Abstract
BackgroundChronic headache following traumatic brain injury (TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions and may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System (FNS) that involves minute pulses of electromagnetic energy stimulation of brainwave activity has been suggested as a means to address symptoms of TBI. This study reports on a clinical series of patients with chronic headache following service-connected TBI treated with FNS.MethodsNine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI and complicated by posttraumatic stress symptoms were treated in 20 individual FNS sessions at the Brain Wellness and Biofeedback Center of Washington (in Bethesda, Maryland, USA). They periodically completed measures including the Brief Pain Inventory-Headache (BPI-HA) past week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version (PCL-M), and individual treatment session numerical rating scale (NRS) for degree of cognitive dysfunction. Data analyses included beginning to end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS.ResultsAll beginning to end of treatment t-test comparisons for the BPI-HA, PCL-M, and cognitive dysfunction NRS indicated statistically significant decreases. All but one participant experienced reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing virtual elimination of headaches. One participant obtained modest headache relief but no improvement in posttraumatic stress or cognitive dysfunction.ConclusionsFNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military service. Further research is needed to investigate the efficacy of FNS within a randomized, controlled clinical trial, to identify characteristics of those most likely to respond, and to explore underlying mechanisms that may contribute to improvement.
Highlights
Chronic headache following traumatic brain injury (TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions and may be complicated by co-morbid posttraumatic stress
In one cohort of US military service members returning from Afghanistan or Iraq, 19.6 % met criteria for a deployment-related concussion; among those, 97.8 % reported having headaches during the final 3 months of deployment; and more than 1 in 3 met criteria for posttraumatic headache, that is headache with onset within 7 days after head trauma [5]
Some evidence suggests mild TBI (mTBI) may result in more severe headache patterns relative to more severe cases of TBI, but this remains controversial [7, 8]
Summary
Chronic headache following traumatic brain injury (TBI) sustained in military service, while common, is highly challenging to treat with existing pharmacologic and non-pharmacologic interventions and may be complicated by co-morbid posttraumatic stress. In one cohort of US military service members returning from Afghanistan or Iraq, 19.6 % met criteria for a deployment-related concussion; among those, 97.8 % reported having headaches during the final 3 months of deployment; and more than 1 in 3 met criteria for posttraumatic headache, that is headache with onset within 7 days after head trauma (or regaining consciousness following head trauma) [5] Such headaches have been associated with greater frequency of headache attacks and increased prevalence of Nelson and Esty Military Medical Research (2015) 2:22 chronic daily headache [5, 6]. Chronic daily headache is a persistent and potentially debilitating sequela of military service related TBI
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
