title: A Randomized Exploratory Study to Evaluate Two Acupuncture Methods for the Treatment of Headaches Associated with Traumatic Brain Injury.
abstract: Background:Headaches are prevalent among Service members with traumatic brain injury (TBI); 80% report chronic or recurrent headache. Evidence for nonpharmacologic treatments, such as acupuncture, are needed.Objective:The aim of this research was to determine if two types of acupuncture (auricular acupuncture [AA] and traditional Chinese acupuncture [TCA]) were feasible and more effective than usual care (UC) alone for TBI-related headache.Materials and Methods:Design:This was a three-armed, parallel, randomized exploratory study.Setting:The research took place at three military treatment facilities in the Washington, DC, metropolitan area.Patients:The subjects were previously deployed Service members (18-69 years old) with mild-to-moderate TBI and headaches.Intervention:The interventions explored were UC alone or with the addition of AA or TCA.Outcome Measures:The primary outcome was the Headache Impact Test (HIT). Secondary outcomes were the Numerical Rating Scale (NRS), Pittsburgh Sleep Quality Index, Post-Traumatic Stress Checklist, Symptom Checklist-90-R, Medical Outcome Study Quality of Life (QoL), Beck Depression Inventory, State-Trait Anxiety Inventory, the Automated Neuropsychological Assessment Metrics, and expectancy of outcome and acupuncture efficacy.Results:Mean HIT scores decreased in the AA and TCA groups but increased slightly in the UC-only group from baseline to week 6 [AA, -10.2% (-6.4 points); TCA, -4.6% (-2.9 points); UC, +0.8% (+0.6 points)]. Both acupuncture groups had sizable decreases in NRS (Pain Best), compared to UC (TCA versus UC:P= 0.0008,d= 1.70; AA versus UC:P= 0.0127,d= 1.6). No statistically significant results were found for any other secondary outcome measures.Conclusions:Both AA and TCA improved headache-related QoL more than UC did in Service members with TBI.
authors.affiliation: Samueli Institute , Alexandria, VA.
authors.forename: Wayne B
authors.initials: WB
authors.lastname: Jonas
authors.affiliation: Samueli Institute , Alexandria, VA.
authors.forename: Dawn M
authors.initials: DM
authors.lastname: Bellanti
authors.affiliation: Samueli Institute , Alexandria, VA.
authors.forename: Charmagne F
authors.initials: CF
authors.lastname: Paat
authors.affiliation: Samueli Institute , Alexandria, VA.
authors.forename: Courtney C
authors.initials: CC
authors.lastname: Boyd
authors.affiliation: Integrative Healing, LLC , Hyattsville, MD.
authors.forename: Alaine
authors.initials: A
authors.lastname: Duncan
authors.affiliation: Samueli Institute , Alexandria, VA.
authors.forename: Ashley
authors.initials: A
authors.lastname: Price
authors.affiliation: Samueli Institute , Alexandria, VA.
authors.forename: Weimin
authors.initials: W
authors.lastname: Zhang
authors.affiliation: National Intrepid Center of Excellence, Walter Reed National Military Medical Center , Bethesda, MD.
authors.forename: Louis M
authors.initials: LM
authors.lastname: French
authors.affiliation: Defense and Veterans Brain Injury Center Clinic , Fort Belvoir Community Hospital, Fort Belvoir, VA.
authors.forename: Heechin
authors.initials: H
authors.lastname: Chae
keywords: Acupuncture; Headache; Pain Management; Traumatic Brian Injury