Behavioral Therapies May Treat Headache and Post-Concussive Symptoms

The treatment of posttraumatic headaches and post-concussive symptoms using mind-body interventions and behavioral therapies suggests that therapeutic interactions may improve outcomes, but further research is needed to have conclusive results, according to a systemic review of literature published in Headache.

Researchers evaluated the efficacy of mind-body interventions and behavioral therapies on posttraumatic headaches and post-concussive symptoms by performing a literature review in Medline, PsycINFO, and EMBASE databases. Study inclusion criteria encompassed randomized controlled trials with more than 50% of the study population having mild traumatic brain injury. Mind-body interventions and behavioral therapies included activities such as stress management therapy, coping skills, relaxation training, meditation, yoga, and biofeedback. Altogether, the 2 independent reviewers included 7 studies.

After compiling studies, there were 1108 adults included, of which 68.8% were men, and most were from the United States. There was a wide variety of patient populations, post-injury recruitment times, types of interventions or therapies, and measurements used to evaluate outcomes. This heterogeneity led to the researchers not being able to identify conclusive results, but observations were noted. Earlier identification and intervention may improve outcomes for patients with mild traumatic brain injury, a history of headaches may increase the likelihood of developing or worsening posttraumatic headaches, an education-based therapy may enable a healthier outcome, and telephonic modalities may improve symptoms of the brain injury.

Future studies need to use changes in headache as an outcome measure, start intervention closer to the time of injury, and include pharmacologic treatments in addition to mind-body interventions and behavioral therapies.

The researchers concluded their “findings appear to suggest supportive, therapeutic relationships may help facilitate improved outcomes” for patients with mild traumatic brain injuries, and “further research should focus on behavioral therapies and [mind-body interventions] to specifically address headache for [post-concussive symptoms].”

Reference

Minen M, Jinich S, Vallespir Ellett G. Behavioral therapies and mind-body interventions for posttraumatic headache and post-concussive symptoms: a systematic review [published online December 1, 2018]. Headache. doi: 10.1111/head.13455