Research Reports - Neurotherapy for chronic headache following traumatic brain injury

Mil Med Res. 2015 Aug 31;2:22. doi: 10.1186/s40779-015-0049-y. eCollection 2015.

Nelson DV(1), Esty ML(2).

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 may be complicated by
co-morbid posttraumatic stress. Recently, a novel form of brainwave-based
intervention known as the Flexyx Neurotherapy System (FNS) that 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 FNS.
METHODS: Nine veterans of the wars in Afghanistan and Iraq with moderate to
severe chronic headaches following service-connected TBI and 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) past week worst and average pain ratings, the Posttraumatic Stress
Disorder Checklist-Military version (PCL-M), and individual treatment session
numerical rating scale (NRS) for 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 reduction in headaches along with
reductions in posttraumatic stress and perceived cognitive dysfunction, with a
subset experiencing virtual elimination of headaches. One participant obtained
modest headache relief but no improvement in posttraumatic stress or cognitive
CONCLUSIONS: FNS may be a potentially efficacious treatment for chronic
posttraumatic headache sustained in military service. Further research is needed
to investigate the efficacy of FNS within a randomized, controlled clinical
trial, to identify characteristics of those most likely to respond, and to
explore underlying mechanisms that may contribute to improvement.

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