Examining Acute Symptoms After Sport-Related Concussion in Collegiate Athletes With Preinjury Migraines

Objective: To examine whether a personal history of migraines is associated with worse acute symptom burden after sport-related concussion (SRC). Design: Retrospective cohort study. Setting: National Collegiate Athletic Association Division III collegiate programs. Participants: Collegiate athletes from a prospective concussion surveillance system between 09, 2014, and 01, 2023. Intervention: Preinjury migraines (yes/no) were self-reported by athletes. Main Outcome Measures: Post-Concussion Symptom Scale (PCSS) were collected within 3 days postinjury. Mann–Whitney U tests compared total PCSS scores and individual symptom scores between athletes with and without preinjury migraines. Chi-squared tests were used to compare proportions of athletes endorsing individual symptoms (ie, item score ≥1) between 2 groups. Multivariable regression analyzed potential predictors of PCSS scores. Results: Of 1190 athletes with SRC, 93 (7.8%) reported a preinjury history of migraines. No significant difference in total PCSS scores was found between athletes with and without preinjury migraines (22.0 ± 16.4 vs 20.5 ± 15.8, U = 48 719.0, P = 0.471). Athletes with preinjury migraines reported greater severity of “sensitivity to light” (1.59 ± 1.59 vs 1.23 ± 1.41, P = 0.040) and “feeling more emotional” (0.91 ± 1.27 vs 0.70 ± 1.30; P = 0.008) and were more likely to endorse “feeling more emotional” (45.2% vs 29.5%, P = 0.002). No differences were found across all other symptoms, including headaches (migraine = 87.1% vs no migraine = 86.3%, P = 0.835). In a multivariable model, a history of migraine was not a significant predictor of acute PCSS scores, but those with a history of psychological disorders (β = 0.12, P <0 .001) and greater number of days to symptom evaluation (β = 0.08, P = 0.005) had higher PCSS scores. Conclusions: Collegiate athletes with a pre-existing history of migraines did not have higher acute symptom burden after SRC.