Background
Recently, the Vestibular/Ocular Motor Screening (VOMS) and the King-Devick (KD) tests have gained popularity as tools to assess vestibular and oculomotor dysfunction following concussion. Position statements have identified migraine and other pre-morbidities and co-morbidities as modifying risk factors for concussion and recovery. At 1 day and 3 days post-concussion, individuals with premorbid migraine headaches reported greater symptom severity scores on migraine-cognitive-fatigue and somatic symptom factors. Compared to concussed athletes without headache and without migraine headache, concussed athletes with migraine headache displayed greater neurocognitive deficits. Individuals with preinjury migraine took 1 day longer to return to play and school following concussion. With growing implementation of multifaceted baseline testing, further understanding of baseline risk factors is needed. No studies exist examining the effects of diagnosed migraines on the VOMS and KD tests.
Purpose
The purpose of this study was to examine the effects of pre-morbid migraine history on baseline VOMS and KD test performance in youth athletes.
Methodology
Participants: A total of 56 youth athletes between the ages of 8 and 14 years participated in the study. 28 individuals were diagnosed with migraine headaches, while 28 individuals were match controlled based on sex, age, sport, height, weight and history of concussion. Procedures: Participants were administered a baseline VOMS and KD test prior to the start of their respective sport season. Main Outcome Measures: VOMS items, and KD baseline time in seconds (fastest of two trials).
Results
Migraine group reported greater VOMS scores and worse KD test performance (54.33s vs. 47.17s, p=0.02) than match controls.
Discussion
This is believed to be the first study to examine the effects of premorbid migraine on the VOMS and KD tests. Results can be attributed to previous findings reporting greater symptom elevation and decreased neurocognition in concussion athletes. Results can be attributed to previous findings reporting greater symptom elevation and decreased neurocognition in concussion athletes. Symptoms of migraine include nausea, vomiting, and photophobia, which have overlap with vestibular-related symptoms. Previous research has linked child migraine headache and a 2.7x likelihood of the presences of learning disability, which may explain KD deficits. Future research is needed to understand post-concussion performance on the VOMS and KD in individuals with diagnosed migraines.
Summary Points
- Youth athletes with a history of diagnosed migraine perform worse on KD than compared to matched controls.