Behavioral treatment for post-traumatic headache after mild traumatic brain injury: Rationale and case series
Bibliographic record
Abstract
BACKGROUND: Headache is among the most common persistent symptoms after mild traumatic brain injury (mTBI). Currently available treatments have limited efficacy. OBJECTIVE: To present a rationale for a novel behavioral treatment approach and a supporting case series with a multiple baseline design. METHOD: Pervasive avoidance of common headache triggers may be maladaptive, promoting sensitization and restricting life participation. Graded exposure to triggers that are prone to sensitization (e.g., stress, light flicker, loud noise) may represent an alternative behavioral approach to treating chronic headaches after mTBI. The present study reports on a series of physician-referred patients (N = 4, aged 28-48, enrolled at 9-19 months post-injury) with persistent headache attributed to mTBI. They participated in an 8-session manualized treatment with a registered psychologist. Patients completed a daily headache diary before, during, and after treatment, as well as pre- and post-treatment assessments with a battery of questionnaires. RESULTS: All patients finished treatment and no adverse events were reported. Improvement was variable across measures of headache frequency/intensity, headache trigger avoidance, post-concussion symptoms, disability, and patient global impression of change. CONCLUSION: Future directions for behavioral management of headache triggers as a potential treatment for chronic post-traumatic headaches after mTBI are discussed.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".