# Imaging Markers of Central and Peripheral Impairment and Chronic Post-traumatic Headache

> **NIH NIH R21** · VETERANS MEDICAL RESEARCH FDN/SAN DIEGO · 2020 · $184,314

## Abstract

PROJECT SUMMARY ABSTRACT
Approximately 1.7 million individuals sustain a traumatic brain injury (TBI) requiring medical attention
every year in the United States. The majority of TBI injuries are mild in severity, yet nearly half of
these individuals report residual disability from post-concussive symptoms that can persist for years
after a traumatic injury. Post-traumatic headache (PTH) is the most common of these symptoms and
is the most frequent type of post-traumatic pain in veteran and civilian populations with mild TBI
(mTBI), where prevalence rates average 58%. Nearly half of those with mTBI and PTH also suffer
from comorbid neck pain, yet the pathophysiologic processes leading to the development of chronic
head and neck pain following a traumatic injury remain unclear. We postulate that nociceptive input
from chronically deconditioned and painful cervical muscles can exacerbate PTH when coupled with
impaired central pain processing networks in patients with comorbid head and neck pain resulting
from mTBI. This project will be the first to concurrently examine structural and functional impairments
in the central nervous system (brain) and periphery (cervical muscles) for clinically distinct subgroups
of individuals with and without PTH and comorbid neck pain. Advanced magnetic resonance imaging
(MRI) techniques will be used to compare (1) brain structure and functional connectivity between
regions involved in descending pain modulation and the default mode network, and (2) markers of
muscle quality and deconditioning in the cervical spine. We will also examine differences in the
efficiency of conditioned pain modulation, and quantify the strength of association between MRI
markers of brain and muscle impairments and the clinical severity of PTH. Findings from this
developmental investigation will provide the foundation for a new line of research to assess whether
subgroups of patients with PTH can benefit from multi-modal therapeutic approaches to address
underlying impairments in distinct, yet related physiologic systems.

## Key facts

- **NIH application ID:** 9970559
- **Project number:** 5R21NS109852-02
- **Recipient organization:** VETERANS MEDICAL RESEARCH FDN/SAN DIEGO
- **Principal Investigator:** Katrina S. Monroe
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $184,314
- **Award type:** 5
- **Project period:** 2019-07-15 → 2022-06-30

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9970559

## Citation

> US National Institutes of Health, RePORTER application 9970559, Imaging Markers of Central and Peripheral Impairment and Chronic Post-traumatic Headache (5R21NS109852-02). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/9970559. Licensed CC0.

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