","author":"Hayden","year":"2013","journal-title":"Ann Intern Med."},{"key":"B24","unstructured":""},{"key":"B25","doi-asserted-by":"publisher","first-page":"1331","DOI":"10.1016\/S0140-6736(02)08336-8","article-title":"Health consequences of intimate partner violence","volume":"359","author":"Campbell","year":"2002","journal-title":"Lancet."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e020064","DOI":"10.1136\/bmjopen-2017-020064","article-title":"Improving Conduct and Reporting of Narrative Synthesis of Quantitative Data (ICONS-Quant): protocol for a mixed methods study to develop a reporting guideline","volume":"8","author":"Campbell","year":"2018","journal-title":"BMJ Open"},{"key":"B27","doi-asserted-by":"publisher","first-page":"875","DOI":"10.1177\/1948550617693058","article-title":"Too true to be bad: when sets of studies with significant and non-significant findings are probably true","volume":"8","author":"Lakens","year":"2017","journal-title":"Soc Psychol Personal Sci."},{"key":"B28","doi-asserted-by":"publisher","first-page":"e476","DOI":"10.1097\/JSM.0000000000000825","article-title":"Using a likelihood heuristic to summarize conflicting literature on predictors of clinical outcome following sport-related concussion","volume":"31","author":"B\u00fcttner","year":"2021","journal-title":"Clin J Sport Med."},{"key":"B29","first-page":"191","volume-title":"Statistical Evidence : A Likelihood Paradigm","author":"Royall","year":"1997"},{"key":"B30","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1177\/0363546510392016","article-title":"Sensitivity and specificity of subacute computerized neurocognitive testing and symptom evaluation in predicting outcomes after sports-related concussion","volume":"39","author":"Lau","year":"2011","journal-title":"Am J Sports Med."},{"key":"B31","doi-asserted-by":"publisher","first-page":"2311","DOI":"10.1177\/0363546511410655","article-title":"Which on-field signs\/symptoms predict protracted recovery from sport-related concussion among high school football players?","volume":"39","author":"Lau","year":"2011","journal-title":"Am J Sports Med."},{"key":"B32","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1089\/neu.2016.4677","article-title":"Longitudinal study of post-concussion syndrome: not everyone recovers","volume":"34","author":"Hiploylee","year":"2017","journal-title":"J Neurotrauma."},{"key":"B33","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1515\/jom-2020-0106","article-title":"First-time sports-related concussion recovery revisited: management changes and impact on recovery","volume":"121","author":"Neidecker","year":"2021","journal-title":"J Osteopa Med."},{"key":"B34","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1016\/j.jsams.2015.12.002","article-title":"Initial symptom burden predicts duration of symptoms after concussion","volume":"19","author":"Meehan","year":"2016","journal-title":"J Sci Med Sport."},{"key":"B35","doi-asserted-by":"publisher","first-page":"3254","DOI":"10.1177\/0363546518796830","article-title":"Identifying persistent post-concussion symptom risk in a pediatric sports medicine clinic","volume":"46","author":"Howell","year":"2018","journal-title":"Am J Sports Med."},{"key":"B36","doi-asserted-by":"publisher","first-page":"54","DOI":"10.3171\/2018.11.PEDS18626","article-title":"Clinical predictors of symptom resolution for children and adolescents with sport-related concussion","volume":"24","author":"Howell","year":"2019","journal-title":"J Neurosurg."},{"key":"B37","doi-asserted-by":"publisher","first-page":"394","DOI":"10.1097\/HTR.0000000000000536","article-title":"Recovery following sport-related concussion: integrating pre- and post-injury factors into multidisciplinary care","volume":"34","author":"Kontos","year":"2019","journal-title":"J Head Trauma Rehabil."},{"key":"B38","doi-asserted-by":"publisher","first-page":"435","DOI":"10.1001\/jamaneurol.2019.4552","article-title":"Association of time since injury to the first clinic visit with recovery following concussion","volume":"77","author":"Kontos","year":"2020","journal-title":"JAMA Neurol."},{"key":"B39","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1097\/JSM.0000000000000494","article-title":"Risk factors for prolonged symptoms of mild traumatic brain injury: a pediatric sports concussion clinic cohort","volume":"29","author":"Fehr","year":"","journal-title":"Clin J Sport Med."},{"key":"B40","doi-asserted-by":"publisher","first-page":"1292","DOI":"10.1016\/j.jsams.2019.08.004","article-title":"Persistent vestibular-ocular impairment following concussion in adolescents","volume":"22","author":"Sinnott","year":"2019","journal-title":"J Sci Med Sport."},{"key":"B41","doi-asserted-by":"publisher","first-page":"e426","DOI":"10.1111\/apa.13486","article-title":"Initial somatic symptoms are associated with prolonged symptom duration following concussion in adolescents","volume":"105","author":"Howell","year":"2016","journal-title":"Acta Paediatr."},{"key":"B42","doi-asserted-by":"publisher","first-page":"165","DOI":"10.3171\/2020.2.PEDS2025","article-title":"Association of time to initial clinic visit with prolonged recovery in pediatric patients with concussion","volume":"26","author":"Eagle","year":"2020","journal-title":"J Neurosurg Pediatr."},{"key":"B43","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1080\/21622965.2017.1381099","article-title":"Clinical and demographic predictors of concussion resolution in adolescents: a retrospective study","volume":"8","author":"Aggarwal","year":"2019","journal-title":"Appl Neuropsychol Child."},{"key":"B44","doi-asserted-by":"publisher","first-page":"127","DOI":"10.1097\/JSM.0000000000000721","article-title":"Use of supervised exercise during recovery following sports-related concussion","volume":"31","author":"Popovich","year":"2021","journal-title":"Clin J Sport Med."},{"key":"B45","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1089\/neu.2017.5443","article-title":"Preinjury migraine history as a risk factor for prolonged return to school and sports following concussion","volume":"36","author":"Terry","year":"2019","journal-title":"J Neurotrauma."},{"key":"B46","doi-asserted-by":"publisher","first-page":"375","DOI":"10.1017\/S1355617719000286","article-title":"Predicting wellness after pediatric concussion","volume":"25","author":"Beauchamp","year":"2019","journal-title":"J Int Neuropsychol Soc."},{"key":"B47","doi-asserted-by":"publisher","first-page":"1490","DOI":"10.1177\/0363546513487982","article-title":"Recovery of post-traumatic migraine characteristics in patients after mild traumatic brain injury","volume":"41","author":"Mihalik","year":"2013","journal-title":"Am J Sports Med."},{"key":"B48","doi-asserted-by":"publisher","first-page":"600","DOI":"10.1177\/0333102412445224","article-title":"Characterization of headache after traumatic brain injury","volume":"32","author":"Lucas","year":"2012","journal-title":"Cephalalgia."},{"key":"B49","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1097\/00001199-199902000-00004","article-title":"Epidemiology and pathogenesis of post-traumatic headache","volume":"14","author":"Packard","year":"1999","journal-title":"J Head Trauma Rehabil."},{"key":"B50","doi-asserted-by":"publisher","first-page":"339","DOI":"10.1097\/00042752-200411000-00003","article-title":"Sport-related concussion: factors associated with prolonged return to play","volume":"14","author":"Asplund","year":"2004","journal-title":"Clin J Sport Med."},{"key":"B51","doi-asserted-by":"publisher","first-page":"905","DOI":"10.1503\/cmaj.092190","article-title":"A prospective study of concussions among national hockey league players during regular season games: the NHL-NHLPA concussion program","volume":"183","author":"Benson","year":"2011","journal-title":"CMAJ."},{"key":"B52","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1177\/1941738108325920","article-title":"Association between previous concussion history and symptom endorsement during preseason baseline testing in high school and collegiate athletes","volume":"1","author":"Register-Mihalik","year":"2009","journal-title":"Sports Health."},{"key":"B53","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1097\/JSM.0b013e318295a834","article-title":"The effects of sleep quality and sleep quantity on concussion baseline assessment","volume":"23","author":"Mihalik","year":"2013","journal-title":"Clin J Sport Med."},{"key":"B54","doi-asserted-by":"publisher","first-page":"850","DOI":"10.3171\/jns.2005.102.5.0850","article-title":"Post-traumatic migraine characteristics in athletes following sports-related concussion","volume":"102","author":"Mihalik","year":"2005","journal-title":"J Neurosurg."},{"key":"B55","doi-asserted-by":"publisher","first-page":"583","DOI":"10.1046\/j.1526-4610.1997.3709583.x","article-title":"Cerebral blood flow in chronic post-traumatic headache","volume":"37","author":"Gilkey","year":"1997","journal-title":"Headache."},{"key":"B56","doi-asserted-by":"publisher","first-page":"2250","DOI":"10.1212\/WNL.0b013e31828d57dd","article-title":"Summary of evidence-based guideline update: evaluation and management of concussion in sports: report of the guideline development subcommittee of the American academy of neurology","volume":"80","author":"Giza","year":"2013","journal-title":"Neurology."},{"key":"B57","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1093\/brain\/117.1.199","article-title":"Pathophysiology of the migraine aura. The spreading depression theory","volume":"117","author":"Lauritzen","year":"1994","journal-title":"Brain."},{"key":"B58","doi-asserted-by":"publisher","first-page":"S406","DOI":"10.1016\/j.pmrj.2011.07.016","article-title":"Headache management in concussion and mild traumatic brain injury","volume":"3","author":"Lucas","year":"2011","journal-title":"PM R."},{"key":"B59","doi-asserted-by":"publisher","first-page":"142","DOI":"10.1046\/j.1526-4610.1997.3703142.x","article-title":"Pathogenesis of post-traumatic headache and migraine: a common headache pathway?","volume":"37","author":"Packard","year":"1997","journal-title":"Headache."},{"key":"B60","doi-asserted-by":"publisher","first-page":"811","DOI":"10.1111\/head.13312","article-title":"Post-traumatic headache: basic mechanisms and therapeutic targets","volume":"58","author":"Kamins","year":"2018","journal-title":"Headache."},{"key":"B61","doi-asserted-by":"publisher","first-page":"3","DOI":"10.1186\/1129-2377-15-3","article-title":"Diagnosis, prevalence estimation and burden measurement in population surveys of headache: presenting the HARDSHIP questionnaire","volume":"15","author":"Steiner","year":"2014","journal-title":"J Headache Pain."},{"key":"B62","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1016\/S1474-4422(16)30293-9","article-title":"Sex differences in the epidemiology, clinical features, and pathophysiology of migraine","volume":"16","author":"Vetvik","year":"2017","journal-title":"Lancet Neurol."},{"key":"B63","doi-asserted-by":"publisher","first-page":"1719","DOI":"10.1089\/neu.2011.1914","article-title":"Natural history of headache after traumatic brain injury","volume":"28","author":"Hoffman","year":"2011","journal-title":"J Neurotrauma."},{"key":"B64","doi-asserted-by":"publisher","first-page":"e160294","DOI":"10.1001\/jamapediatrics.2016.0294","article-title":"Point of health care entry for youth with concussion within a large pediatric care network","volume":"170","author":"Arbogast","year":"2016","journal-title":"JAMA Pediatr."}],"container-title":["Frontiers in Neurology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.915357\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,6,20]],"date-time":"2022-06-20T03:15:08Z","timestamp":1655694908000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fneur.2022.915357\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,20]]},"references-count":64,"alternative-id":["10.3389\/fneur.2022.915357"],"URL":"https:\/\/doi.org\/10.3389\/fneur.2022.915357","relation":{},"ISSN":["1664-2295"],"issn-type":[{"value":"1664-2295","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,20]]},"article-number":"915357"}}