{"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":1785254390303,"version":"3.55.0"},"reference-count":24,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["headachejournal.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Headache"],"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>There are no clear guidelines on how to treat posttraumatic headache (PTH) or post\u2010concussive symptoms (PCS). However, behavioral interventions such as cognitive behavioral therapy, biofeedback, and relaxation are Level\u2010A evidence\u2010based treatments for headache prevention. To understand how to develop and study further mind\u2010body interventions (MBIs) and behavioral therapies for PTH and PCS, we developed the following question using the PICO framework: Are behavioral therapies and MBIs effective for treating PTH and PCS?<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a systematic search of 3 databases (Medline, PsycINFO, and EMBASE) for behavioral interventions and MBIs with the subject headings and keywords for PTH, concussion, and traumatic brain injury (TBI). Inclusion criteria were (1) randomized controlled trials, (2) the majority of the intervention had to be behavioral or mind\u2010body therapy focused, (3) the majority of the participants (&gt;50%) had to have had a mild TBI (not a moderate or severe TBI), (4) published in a peer\u2010reviewed publication, and (5) meeting pre\u2010specified primary and\/or secondary outcomes. Primary outcome(s): whether there was a significant change in concussion symptom severity (yes\/no) based on the symptom severity checklist\/scale used, whether there was a 50% reduction in headache days and\/or disability; secondary outcome(s): sleep variables, cognitive complaints, depression, and anxiety. The search identified 917 individual studies. Two independent reviewers screened citations and full\u2010text articles independently. Nineteen articles were pulled for full article review. Seven articles met the final inclusion criteria. The systematic review was registered in Prospero (CRD42017070072).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, there was vast heterogeneity across the studies, making it difficult to fully assess efficacy. The heterogeneity ranged from differences in patient populations, the timing of when the interventions were initiated, the types of intervention implemented, and the measures used to assess outcomes. Seven studies were identified as meeting final inclusion criteria, resulting in a total of 1108 adult participants ranging from 18 to 80. Sixty\u2010nine percent were male. Of the 7 studies, 3 were focused on military staff (retired and active). Time post\u2010injury for inclusion into the studies varied from 48 hours post\u2010injury to more than 2 years post\u2010injury. One of the 7 studies did not include time post\u2010TBI in the inclusion criteria. Two studies recruited patients who had visited their emergency departments, 4 of the studies recruited subjects through outpatient referrals, and 1 study recruited patients who had been in a prior traffic accident with resulting chronic PTH directly from a headache center. Group cognitive behavioral therapy (CBT) sessions and telephonic counseling or communication were common intervention methods used in the studies, with group CBT being used in 2 of the studies and telephonic counseling being used in 3. Other intervention methods used included individual CBT, cognitive training, psychoeducation, and computer\u2010based and\/or therapist\u2010directed cognitive rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Many of the interventions offered vastly different methods of delivery of intervention and doses of intervention. Many of the negative studies were done after an extended duration post\u2010injury (&gt;1\u2010year posttraumatic brain injury [TBI]). In addition, the participants were lumped together regardless of their pre\u2010concussion comorbidities, their mechanism of injury, their symptoms, and the duration from injury to the start of the intervention. The mass heterogeneity found between the studies led to inconclusive findings. Thus, there are various considerations for the design of the intervention for future behavioral\/MBI studies for PTH and concussion that must be addressed before the leading question of this review may be effectively answered.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/head.13455","type":"journal-article","created":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T07:34:06Z","timestamp":1543649646000},"page":"151-163","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":29,"title":["Behavioral Therapies and Mind\u2010Body Interventions for Posttraumatic Headache and Post\u2010Concussive Symptoms: A Systematic Review"],"prefix":"10.1111","volume":"59","author":[{"given":"Mia","family":"Minen","sequence":"first","affiliation":[{"name":"Departments of Neurology and Population Health NYU Langone Medical Center New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Jinich","sequence":"additional","affiliation":[{"name":"Barnard College Columbia University New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gladys","family":"Vallespir Ellett","sequence":"additional","affiliation":[{"name":"NYU College of Nursing New York NY USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2018,12]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2015.04.011"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.434"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2340\/16501977-1182"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsr.2017.04.002"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.170092"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097878"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11916-017-0624-x"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2011.01905.x"},{"key":"e_1_2_7_10_1","article-title":"Evidence\u2010based guidelines for migraine headache: behavioral and physical treatments","author":"Campbell J","year":"2000","journal-title":"U.S. Headache Consortium"},{"key":"e_1_2_7_11_1","first-page":"257","article-title":"Clinical practice guidelines for mild traumatic brain injury and persistent symptoms","volume":"58","author":"Marshall S","year":"2012","journal-title":"Can Fam Physician"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11910-016-0697-7"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1526-4610.2012.02238.x"},{"key":"e_1_2_7_14_1","unstructured":"Covidence systematic review software. 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