title: Behavioral Treatments for Post-Traumatic Headache.
abstract: OBJECTIVE
  Post-traumatic headache (PTH) is a common headache type after traumatic brain injury (TBI). There are no FDA approved medications for PTH, and it is unknown how medications can affect the brain's ability to recover from TBI. Thus, we sought to examine the biopsychosocial factors that influence PTH and the non-pharmacologic treatments studied for headache treatment. We also sought to determine if there is literature examining whether the non-pharmacologic treatments influence the biopsychosocial factors. The non-pharmacologic treatments assessed included cognitive behavioral therapy (CBT), biofeedback, progressive muscle relaxation therapy (PMR), acupuncture, and physical therapy (PT).
  
  
  RESULTS
  Factors associated with prognosis in PTH may include the following: severity of TBI, stress, post-traumatic stress disorder, other psychiatric comorbidities, sociocultural and psychosocial factors, litigation, base rate misattribution, expectation as etiology, and chronic pain. There are few high quality studies on the non-pharmacologic treatments for PTH. Thermal and EMG biofeedback appear to have been examined the most followed by CBT. Studies did not have secondary outcomes examining the psychosocial factors related to PTH. Most of the behavioral studies involved a multi-modality intervention limiting the ability to assess the individual non-pharmacologic interventions we sought to study. There were very few randomized clinical trials evaluating the efficacy of non-pharmacologic interventions. Therefore, future research, which considers the noted biopsychosocial factors, is needed in the field to determine if these interventions reduce PTH.
authors.affiliation: Rusk Rehabilitation, NYU Langone Medical Center, New York City, USA.
authors.forename: Felicia
authors.initials: F
authors.lastname: Fraser
authors.affiliation: Rusk Rehabilitation, NYU Langone Medical Center, New York City, USA.
authors.forename: Yuka
authors.initials: Y
authors.lastname: Matsuzawa
authors.affiliation: Rusk Rehabilitation, NYU Langone Medical Center, New York City, USA.
authors.forename: Yuen Shan Christine
authors.initials: YSC
authors.lastname: Lee
authors.affiliation: Department of Neurology, NYU Langone Medical Center, 240 East 38th Street 20th floor, NY, NY, 10016, USA. minenmd@gmail.com.
authors.forename: Mia
authors.initials: M
authors.lastname: Minen
mesh_terms: D015670:Acupuncture Therapy / Q000379:methods; D001676:Biofeedback, Psychology / Q000379:methods; D015928:Cognitive Behavioral Therapy / Q000379:methods; D006801:Humans; D026741:Physical Therapy Modalities; D051298:Post-Traumatic Headache / Q000628:therapy*
keywords: Behavioral treatment; Biofeedback; Cognitive behavioral therapy; Post-traumatic headache; Relaxation therapy; Traumatic brain injury