Pain management · 2026
The effect of multidisciplinary open-label treatment in patients with persistent post-traumatic headache at two tertiary headache centers.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод в очереди
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Wasfi Abd-Albaqi Sarah, Kjeldgaard Madsen Bjarne, Salomon Simon Møller, Caspersen Nina, Krøll Lotte Skytte, Larsen Kirsten, Danielsen Tatiana, Thomsen Sidsel Thorup, Gaj Baatz Sasha Revelius, Mose Louise Schlosser, Amin Faisal Mohammad, Schytz Henrik Winther
Аннотация
BACKGROUND: Persistent post-traumatic headache (PTH) is a frequent and disabling sequela of mild traumatic brain injury. This proof-of-concept study investigated whether a one-year multidisciplinary intervention could reduce PTH and other post-concussion symptoms in patients treated at the Danish Headache Center and the Headache Center in Southwest Jutland.
METHODS: This prospective, non-randomized cohort study included consultations with a doctor, nurse, physiotherapist, and psychologist, and offered pharmacological treatment with candesartan, amitriptyline, or gabapentin. Data were collected before and after the intervention using medical records and electronic questionnaires, including the Rivermead Post-Concussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI).
RESULTS: Fifty-eight patients with PTH (mean duration 36 months) were enrolled between August 2021 and February 2023. Headache frequency decreased by 1.7 days per month (p = 0.044). There were no significant changes in acute medication use (p = 0.965), Rivermead score (p = 0.169), HADS-anxiety (p = 0.792), HADS-depression (p = 0.898), ISI (p = 0.138), physical activity (p = 0.071), or self-rated health (p = 0.598). Candesartan, amitriptyline, and gabapentin were reported effective by 28%, 6.5%, and 22% of users, respectively.
CONCLUSION: A comprehensive multidisciplinary program did not produce clinically meaningful improvement in headache or associated symptoms, although patient satisfaction remained high. Further research is needed to improve treatment strategies.Clinical trial registration: The ClinicalTrials.gov identifier is NCT05328635.
METHODS: This prospective, non-randomized cohort study included consultations with a doctor, nurse, physiotherapist, and psychologist, and offered pharmacological treatment with candesartan, amitriptyline, or gabapentin. Data were collected before and after the intervention using medical records and electronic questionnaires, including the Rivermead Post-Concussion Symptoms Questionnaire, Hospital Anxiety and Depression Scale (HADS), and Insomnia Severity Index (ISI).
RESULTS: Fifty-eight patients with PTH (mean duration 36 months) were enrolled between August 2021 and February 2023. Headache frequency decreased by 1.7 days per month (p = 0.044). There were no significant changes in acute medication use (p = 0.965), Rivermead score (p = 0.169), HADS-anxiety (p = 0.792), HADS-depression (p = 0.898), ISI (p = 0.138), physical activity (p = 0.071), or self-rated health (p = 0.598). Candesartan, amitriptyline, and gabapentin were reported effective by 28%, 6.5%, and 22% of users, respectively.
CONCLUSION: A comprehensive multidisciplinary program did not produce clinically meaningful improvement in headache or associated symptoms, although patient satisfaction remained high. Further research is needed to improve treatment strategies.Clinical trial registration: The ClinicalTrials.gov identifier is NCT05328635.