{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T15:59:50Z","timestamp":1785254390240,"version":"3.55.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"19-20","license":[{"start":{"date-parts":[[2025,10,1]],"date-time":"2025-10-01T00:00:00Z","timestamp":1759276800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    Targeted manipulation of dietary omega-3 and omega-6 fatty acids has previously been shown to decrease nontraumatic headaches in controlled trials. This study assessed the effects of a diet high in omega-3 fatty acids and low in omega-6 linoleic acid (H3L6 diet) on headache frequency and severity, headache impact, and plasma nociceptive mediators in a persistent post-traumatic headache (pPTH) population. One hundred and twenty-two participants with pPTH were randomized 1:1 to 12 weeks of either the H3L6 (\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 62) or a control (n = 60) diet.\n                    <jats:italic toggle=\"yes\">A priori<\/jats:italic>\n                    primary end-points were the plasma levels of the antinociceptive docosahexaenoic acid (DHA) derivative 17-hydroxy-DHA and the Headache Impact Test (HIT-6) score. Secondary end-points included headache days\/month and average daily headache pain intensity (0\u201310 scale). Statistical analyses followed intention-to-treat principles and were adjusted for baseline values. Relative to the control group, the H3L6 group significantly reduced headache days\/month (\u22122.1, 95% confidence interval [CI]: \u22123.5 to \u22120.8,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.002) and average headache intensity (\u22120.9, 95% CI: \u22121.2 to \u22120.5,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    &lt; 0.001) and increased circulating 17-hydroxy-DHA (nanograms\/milliliter; difference 0.07, 95% CI: 0.02\u20130.11,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.003), although it did not significantly improve HIT-6 scores (\u22121.6, 95% CI: \u22124.0 to 0.8,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.18). In conclusion, the H3L6 diet reduced headache pain and increased antinociceptive mediators, supporting its potential as an adjunct nonpharmacological pPTH therapy.\n                  <\/jats:p>","DOI":"10.1089\/neu.2025.0126","type":"journal-article","created":{"date-parts":[[2025,7,2]],"date-time":"2025-07-02T05:25:21Z","timestamp":1751433921000},"page":"1719-1731","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["A High Omega-3, Low Omega-6 Diet Reduces Headache Frequency and Intensity in Persistent Post-Traumatic Headache: A Randomized Trial"],"prefix":"10.1177","volume":"42","author":[{"given":"Daisy","family":"Zamora","sequence":"first","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation, University of North Carolina, Chapel Hill, North Carolina, USA."},{"name":"Lipid Peroxidation Unit, Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimbra","family":"Kenney","sequence":"additional","affiliation":[{"name":"Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0061-8586","authenticated-orcid":false,"given":"Mark","family":"Horowitz","sequence":"additional","affiliation":[{"name":"Lipid Peroxidation Unit, Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wesley R.","family":"Cole","sequence":"additional","affiliation":[{"name":"Department of Exercise and Sport Science, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth A.","family":"MacIntosh","sequence":"additional","affiliation":[{"name":"Metabolic and Nutrition Research Core, University of North Carolina Health, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacques P.","family":"Arrieux","sequence":"additional","affiliation":[{"name":"Department of Brain Injury Medicine, Intrepid Spirit Center, Womack Army Medical Center, Fort Bragg, North Carolina, USA."},{"name":"Traumatic Brain Injury Center of Excellence, Research and Engineering Directorate, Defense Health Agency, Fort Bragg, North Carolina, USA."},{"name":"General Dynamics Information Technology, Falls Church, Virginia, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Dunlap","sequence":"additional","affiliation":[{"name":"Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olafur S.","family":"Palsson","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cora","family":"Davis","sequence":"additional","affiliation":[{"name":"Henry M. Jackson Foundation in support of Uniformed Services University at the National Intrepid Center of Excellence, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol B.","family":"Moore","sequence":"additional","affiliation":[{"name":"Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wanda","family":"Rivera","sequence":"additional","affiliation":[{"name":"Henry M. Jackson Foundation in support of Uniformed Services University at the National Intrepid Center of Excellence, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9858-2931","authenticated-orcid":false,"given":"J. Kent","family":"Werner","sequence":"additional","affiliation":[{"name":"Department of Neurology, Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramon","family":"Diaz-Arrastia","sequence":"additional","affiliation":[{"name":"Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony F.","family":"Domenichiello","sequence":"additional","affiliation":[{"name":"Office of Pain Policy and Planning, National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pranavi","family":"Nara","sequence":"additional","affiliation":[{"name":"Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ameer Y.","family":"Taha","sequence":"additional","affiliation":[{"name":"Department of Food Science and Technology, College of Agriculture and Environmental Sciences, University of California, Davis, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Duncan A.","family":"Sylvestre","sequence":"additional","affiliation":[{"name":"Department of Food Science and Technology, College of Agriculture and Environmental Sciences, University of California, Davis, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris E.","family":"Ramsden","sequence":"additional","affiliation":[{"name":"Lipid Peroxidation Unit, Laboratory of Clinical Investigation, National Institute on Aging, National Institutes of Health, Baltimore, Maryland, USA."},{"name":"National Institute on Alcohol Abuse and Alcoholism, National Institutes of Health, Bethesda, Maryland, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keturah R.","family":"Faurot","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine &amp; Rehabilitation, University of North Carolina, Chapel Hill, North Carolina, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,10,6]]},"reference":[{"key":"e_1_3_7_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00094-6"},{"key":"e_1_3_7_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwy199"},{"key":"e_1_3_7_4_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2011.1914"},{"key":"e_1_3_7_5_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102412445224"},{"key":"e_1_3_7_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/0333102420909865"},{"key":"e_1_3_7_7_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41582-019-0243-8"},{"key":"e_1_3_7_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s10194-020-01201-7"},{"key":"e_1_3_7_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2013.07.028"},{"key":"e_1_3_7_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.plefa.2017.11.002"},{"key":"e_1_3_7_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.clnu.2021.04.050"},{"key":"e_1_3_7_12_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n1448"},{"key":"e_1_3_7_13_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpain.2023.1231054"},{"key":"e_1_3_7_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.plipres.2022.101165"},{"key":"e_1_3_7_15_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.2011.01345.x"},{"key":"e_1_3_7_16_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainresbull.2019.11.002"},{"key":"e_1_3_7_17_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.2010.00909.x"},{"key":"e_1_3_7_18_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.2011.01568.x"},{"key":"e_1_3_7_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11481-012-9394-8"},{"key":"e_1_3_7_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuropharm.2014.05.043"},{"key":"e_1_3_7_21_2","doi-asserted-by":"publisher","DOI":"10.1155\/2016\/5259321"},{"key":"e_1_3_7_22_2","doi-asserted-by":"publisher","DOI":"10.2147\/JIR.S142424"},{"key":"e_1_3_7_23_2","doi-asserted-by":"publisher","DOI":"10.1155\/2015\/275126"},{"key":"e_1_3_7_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/bph.14647"},{"key":"e_1_3_7_25_2","doi-asserted-by":"publisher","DOI":"10.1194\/jlr.M006007"},{"key":"e_1_3_7_26_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-017-09516-3"},{"key":"e_1_3_7_27_2","unstructured":"Assistant Secretary of Defense. 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