Patient‐reported auditory handicap measures following mild traumatic brain injury

Knoll, Renata M.; Herman, Seth; Lubner, Rory J.; Babu, Ashwin N.; Wong, Kevin; Sethi, Rosh K.V.; Chen, Jenny; Rauch, Steven D.; Remenschneider, Aaron K.; Jung, David; Kozin, Elliott D.

doi:10.1002/lary.28034

Cited by 26 publications

(23 citation statements)

References 66 publications

(142 reference statements)

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“…Hyperacusis is the condition of reduced tolerance or increased sensitivity to sound, and is characterized by excessive loudness, troublesomeness, anxiety, and pain when the person is exposed to sound (58,59). Auditory symptoms including subjective hearing loss, tinnitus, and hyperacusis are common in those with mTBI, and 67.3% of non-blast mTBI patients reported hyperacusis according to a recent patientreported outcome measures study (60). Mechanisms underlying hyperacusis following mTBI are unknown, although proposed theories suggest a tonotopic reorganization and hyperexcitability of the auditory cortex involving a malfunction of 5-HT (61), a release of endogenous opioid peptides (62), and a decreased GABA A -mediated inhibition in the inferior colliculus (63).…”

Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine

Kim

Chong

Dumkrieger

et al. 2020

Preprint

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Background Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. Methods In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher’s test and one-way ANOVA or Tukey’s Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms. Results Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) ( p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho ( Common.EditSubmissionSteps.Transform.EquationText ) = 0.634, p < 0.01), followed by Trait Anxiety ( Common.EditSubmissionSteps.Transform.EquationText = 0.522, p < 0.01), PTSD ( Common.EditSubmissionSteps.Transform.EquationText = 0.505, p < 0.01), HQ ( Common.EditSubmissionSteps.Transform.EquationText = 0.469, p < 0.01), State Anxiety ( Common.EditSubmissionSteps.Transform.EquationText = 0.437, p < 0.01), and MIDAS scores ( Common.EditSubmissionSteps.Transform.EquationText = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine. Conclusions Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.

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Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine

Kim

Chong

Dumkrieger

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Hyperacusis is the condition of reduced tolerance or increased sensitivity to sound, and is characterized by excessive loudness, troublesomeness, anxiety, and pain when the person is exposed to sound [58,59]. Auditory symptoms including subjective hearing loss, tinnitus, and hyperacusis are common in those with mTBI, and 67.3% of non-blast mTBI patients reported hyperacusis according to a recent patientreported outcome measures study [60]. Mechanisms underlying hyperacusis following mTBI are unknown, although proposed theories suggest a tonotopic reorganization and hyperexcitability of the auditory cortex involving a malfunction of 5-HT [61], a release of endogenous opioid peptides [62], and a decreased GABA Amediated inhibition in the inferior colliculus [63].…”

Section: Discussionmentioning

confidence: 99%

Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine

et al. 2020

View full text Add to dashboard Cite

Background: Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. Methods: In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher's test and one-way ANOVA or Tukey's Honest Significant Difference were used to assess group differences of categorical and continuous data. Stepwise linear regression analyses were conducted to identify clinical variables associated with insomnia symptoms. Results: Those with PPTH had significantly higher ISI scores (16.7 ± 6.6) compared to migraine patients (11.3 ± 6.4) and healthy controls (4.1 ± 4.8) (p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho (ρ) = 0.634, p < 0.01), followed by Trait Anxiety (ρ = 0.522, p < 0.01), PTSD (ρ = 0.505, p < 0.01), HQ (ρ = 0.469, p < 0.01), State Anxiety (ρ = 0.437, p < 0.01), and MIDAS scores (ρ = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine.

show abstract

“…Hyperacusis is the condition of reduced tolerance or increased sensitivity to sound, and is characterized by excessive loudness, troublesomeness, anxiety, and pain when the person is exposed to sound (55,56). Auditory symptoms including subjective hearing loss, tinnitus, and hyperacusis are common in those with mTBI, and 67.3% of non-blast mTBI patients reported hyperacusis according to a recent patientreported outcome measures study (57). Mechanisms underlying hyperacusis following mTBI are unknown, although proposed theories suggest a tonotopic reorganization and hyperexcitability of the auditory cortex involving a malfunction of 5-HT (58), a release of endogenous opioid peptides (59), and a decreased GABA A -mediated inhibition in the inferior colliculus (60).…”

Section: Discussionmentioning

confidence: 99%

Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine

Kim

Chong

Dumkrieger

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Close associations between insomnia with other clinical factors have been identified in migraine, but there have been few studies investigating associations between insomnia and clinical factors in patients with persistent post-traumatic headache (PPTH). The study objective was to contrast the severity of insomnia symptoms in PPTH, migraine, and healthy controls, and to identify factors associated with insomnia in patients with PPTH vs. migraine. Methods: In this cross-sectional cohort study, 57 individuals with PPTH attributed to mild traumatic brain injury, 39 with migraine, and 39 healthy controls were included. Participants completed a detailed headache characteristics questionnaire, the Migraine Disability Assessment Scale (MIDAS), Insomnia Severity Index (ISI), Hyperacusis Questionnaire (HQ), Allodynia Symptom Checklist, Photosensitivity Assessment Questionnaire, Beck Depression Inventory (BDI), State-Trait Anxiety Inventory, Post-Traumatic Stress Disorder (PTSD) checklist, Ray Auditory Verbal Learning Test, and the Trail Making Test A and B to assess headache characteristics, disability, insomnia symptoms, sensory hypersensitivities, and neuropsychological factors. Fisher’s test and one-way ANOVA were used to assess group differences of categorical and continuous data. Stepwise logistic regression analyses were conducted to identify clinical variables associated with insomnia symptoms. Results: Those with PPTH had significantly higher ISI scores (16.72 ± 6.58) compared to migraine patients (11.28 ± 6.42) and healthy controls (4.05 ± 4.80) (p < 0.001). For those with PPTH, insomnia severity was most strongly correlated with the BDI (Spearman's rho (ρ) = 0.634, p < 0.01), followed by Trait Anxiety (ρ = 0.522, p < 0.01), PTSD (ρ = 0.505, p < 0.01), HQ (ρ = 0.469, p < 0.01), State Anxiety (ρ = 0.437, p < 0.01), and MIDAS scores (ρ = 0.364, p < 0.01). According to linear regression models, BDI, headache intensity, and hyperacusis scores were significantly positively associated with insomnia severity in those with PPTH, while only delayed memory recall was negatively associated with insomnia severity in those with migraine. Conclusions: Insomnia symptoms were more severe in those with PPTH compared to migraine and healthy control cohorts. Depression, headache intensity, and hyperacusis were associated with insomnia in individuals with PPTH. Future studies should determine the bidirectional impact of treating insomnia and its associated symptoms.

show abstract

Patient‐reported auditory handicap measures following mild traumatic brain injury

Cited by 26 publications

References 66 publications

Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine

Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine

Clinical correlates of insomnia in patients with persistent post-traumatic headache compared with migraine

Clinical Correlates of Insomnia in Patients with Persistent Post-Traumatic Headache Compared with Migraine

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