Exploring cerebral structural and functional abnormalities in a mouse model of post-traumatic headache induced by mild traumatic brain injury

Mild traumatic brain injury(mTBI)-induced post-traumatic headache(PTH)is a pressing public health concern and leading cause of disability worldwide.Although PTH is often accompanied by neurological disorders,the exact underlying mechanism remains largely unknown.Identifying potential biomarkers may prompt the diagnosis and development of effective treatments for mTBI-induced PTH.In this study,a mouse model of mTBI-induced PTH was established to investigate its effects on cerebral structure and function during short-term recovery.Results indicated that mice with mTBI-induced PTH exhibited balance deficits during the early post-injury stage.Metabolic kinetics revealed that variations in neurotransmitters were most prominent in the cerebellum,temporal lobe/cortex,and hippocampal regions during the early stages of PTH.Additionally,variations in brain functional activities and connectivity were further detected in the early stage of PTH,particularly in the cerebellum and temporal cortex,suggesting that these regions play central roles in the mechanism underlying PTH.Moreover,our results suggested that GABA and glutamate may serve as potential diagnostic or prognostic biomarkers for PTH.Future studies should explore the specific neural circuits involved in the regulation of PTH by the cerebellum and temporal cortex,with these two regions potentially utilized as targets for non-invasive stimulation in future clinical treatment.

Three-step acupuncture and cupping therapy:an effective approach to treat cervicogenic headache

As early as 1983,Sjaastad proposed the concept of cervicogenic headache(CH)in the World Headache Conference,that is,the pain from upper cervical joints and muscles can be referred to the head.CH is a group of syndromes mainly caused by dysfunction of the upper cervical spine and its component muscles,ligaments,bony,vertebral arteries and/or soft tissue elements,usually not accompanied by neck pain.Therefore,the treatment strategy of CH focuses on pain relief and repair cervical lesions.Patients with painful disorders of upper cervical zygapophysial joints showed significant headache relief after directly treated at disordered cervical joints[1].

A randomized controlled trial of ketorolac for prevention of headache related to electroconvulsive therapy

Background and Purpose: Headache is one of the most common side effects of electroconvulsive therapy (ECT), with a reported prevalence as high as 45%. Typical pharmacologic measures include aspirin, acetaminophen, or nonsteroidal anti-inflammatory medications. Among the latter, ketorolac may be especially advantageous in that it can be administered intravenously right before a treatment. The primary aim of this study was to measure the efficacy of intravenous ketorolac administration for the prevention of post-ECT headache at the first treatment session. Methods: Sixteen patients were assigned to the control group, while eight patients were assigned to the ketorolac treatment group (8 males, 16 females;mean age ± standard deviation = 46 ± 13.5 years). Statistical analysis consisted of a one-way analysis of variance using the two-sample test. We utilized a post-ECT headache severity scale from zero (no headache) to 3 (severe headache). Results:The mean score for the control group was 1.3 (±1.1), while the mean score for the ketorolac treatment group was 1.2 (±1.1), p = 0.86 (not significant). Conclusions: Ketorolac administration does not decrease the incidence of post ECT headache at the first treatment session. It is possible that ketorolac may be effective at subsequent treatments for patients with particularly bothersome headaches after the first treatment. Implications: Ketorolac should not be routinely used at the first treatment session to prevent headache associated with ECT.

A multi-center randomized controlled clinical trial of three-step acupuncture and cupping therapy for cervicogenic headache

Objective:To assess the clinical efficacy and safety of three-step acupuncture and cupping therapy for cervicogenic headache(CEH).Methods:A randomized,single-blind,multi-center,parallel controlled clinical trial was performed,including 63 patients with CEH who met the study criteria.They were randomly divided into treatment(n=32)and control groups(n=31).The treatment group was treated with three-step acupuncture and cupping therapy,and the control group was treated with sham acupuncture.The simplified McGill pain scores,comprising three parts:the pain rating index,visual analogue scale score,and present pain intensity,alongside head and neck stiffness and cervical vertebra range of motion,and a safety evaluation were recorded in the two groups before treatment,immediately after the first treatment,after 10 days of treatment,after 20 days of treatment,and 3 months after the end of treatment.Results:Compared with before treatment,the scores at each follow-up time point were significantly improved after treatment;moreover,the treatment group was significantly better than the control group.When the scores at the 3 months follow-up after the end of the treatment were compared with the scores after 20 days of treatment,there were no significant differences in the treatment group while significant differences from the scores of the control group,suggesting that the treatment group had better long-term benefits than the control group.Conclusion:Compared with the sham acupuncture group,the three-step acupuncture and cupping method has a beneficial effect in the treatment of CEH.It provides rapid benefits,has better short-and long-term efficacy than sham acupuncture,and is associated with a low recurrence rate.

Clinical effect of sodium hyaluronate joint cavity filling combined with exercise therapy on patients with post-traumatic knee arthritis

Objective:To research the sodium hyaluronate joint cavity filling combined with exercise therapy on the indicator of pain,motor function,and levels of inflammatory factors in joint fluid in patients with post-traumatic knee arthritis.Method Totally 100 patients(Department of Orthopaedics,The second Affiliated Hospital to Liaoning University of Chinese Medicine,2013.10-2018.8)with post-traumatic knee arthritis were selected,then they were divided into observation group(n=50)and control group(n=50).The control group was given glucosamine sulfate and sodium hyaluronate joint cavity filling,the observation group was given leg press with visual feedback,they were treated 4 weeks.Assessing the pain degree through visual analog scale(VAS),hospital for special surgery knee score(HSS)as the indicator of motor function,inflammatory factor(TNF-α,IL-6,and IL-8)in the joint fluid.Results The score of VAS were lower than pretherapy(P<0.05),the degree of VAS of observation group were lower than control group(P<0.05).The score of HSS were higher than pretherapy(P<0.05),the degree of VAS of observation group were higher than control group(P<0.05).The inflammatory factor(TNF-α,IL-6,and CRP)in the joint fluid were lower than pretherapy(P<0.05),and the observation group were lower than control group(P<0.05).Conclusions Giving sodium hyaluronate joint cavity filling combined with exercise therapy can improve the function of joint.

A Case Report on Sandplay Therapy for a 3-Year-11-Month-Old Child with Post-Traumatic Stress Disorder

This report presents a case study of sandplay therapy for a 3-year-11-month-old child with post-traumatic stress disorder. The child had experienced a distressing traumatic event and exhibited symptoms of anxiety, fear, and traumatic reenactment. Sandplay therapy, as a therapeutic modality, was utilized to provide a safe environment for the child to express and process their inner experiences. The case report provides a detailed account of the child’s presentation, treatment goals, therapeutic strategies, and treatment outcomes. Through sandplay therapy, the child achieved emotional release, resolution of internal conflicts, and a reframing of the traumatic event. Ultimately, a significant reduction in symptoms of post-traumatic stress disorder was observed, along with improved functioning and psychological well-being.

Clinical application of repetitive transcranial magnetic stimulation for post-traumatic stress disorder:A literature review

The efficacy of traditional treatment for post-traumatic stress disorder(PTSD)is still unsatisfactory.Repetitive transcranial magnetic stimulation(rTMS)has been widely used in the treatment of various types of mental disorders,including PTSD.Although rTMS has been demonstrated to be effective in many cases,there are still arguments regarding its mechanism and protocol.This review aims to summarize the origin,development,principle,and future direction of rTMS and introduce this neuro-stimulation therapy to relevant clinicians.

TREATING 100 CASES OF HEADACHE BY MAINLY NEEDLING FENGCHI AND TAICHONG

This article introduces the writers’ experience in treating 100 cases of headache bymainly needling Fengchi (GB 20) and Taichong (LR 3). It is considered in TCM that headache ismostly caused by pathogenic wind, and there is a saying of "no wind, no headache". The combinationof the two points can expel both endogenous and exogenous wind. So we treat headache mainly withneedling Fengchi and Taichong. The result is good, especially for cluster headache and psychicheadache.’

Drawing soldiers out of post-traumatic stress disorder

Art therapies are a broad suite of treatments including drawing, painting and music that can facilitate non-verbal communication through artistic expression. They have been used as adjunctive therapies for a range of mental health conditions. Significant numbers of returning military personnel experience post-traumatic stress disorder(PTSD), and discontinuation of care is a concern. Using drawing-based art therapy as an adjuvant to classical therapies may provide a benefit for such military patients.

Post Dural Puncture Headache—Review and Suggested New Treatment

Objectives: After reading this article, readers should be able to recognize Post Dural Puncture Headache, understand its mechanism and diagnostic criteria, evaluate the different treatment options available, and be familiar with a novel treatment option. Background: Post-dural puncture headache is the most common serious complication resulting from lumbar puncture and epidural or spinal anesthetics. The syndrome is characterized by severe headache that occurs within 48 hours following the puncture, located in the frontal and/or occipital region, worsened in the upright position and refractory to routine analgesia. The syndrome incidence was reported to be approximately 1% with typical obstetric anesthesiology practice which reflects more than 20,000 cases per 2014 in the US. Two possible mechanisms are hypothesized as responsible for this syndrome;cerebrospinal fluid leakage and pneumocephalus. Multiple methods of treatment have been applied with wide-ranging results. Design or Methods: Review article with introduction of a novel treatment option. Results: We postulate that Hyperbaric Oxygen Therapy can be used to treat post-dural puncture headache. The rationale for treatment is dual: enhancement of fibroblast proliferation at the site of dural puncture to facilitate faster closure of the tear and compression of air bubbles in case of pneumocephalus according to Boyle’s law. We also claim that hyperbaric oxygen therapy should be considered a prophylactic treatment, if a dural tear is suspected.

The Effectiveness of Psychotherapy on Posttraumatic Stress Disorder in Soldier:A Systematic Review

The objective of this systematic review is to examine the effectiveness of psychotherapy in treating Post-Traumatic Stress Disorder(PTSD)in military personnel.PubMed,Web of Science,The Cochrane Library,EBSCO and CNKI databases were searched from 1 January,2000 to November 2022 for Randomized Controlled Trials(RCTs)on psychotherapeutic interventions for military PTSD.The physical Therapy Evidence Database(PEDro)scale was used to evaluate the quality of the literature.Two researchers conducted literature screening,data extraction,and risk bias assessment in accordance with inclusion and exclusion criteria.Ultimately,49 RCTs were included,involving a total of 5073 veterans,retired and active military from four countries.The average score on the PEDro scale was 7.60.The primary psychotherapeutic modalities for military PTSD intervention include Cognitive-Behavioral Therapy,Exposure Therapy,Mindfulness interventions,psychotherapy based on new technological tools,and other emerging psychotherapeutic tools.The review highlights that Cognitive Processing Therapy(CPT)and Prolonged Exposure Therapy(PET)stand out as the primary psychotherapeutic modalities for treating PTSD in military personnel.In cases where CPT and PET yield limited benefits,Mindfulness interventions emerge as effective alternatives.Moreover,considering the diverse needs and high dropout rates in the military,population,the review suggests using web-based,computer,and virtual reality technology tools as supplements to first-line treatments(CPT/PET)to enhance overall intervention effectiveness.For the advancement of future psychotherapeutic initiatives,there is a pronounced emphasis on prioritizing proven first-line interventions,CPT and PET while also recognizing the potential of mindfulness-based interventions as credible alternatives.In tandem with this,the active integration of technological tools is advocated to amplify the therapeutic impact of conventional psychological treatment modalities.

Efficacy of super-pulsed 905 nm Low Level Laser Therapy (LLLT) in the management of Traumatic Brain Injury (TBI): A case study

Traumatic brain injury is a major health concern worldwide with massive financial and social impact. Conventional treatments primarily focus on the prevention of further damage to the brain parenchyma, while failing to address the already existent symptoms. Previous clinical studies have shown that Low Level Laser Therapy (LLLT) can significantly reduce pain and induce temporary vasodilation in capillaries, which the authors hypothesize can be used to improve the quality of life in TBI patients by treating their current symptoms, which are predominately migraine-like headaches. This case report illustrates the use of LLLT in the treatment of a patient with a TBI and the great clinical success achieved in the reduction of pain, as measured by VAS—achievable within five treatments of 10 minutes in duration.

耳穴贴压联合针灸对高血压病患者血压血脂的影响

目的 探析高血压病患者采用耳穴贴压联合针灸治疗对血压与血脂的影响。方法 选择枣庄市立医院2021年3月—2022年3月接诊的90例高血压病患者,按照随机数字表法分为2组,每组45例。对照组口服药物治疗,观察组耳穴贴压联合针灸治疗。比较2组患者血压、血脂、中医证候积分和治疗总有效率。结果 治疗后,观察组舒张压、收缩压均低于对照组,差异有统计学意义(P<0.05);观察组总胆固醇(TC)、三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)低于对照组,高密度脂蛋白胆固醇(HDL-C)高于对照组,差异均有统计学意义(P<0.05);观察组主症(头痛、眩晕)与次症(心悸、胸闷、畏寒肢冷)中医证候积分均低于对照组,差异有统计学意义(P<0.05)。观察组的治疗总有效率为97.78%(44/45),高于对照组的80.00%(36/45),差异有统计学意义(P<0.05)。结论 高血压病患者采用耳穴贴压联合针灸治疗可以更好地改善血压与血脂,值得推广。

基于“经筋理论”运用多功能套针浮刺疗法治疗颈源性头痛的临床研究

目的:评价基于“经筋理论”运用多功能套针浮刺疗法对颈源性头痛的临床疗效。方法:将64例颈源性头痛患者随机分为观察组与对照组各31例(各脱落1例)。观察组采用多功能套针浮刺疗法,对照组为常规针刺治疗,两组患者均治疗7 d。分别于治疗前后观察两组患者的视觉模拟量表(VAS)评分、头痛影响测定表-6(HIT-6)评分、颈椎功能障碍指数(NDI)评分和伴随症状量表评分,并于治疗结束后3个月观察复发率。结果:两组患者的VAS量表评分、HIT-6量表评分、NDI量表评分及伴随症状积分治疗后均优于治疗前,差异有统计学意义(P<0.05),且观察组比对照组效果更佳,差异有统计学意义(P<0.05);于治疗后3个月随访,以上量表评分与治疗后相比均有改善,且观察组优于对照组,差异有统计学意义(P<0.05);观察组临床总有效率为93.55%(29/31),高于对照组的83.87%(26/31),差异有统计学意义(P<0.05)。结论:应用多功能套针浮刺疗法能有效改善颈源性头痛患者症状,见效较快且效果持久,值得临床推广应用。

银质针导热疗法治疗颈源性头痛的临床疗效及其机制探讨

目的:探究银质针导热疗法对颈源性头痛的临床疗效与作用机制。方法:90例颈源性头痛患者随机分为银质针非导热组(30例)、布洛芬片组(30例)和银质针导热组(30例)。银质针非导热组接受银质针非导热治疗,布洛芬片组口服布洛芬片治疗,银质针导热组采用银质针导热治疗,疗程均为1周。对比治疗前后患者的疼痛视觉模拟评分量表(VAS)评分、颈椎活动度评分(ROM)、血清促肾上腺皮质激素(ACTH)、β-内啡肽、皮质醇、一氧化氮(NO)、内皮素-1(ET-1)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)、白细胞介素-1(IL-1)、血清前列腺素F2α(PGF2α)及血管加压素(AVP)水平,并运用血液流变学测量仪检测患者血浆黏度、红细胞压积以及纤维蛋白原水平。结果:治疗后,银质针导热组有效率(88.57%)显著高于银质针非导热组(40.00%)和布洛芬片组(66.57%)(P<0.05),银质针非导热组与布洛芬片组有效率差异无统计学意义(P>0.05)。相较于银质针非导热组和布洛芬片组,银质针导热组治疗后的VAS、ROM评分降低(P<0.05);ACTH、皮质醇水平降低(P<0.05),β-内啡肽水平升高(P<0.05);TNF-α、IL-6、IL-1水平均降低(P<0.05);血清PGF2α及AVP水平均下降(P<0.05);NO水平升高(P<0.05),ET-1水平降低(P<0.05);血浆黏度、红细胞压积、纤维蛋白原水平均下降(P<0.05)。治疗后银质针非导热组与布洛芬片组各指标差异无统计学意义(P>0.05)。结论:银质针导热疗法可改善颈源性头痛症状,其机制可能与其下调ACTH、炎性因子、提高疼痛阈值、缓解血管紧张、改善血流灌注有关。

头穴扬刺为主治疗频发性紧张型头痛的疗效观察

目的观察头穴扬刺为主治疗频发性紧张型头痛的临床疗效。方法将66例频发性紧张型头痛患者随机分为观察组(33例)和对照组(33例),两组均脱落2例,最终纳入每组31例。观察组予头穴扬刺为主联合常规针刺治疗,对照组予常规针刺治疗。观察两组治疗前后疼痛视觉模拟量表(visual analog scale,VAS)评分、头痛频率、持续时间、头痛指数、汉密顿焦虑量表(Hamilton anxiety scale,HAMA)评分、汉密顿抑郁量表(Hamilton depression scale,HAMD)评分和生存质量测定量表简表(World Health Organization quality of life brief,WHOQOL-BREF)评分以及双侧大脑前动脉(anterior communicating artery,ACA)、大脑中动脉(middle cerebral artery,MCA)和大脑后动脉(posterior cerebral artery,PCA)血流速度的变化,比较两组临床疗效和复发情况。结果治疗后和治疗后3个月随访时,两组疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分均降低(P<0.05),WHOQOL-BREF评分均升高(P<0.05),两侧ACA、MCA和PCA血流速度均下降(P<0.05)。观察组治疗后和治疗后3个月随访时疼痛VAS评分、头痛频率、持续时间、头痛指数、HAMA评分和HAMD评分低于对照组(P<0.05),WHOQOL-BREF评分高于对照组(P<0.05),两侧ACA、MCA和PCA血流速度低于对照组(P<0.05)。观察组总有效率为90.3%,优于对照组的77.4%(P<0.05)。观察组复发率低于对照组(P<0.05)。结论在常规针刺治疗基础上,头穴扬刺为主治疗可提高频发性紧张型头痛的临床疗效,可进一步降低脑血流速度,减轻头痛程度,减少疼痛持续时间和发作频率,缓解焦虑和抑郁状态,提高患者生活质量,降低复发率。

Clinical Observation on Vascular Headache Treated by Auricular Point Sticking Therapy

Objective： To evaluate the clinical effect of auricular sticking therapy in treating vascular headache. Methods： Fifty patients with vascular headache were randomized into two groups, 25 cases in each. The treatment group received auricular sticking therapy with magnetic pearls, and the control group was treated by Flunarizine Hydrochloride, 30 d as a treatment session, and the results were measured after one treatment session. Result： The total effective rate was 92.0% in the treatment group while 60.0% in the control group, and the difference was significant （P〈0.01）. A marked decrease of blood pressure was detected in the treatment group （P〈0.05）. The mean velocity in middle cerebral artery and anterior cerebral artery both changed significantly （P〈0.01）. Conclusion： Auricular sticking therapy can significantly improve the condition of vascular headache, as well as reduce blood pressure and help cerebral blood flow.

Clinical Study on Treatment of the Earthquake-caused Post-traumatic Stress Disorder by Cognitive-behavior Therapy and Acupoint Stimulation

Objective： To study the curative effect of acupoint stimulation on the earthquake-caused post-traumatic stress disorder （PTSD）. Methods： The 91 PTSD patients in Wenchuan hit by a strong earthquake were randomly divided into a control group of 24 cases treated by the cognitive-behavior therapy, and a treatment group of 67 cases treated by both cognitive-behavior therapy and acupoint stimulation. The scores were evaluated according to Chinese version of the incident effect scale revised （IES-R） and the self-compiled questionnaire for the major post-traumatic psychological condition, and the curative effect was compared between the two groups. Results： The total scores of IES-R, the scores of all factors and the total scores of the questionnaire in the two groups after treatment were much lower than those before treatment （P〈0.01）. The comparison of reduction in the factor scores between the two groups showed that the curative effect inthe treatment group was better that of in the control group. Conclusion： The acupoint stimulation is effective for the PTSD patients, with better results than that of cognitive-behavior therapy used alone

银质针疗法联合颈2背根神经节脉冲射频治疗颈源性头痛的疗效分析

目的 分析银质针疗法联合颈2背根神经节脉冲射频治疗颈源性头痛的效果。方法 选出80例颈源性头痛患者作为研究对象,按照治疗方法不同分成对照组和观察组,每组40例。对照组采用颈2背根神经节脉冲射频治疗,观察组采用银质针疗法联合颈2背根神经节脉冲射频治疗。对比两组临床治疗效果,治疗前后的视觉模拟评分法(VAS)评分、颈椎关节活动度(ROM)、颈部血管搏动指数(PI)、阻力指数(RI)、椎动脉平均血流速度(Vm),治疗满意度。结果 观察组治疗总有效率92.50%高于对照组的75.00%,对比有差异(P<0.05)。治疗后,两组VAS评分低于本组治疗前, ROM大于本组治疗前,且观察组VAS评分(2.05±0.34)分低于对照组的(5.22±1.06)分, ROM(41.04±8.21)°大于对照组的(34.18±8.57)°,对比有差异(P<0.05)。治疗后,两组PI、RI小于本组治疗前, Vm大于本组治疗前,且观察组PI(0.61±0.42)、RI(0.51±0.07)小于对照组的(0.85±0.53)、(0.61±0.11), Vm(36.98±6.38)cm/s大于对照组的(30.13±5.92)cm/s,对比有差异(P<0.05)。观察组满意度97.50%高于对照组的85.00%,对比有差异(P<0.05)。结论 联合治疗(银质针疗法+颈2背根神经节脉冲射频)可有效缓解颈源性头痛患者的疼痛和活动受限,提高临床治疗效果,改善血流动力学,值得临床推广。

Clinical Observation on Tuina Therapy for Cervicogenic Headache

Objective： To observe the clinical effects of tuina therapy for cervicogenic headache. Methods： Fifty-four cases were randomized allocated into tuina group and medicine group, 27 cases in each group. The patients in the tuina group treated with tuina therapy, and the patients in the medicine group take ibuprofen orally. The headache degree （Visual Analogue Scale, VAS）, frequency of headache occurrence and the neck disability index （NDI） were compared 2 weeks pre-treatment and 2 weeks post-treatment. Results： Before treatment, there were no significant differences in the headache VAS, frequency and NDI between the two groups. After treatment, headache VAS, frequency and NDI were significantly decreased, and there were statistical differences between the tuina group and the medicine group （P 〈 0.01）. Conclusion： Tuina therapy is more effective for treating cervicogenic headache than routine dose of ibuprofen.