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2017 ; 96
(7
): e5917
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Concussion/mild traumatic brain injury-related chronic pain in males and females:
A diagnostic modelling study
#MMPMID28207508
Mollayeva T
; Cassidy JD
; Shapiro CM
; Mollayeva S
; Colantonio A
Medicine (Baltimore)
2017[Feb]; 96
(7
): e5917
PMID28207508
show ga
Pain is an unpleasant, complex, and perceived experience that places a
significant burden on patients and clinicians. Its severity may be mediated by
emotion, attitude, and environmental influences, and pain may be expressed
differently in males and females. Traumatic brain injury (TBI) is frequently
associated with chronic pain. This diagnostic modeling study examined sex
differences in the construct of chronic pain in patients with delayed recovery
from concussion/mild traumatic brain injury (mTBI).Data were collected from
standardized questionnaires, neuroimaging records, and comprehensive clinical
assessments. Bivariate associations were calculated using the Spearman
correlation coefficient or analysis of variance. We established sex-specific
stepwise multivariate linear regression models of factors associated with pain.Of
the 94 participants diagnosed with mTBI (the mean age was 45.20?±?9.94 years;
61.2% were males; the median time since injury was 197 days [interquartile range
139-416]), head/neck, and bodily pain were reported by 93% and 64%, respectively.
No sex differences were identified in pain frequencies or severity. Pain was
significantly associated with certain socio-demographic, injury-related,
behavioral, and clinical variables. In the multivariable regression analysis,
several determinants explained 60% of the pain variance in males and 46% in
females.Pain is common in patients with delayed recovery from mTBI and is
significantly associated with potentially modifiable clinical and nonclinical
variables. Examining the multidimensional construct of pain in concussion/mTBI
through a sex lens garners new directions for future longitudinal research on the
pain mechanisms involved in postconcussion syndrome.
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