Neurotherapy for chronic headache following traumatic brain injury

作     者：David V.Nelson Mary Lee Esty 

作者机构：Department of Psychology and PhilosophyBox 2447Sam Houston State University Brain Wellness and Biofeedback Center of Washington 

出 版 物：《Journal of Medical Colleges of PLA(China)》 (中国人民解放军军医大学学报（英文版）)

年 卷 期：2015年第30卷第2期

页      面：91-95页

学科分类：1002[医学-临床医学] 10[医学] 1009[医学-特种医学] 

主　　题：Chronic headache Posttraumatic headache Traumatic brain injury Neurotherapy Electroencephalograph(EEG) biofeedback Neurofeedback 

摘      要：Background: 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 it may be complicated by co-morbid posttraumatic stress. Recently, a novel form of brainwave-based intervention known as the Flexyx Neurotherapy System(FNS), which 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 ***: Nine veterans of the wars in Afghanistan and Iraq with moderate to severe chronic headaches following service-connected TBI 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), previous week worst and average pain ratings, the Posttraumatic Stress Disorder Checklist-Military version(PCL-M), and an individual treatment session numerical rating scale(NRS) for the 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. Results: All 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 a reduction in headaches along with reductions in posttraumatic stress and perceived cognitive dysfunction, with a subset experiencing the virtual elimination of headaches. One participant obtained modest headache relief but no improvements in posttraumatic stress or cognitive dysfunction. Conclusions: FNS may be a potentially efficacious treatment for chronic posttraumatic headache sustained in military service.