Headache level during neuropsychological testing and test performance in patients with chronic posttraumatic headache

This study addresses (1) the relationship between headache presence/intensi ty :lt time of testing and neurocognitive performance, and (2) the probabil ity that testing triggers or intensifies pain. Subjects were 125 patients w ith chronic posttraumatic headache (mean = 2.67 years post injury) who comp leted a 4-hour test battery emphasizing memory. Comparisons of 34 individua l tests/subtests and the five Wechsler Memory Scale-Revised (WMS-R) indices of relative memory impairment for 73 patients with no headache or mild hea dache versus 52 patients with moderate to severe pain revealed no significa nt differences. Testing intensified existing headaches for 55% but triggere d headache for only 1 of 20 (5%; P = .00003). Results support the validity of neuropsychological test performance regardless of pain level, although t esting can be painful.