Migraine history affects vestibular ocular motor screening, King-Devick, and reported symptoms in collegiate student-athletes: Findings from the concussion assessment, research, and education consortium

Background: Migraine, a common neurological disease, can negatively impact vestibular and oculomotor functioning. Vestibular and oculomotor function and symptomology are routinely tested in collegiate athletes as part of baseline concussion assessments. The purpose of this study was to identify how migraine history influences vestibular ocular baseline assessments in collegiate student-athletes. Methods: A total of 1775 collegiate student-athletes from de-identified data provided by the National Collegiate Athletic Association – Department of Defense Grand Alliance from 2014 to 2020. Participants self-reported migraine status, sex, age, Hospital Anxiety and Depression score, and sleep were used to predict Vestibular/Ocular Motor (VOMS) provocation scores, King-Devick times, and Sport Concussion Assessment Tool (SCAT) symptom scores. Results: Participants with migraine history have 1.75 odds of reporting abnormal baseline VOMS symptoms (≥2) than those without migraine (p = 0.007, 95% confidence interval [CI] 1.15, 2.63). Participants with migraine also had a predicted 1.15-point higher total symptom score and a 4.1-point symptom severity increase on the SCAT. Migraine did not significantly influence King-Devick performance. Females had 1.44 odds of slower reading times on the King-Devick (p < 0.001, 95% CI: 1.15, 1.81). Conclusions: Migraine history was the highest predictor of abnormal baseline vestibular ocular performance and symptoms in collegiate student-athletes. Female sex, concussion history, sleep, and anxiety and depression history also significantly contributed to baseline concussion performance. Identification of patient history prior to test interpretation is vital for appropriate diagnosis and care.