Long Term Pain Outcomes Following Adolescent Traumatic Brain Injury

Introduction: Traumatic Brain Injury (TBI) is a significant public health issue. Despite this, the long-term course of many TBI sequelae remains poorly understood, particularly in the adolescent population, where parent reported outcomes are often used in the place of those reported by the participant. This study aims to investigate the prevalence of self-reported pain outcomes among adolescents treated for a TBI compared to those treated for an arm injury.

Methods: Using the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System, 121 eligible participants (107 TBI and 14 arm injury [AI] control), age 14-18, were retrospectively identified from the Child Health After Injury (CHAI) data repository. Data on participant-reported pain outcomes at 12-, 24-, and 36-months post-injury was examined. The specific pain outcomes of interest were the presence of a bothersome headache, the presence of pain other than a headache, and the presence of a clinically diagnosed chronic pain problem.

Results: There were no statistically significant differences between the prevalence of any of the three pain outcomes at 12-, 24-, or 36-months post-injury among participants with mild TBI or moderate-severe TBI compared to participants with arm injury but trends in pain outcome prevalence may indicate some differences. Among only those with mild TBIs, at 12-months post injury, females reported being bothered by headache in the four weeks prior to the interview more frequently than males (84.6% vs. 42.9%, P = 0.007). This finding continued to hold true at 24-months post injury with females reported being bothered by headache pain 75.0% of the time vs. males 38.6% of the time (P = 0.025).

Conclusion : While not statistically significant, some signs indicate there may be differences in long term pain outcomes in the TBI group compared to the AI group. Additionally, amongst those with mild TBI, pain, particularly headache pain, may chart different courses amongst male and female adolescents. Further work is needed to validate these findings in a more robust population.