Article

Data Trends 2022: Neurologic Disorders

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  • Chronic migraines and daily headaches occur in 20% of those who served in combat post 9-11 compared to 3% of civilians.1 People with migraines often have other comorbidities and health behaviors that can complicate treatment, and the presence of these factors is elevated in the veteran population.1,2

  • These factors all interact with migraine symptomology and correspond to certain mental health outcomes. A retrospective study of over 3 million veterans assessed the relationship between chronic headaches, TBI, and the risk of suicide.3 Results show that veterans with chronic headache are more likely to attempt suicide, and the co-occurrence of headaches and TBI further increases the risk for suicide attempt.

  • The retrospective veteran study also compared different types of chronic pain over 10 years (2001-2010). Headache pain led to more suicide attempts.3

  • Migraine patients have also been shown to have structural brain changes.4 Changes occur in neural regions that deal with pain modulation, affective and cognitive processing, and visual processing. The volumes of some brain regions vary between patients with episodic and chronic migraines, and may dynamically alter with different migraine frequencies.

  • About 18,000 to 20,000 patients with MS are evaluated annually in the VHA.5 Adherence to disease-modifying therapies (DMTs) plays a large role in overall functional outcomes. In a recent study evaluating veterans with MS, those with good DMT adherence had less decline in cognition, disability, and disease severity—all symptoms related to MS disease state progression.6

  • Results from a 20-year study drawing on data from more than 10 million active-duty service members found a 32-fold increased risk for MS diagnosis in those who became infected with Epstein-Barr virus (EBV). The study found no correlation between risk for MS diagnosis and any other viral infections.7 It is important to note that EBV infection is very common, and that most people who have had it do not develop MS.

  • MS has also been linked with increased risk for other infections, including respiratory infection, urinary tract infection (UTI), and sepsis.8


 

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