Methods for Factors Affecting Behavioral Treatment in Veterans with Headache Attributable to Mild to Moderate Traumatic Brain Injury

Over 400,000 U.S. military personnel have been diagnosed with a mild or moderate traumatic brain injury (TBI) since the year 2000. Posttraumatic headache (PTH) is one of the most common and bothersome sequela after a mild or moderate head injury. Persistent posttraumatic headache are headaches due to the head injury lasting longer than 3 months. About 40% of military personnel who develop PTH after a TBI have persistent PTH and about 20% have PTH lasting longer than a year after the original injury. Persistent PTH has a negative impact on daily activities, including work and social functioning. There are no available guidelines for treating posttraumatic headache, and there is extraordinary variability in treatment practices as a result. The present study aims to identify predictive factors that account for heterogeneity in response to behavioral intervention for posttraumatic headache attributable to mild to moderate TBI. We intend to create a predictive model of PTH through the adoption of the Predictive Approaches to Treatment effect Heterogeneity Statement (PATH Statement). This rigorous, guided approach will be used to develop and validate a predictive model of psychosocial factors related to PTH treatment outcomes, thereby improving individualized treatment of PTH. This protocol provides an overview of the research design and methods for this study.