Migraine and traumatic brain injury: a cohort study in Taiwan

BMJ Open. 2019 Jul 30;9(7):e027251. doi: 10.1136/bmjopen-2018-027251.

Abstract

Objective: Traumatic brain injury is now a major contributor to the global healthcare burden. Migraine is another debilitating disease with a global health impact. While most researchers agree that traumatic brain injury is a risk factor for migraine, whether migraine is a risk factor for traumatic brain injury still remains under debate. We therefore aimed to investigate whether migraine was a risk factor for developing traumatic brain injury.

Study design: Retrospective population-based cohort study.

Setting: Data for people who had been diagnosed with migraine were retrieved from Taiwan's National Health Insurance Research Database.

Participants: We identified 7267 patients with newly diagnosed migraine during 1996-2010. The migraineurs to non-migraineurs ratio was set at 1:4 to enhance the power of statistical tests.

Primary and secondary outcome measures: We used multivariate Cox proportional hazard regression models to assess the effects of migraines on the risk of traumatic brain injury after adjusting for potential confounders.

Results: The overall traumatic brain injury risk was 1.78 times greater in the migraine group compared with the non-migraine group after controlling for covariates. Additionally, patients with previous diagnoses of alcohol-attributed disease, mental disorders and diabetes mellitus had a significantly higher traumatic brain injury risk compared with those with no history of these diagnoses.

Conclusions: This study of a population-based database indicated that migraine is a traumatic brain injury risk factor. Greater attention to migraine-targeted treatment modalities may reduce traumatic brain injury-related morbidity and mortality.

Keywords: Taiwan health programmes; migraine; traumatic brain injury.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Brain Injuries, Traumatic / complications
  • Brain Injuries, Traumatic / epidemiology*
  • Databases, Factual
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Migraine Disorders / epidemiology*
  • Migraine Disorders / etiology
  • Morbidity / trends
  • Population Surveillance / methods*
  • Retrospective Studies
  • Risk Assessment / methods*
  • Risk Factors
  • Survival Rate / trends
  • Taiwan / epidemiology
  • Young Adult