New therapy significantly reduces headache disability, posttraumatic stress following brain injury

The first therapy to be developed specifically for posttraumatic headache significantly reduced related disability in veterans following a traumatic brain injury. It also reduced co-occurring symptoms of posttraumatic stress disorder (PTSD) comparably to a gold-standard PTSD treatment.

Moreover, the innovative treatment, cognitive behavioral therapy for headache, was appealing to patients, showing low drop-out rates, and is easy for therapists to learn and deliver, increasing its potential to be broadly disseminated and to improve the lives of hundreds of thousands of service members and veterans.

Those findings were reported today in JAMA Neurology by a team of investigators led by Don McGeary PhD, of The University of Texas Health Science Center at San Antonio (UT Health San Antonio). Their effort was part of the work of the Consortium to Alleviate PTSD, a group jointly funded by the Departments of Defense and Veterans Affairs.

“We are excited by this development in the treatment of posttraumatic headache, which along with traumatic brain injury is poorly understood and for which treatment options are so limited,” said Dr. McGeary, associate professor of psychiatry and behavioral sciences in the university’s Joe R. and Teresa Lozano Long School of Medicine. “To find the first major treatment success for posttraumatic headache, which is arguably the most debilitating symptom of traumatic brain injury, and that the treatment also significantly reduces comorbid PTSD symptoms, is a major breakthrough.”

Both traumatic brain injury and PTSD are signature wounds of post-9/11 military conflicts, and the two conditions commonly occur together. Posttraumatic headaches, or headaches that develop or worsen following a head or neck injury, become chronic and debilitating in a large percentage of those who experience a traumatic brain injury such as a concussion, inhibiting their ability to engage in the activities of daily life. When PTSD is co-occurring, it can worsen the headaches and make them more difficult to treat.

Effective treatments exist for PTSD but not for posttraumatic headache, which along with traumatic brain injury, scientists are still working to understand. Migraine medications commonly used to alleviate headache pain do not relieve related disability. They also often have unwanted side effects, and their overuse can worsen headaches.

Dr. McGeary explained the current theory that PTSD may be a “driver” of posttraumatic headache and the disability it causes. So the research team wanted both to study the interaction of the conditions and their treatment and to find a therapy effective for both.

Source: News Release
University of Texas Health Science Center at San Antonio
June 27, 2022