Symptoms of allodynia and pain thresholds amongst those with acute post-traumatic headache attributed to mild traumatic brain injury: a prospective, longitudinal study

Q: What was the main purpose of the prospective longitudinal study?

To compare cutaneous allodynia symptoms and heat pain thresholds between males and females with acute PTH and healthy controls, and to determine whether these measures associate with PTH outcomes.

Q: How were participants assessed during the study?

PTH participants completed a baseline visit near symptom onset and a follow-up three to four months later, with the Allodynia Symptom Checklist (ASC-12) at each visit. Quantitative sensory testing measured cutaneous heat pain thresholds at baseline, 4 weeks, and 16 weeks for selected participants.

Q: What key findings were reported regarding allodynia and pain thresholds?

PTH participants showed higher ASC-12 scores than controls at the first visit and differences between improved versus non-improved cohorts, and females with PTH had higher ASC-12 scores than males. Cutaneous heat pain thresholds at the forehead and forearms did not differ between groups.

Sep 29, 2026

Uploaded by Grenda

Post-traumatic headache (PTH) is a common acute and persistent symptom after mild traumatic brain injury (mTBI). Cutaneous allodynia symptoms and nociceptive sensitization may relate to acute PTH and its persistence. The study compared allodynia symptoms and cutaneous heat pain thresholds between males and females with acute PTH and healthy controls, and assessed whether pain thresholds and allodynia predict PTH outcomes.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusions

Ziff etal. The Journal of Headache and Pain (2026) 27:3 [https://doi.org/10.1186/s10194-025-02230-w](https://doi.org/10.1186/s10194-025-02230-w) The Journal of Headache and Pain RESEARCH Open Access Symptoms of allodynia and pain thresholds amongst those with acute post-traumatic headache attributed to mild traumatic brain injury: a prospective, longitudinal study Noah Ziff1, Gina Dumkrieger 1, Santiago Garza 1, Amaal Starling 1, Dmitry Esterov2, Kevin M. Barrett3, Katherine Ross4, Trent Anderson5, Frank Porreca5, Edita Navratilova5, Simona Nikolova 1, Jing Li6, Teresa Wu7, Matthew Huentel man8, Catherine D. Chong 1 and Todd J. Schwedt 1* Abstract Background Post-traumatic headache (PTH) is a common acute and persistent symptom following mild traumatic brain injury (mTBI) . Symptoms of cutaneous allodynia and presence of nociceptive sensitization might be associated with acute PTH and its persistence. The objectives ofthis study were to compare allodynia symptoms and cutaneous heat pain thresholds amongst males and females with acute PTH to healthy controls (HC) and determine if pain thresholds and al lodynia symptoms are associated with PTH outcomes. Methods This prospective longitudinal study enrolled 139 adults with acute PTH attributed to mTBI as defined by the International Classification of Headache Disorders and 95 HC. All PTH participants completed a baseline research visit near PTH onset and a follow-up visit three to four months later. All PTH participants and a subset of HC completed the Allodynia Symptom Checklist (ASC-12) at each research visit. A different subset of the PTH participants (n = 37) and HC (n = 36) underwent quantitative sensory testing (QST) during baseline, 4-week, and 16-week research visits to quantify cutaneous heat pain thresholds at the forehead and forearms. Data from daily headache diaries were used to determine longitudinal PTH improvement versus non-improvement at three months. ASC-12 score and pain threshold comparisons were made between PTH and HC groups, PTH improved versus non-improved cohorts, and between PTH males and females. Results Participants with PTH had an average age of 42.6 years and 64. 0% were female. HC had an average age of 40.0 years and 65. 3% were female. At the first visit, PTH participant ASC-12 scores averaged 3.6 versus 0.1 amongst HC, p < 0.001. 57. 1% of PTH participants had headache improvement at 3 months. ASC-12 scores were higher in the PTH non-improved versus improved group at baseline (4 versus 2 . 7, p = 0 . 046) and 3-month follow-up (3 .8 versus 1. 9, p = 0 . 004) . ASC-12 scores were higher in females than males at baseline (4 .7 versus 1. 6, p < 0. 001) and 3-months (3 .9 versus 1. 2, p < 0. 001) . Cutaneous heat pain thresholds at the forehead and forearm did not differ between any group. *Correspondence: Todd J. Schwedt [Schwedt.Todd@mayo.edu](Schwedt.Todd@mayo.edu) Full list of author information is available at the end of the article © The Author(s) 2025. Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit [http://creat

FAQs

What was the main purpose of the prospective longitudinal study?

To compare cutaneous allodynia symptoms and heat pain thresholds between males and females with acute PTH and healthy controls, and to determine whether these measures associate with PTH outcomes.

How were participants assessed during the study?

PTH participants completed a baseline visit near symptom onset and a follow-up three to four months later, with the Allodynia Symptom Checklist (ASC-12) at each visit. Quantitative sensory testing measured cutaneous heat pain thresholds at baseline, 4 weeks, and 16 weeks for selected participants.

What key findings were reported regarding allodynia and pain thresholds?

PTH participants showed higher ASC-12 scores than controls at the first visit and differences between improved versus non-improved cohorts, and females with PTH had higher ASC-12 scores than males. Cutaneous heat pain thresholds at the forehead and forearms did not differ between groups.

Sep 29, 2026

Uploaded by Grenda