Post-traumatic headaches (PTHs) are associated with mild traumatic brain injuries (mTBI) and may predict the persistence of concussion symptoms. Altered brain networks implicated in brain injury and the affective components of headache-related pain may underlie the resolution of PTH. This is a hypothesis-generating investigation to evaluate the extent to which pain symptom reporting and functional brain changes are different in a cohort of young mTBI patients with resolved (PTH-R) and persistent (PTH-P) post-traumatic headache symptoms relative to healthy controls. This was a cross-sectional investigation involving 59 participants between the ages of 12-24 (PTH-P, n = 21; PTH-R, n = 18; healthy control, n = 20). Participants had no significant history of pre-existing headaches, chronic pain, or psychiatric neurological conditions. The primary outcome was resting-state functional connectivity (RS-Fc) alterations between cohorts. Secondary outcomes were self-reported pain-related symptoms. Elevated scores were reported for fear of pain in both PTH cohorts. Using a false discovery rate of p = 0.05, the PTH-P cohort showed altered connectivity relative to healthy controls in brain regions such as the frontal, temporal, and cerebellar regions, as well as sub-cortical regions including the amygdala and accumbens. The PTH-R cohort showed altered RS-Fc between cerebellar and temporal lobe sub-regions. Our results indicate that a core network of brain regions implicated in the affective pain response are functionally altered in PTH cohorts. Results should be interpreted given limitations on sample size and multiple comparisons. Despite the resolution of symptoms, persons who experience PTH may experience ongoing functional brain abnormalities, which may underlie symptom chronification.

中文翻译：

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改变的大脑网络连接是青少年轻度创伤性脑损伤后持续的创伤后头痛的基础

创伤后头痛 (PTH) 与轻度创伤性脑损伤 (mTBI) 相关，并且可以预测脑震荡症状的持续性。与脑损伤有关的脑网络改变和头痛相关疼痛的情感成分可能是 PTH 消退的基础。这是一项产生假设的调查，旨在评估一组年轻 mTBI 患者的疼痛症状报告和功能性大脑变化的不同程度，这些患者的创伤后头痛症状缓解（PTH-R）和持续性（PTH-P）相对于健康的对照。这是一项横断面调查，涉及 59 名 12-24 岁的参与者（PTH-P，n  = 21；PTH-R，n  = 18；健康对照组，n = 20)。参与者没有明显的既往头痛、慢性疼痛或精神神经疾病病史。主要结果是队列之间的静息状态功能连接（RS-Fc）改变。次要结果是自我报告的疼痛相关症状。在两个 PTH 队列中，由于害怕疼痛而报告了分数升高。使用p的错误发现率 = 0.05，PTH-P 队列显示出与健康对照组相比，大脑区域（如额叶、颞叶和小脑区域）以及包括杏仁核和伏隔核在内的皮层下区域的连通性发生了改变。PTH-R 队列显示小脑和颞叶亚区之间的 RS-Fc 改变。我们的研究结果表明，与情感疼痛反应有关的大脑区域核心网络在 PTH 队列中的功能发生了改变。鉴于样本量和多重比较的限制，应解释结果。尽管症状得到解决，但患有 PTH 的人可能会出现持续的脑功能异常，这可能是症状慢性化的基础。