Exploratory Study to Evaluate 2 Acupuncture Methods for the Treatment of Headaches Associated With TBI
|Headache Traumatic Brain Injury||Procedure: Traditional Chinese Acupuncture (TCA) Procedure: Auricular (Ear) Acupuncture Other: Usual Care||Phase 2 Phase 3|
|Study Design:||Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Open Label
Primary Purpose: Treatment
|Official Title:||A Randomized Exploratory Study to Evaluate Two Acupuncture Methods for the Treatment of Headaches Associated With Traumatic Brain Injury|
- Change from Baseline in Headache Impact Test at Week 6 [ Time Frame: Baseline, Week 6, Week 12 ]This is a 6-item measure that assesses headache severity. This will take approximately 1 minute to complete.
- Daily Headache Diary [ Time Frame: Completed daily for 6 weeks ]Before bedtime, participants will note whether or not they had a headache that day. If they experienced a headache, they will rate it's severity and whether or not they took any medications for the headache. It takes less than a minute to complete.
- Change from Baseline in Numerical Rating Scale at Week 6 [ Time Frame: Baseline, Week 6 ]This assesess pain along a 0-10 scale. It takes less than a minute to complete.
- Change from Baseline in Beck Depression Inventory at Week 6 [ Time Frame: Baseline, Week 6 ]This is a 21-question inventory that rates depressive symptoms. It takes approximately 5 minutes to complete.
- Change from Baseline in State-Trait Anxiety Inventory at Week 6 [ Time Frame: Baseline, Week 6 ]This is a 40-item survey that measures anxiety symptoms. It takes approximately 5 minutes to complete.
- Change from Baseline in Post-Traumatic Stress Checklist (Civilian Version) at Week 6 [ Time Frame: Baseline, Week 6 ]Participants will indicate the degree to which they have experienced PTSD symptoms on a 5-point scale during the past month. It takes approximately 5 minutes to complete.
- Change from Baseline in Symptom Checklist 90-R at Week 6 [ Time Frame: Baseline, Week 6 ]This is a 90-item checklist that evaluates a broad range of symptoms and psychological symptoms. It takes approximately 15 minutes to complete.
- Change from Baseline in Medical Outcome Study Quality of Life at Week 6 [ Time Frame: Baseline, Week 6 ]This measure evaluates physical and psychological functioning. It takes approximately 10 minutes to complete.
- Change from Baseline in Automated Neuropsychological Assessment Metrics at Week 6 [ Time Frame: Baseline, Week 6 ]This measure evaluates cognitive function and takes approximately 30 minutes to complete.
- Change from Baseline in Pittsburgh Sleep Quality of Life at Week 6 [ Time Frame: Baseline, Week 6 ]This measure evaluates sleep quality and disturbances over athe past month. It takes approximately 7 minutes to complete.
- Change from Baseline in Expectancy Scale at Week 6 [ Time Frame: Baseline, Week 6 ]This measures participants' pre-conceived expectations about the effect of acupuncture on headaches. It takes less than a minute to complete.
|Study Start Date:||February 2011|
|Study Completion Date:||April 2015|
|Primary Completion Date:||April 2015 (Final data collection date for primary outcome measure)|
Experimental: Auricular (Ear) Acupuncture
Auricular (Ear) Acupuncture is administered in a step-wise, algorithmic acupuncture approach in which needles are inserted at specific auricular landmarks. The sequence and location of needled points is determined by the participant's severity of headache pain at presentation and response to needling. Between six and nine points are needled in each treatment session depending on the individual's response (i.e., a decrease or persistence of headache pain). In-dwelling ASP needles are inserted at the end of each session. Participants are instructed to remove the needles after 3 days, or sooner if pain or redness developed at a needle site. Ten 45-minute acupuncture treatment sessions are administered over 6 weeks.
Procedure: Auricular (Ear) Acupuncture
An acupuncturist will insert sterile stainless steel needles and an ASP ear needle into various points in subject's outer ear. The ASP is a shorter needle that will stay in the participant's ear for a few days. Patients will receive 10 treatments over a 6 week period.
Experimental: Traditional Chinese Acupuncture (TCA)
A semi-standardized form of Traditional Chinese Acupuncture (TCA) is administered, incorporating the insertion of up to 22 acupuncture needles associated with each individual participant's: (1) primary headache pattern (up to three pairs of points); (2) secondary headache pattern (up to 2 pairs of points); (3) Ah-Shi or tender points (up to 4 points); (4) constitutional points (source points on two meridians); and, (5) up to 2 pairs of additional points from a selected list. Point selection was reassessed every two weeks per TCM diagnostic and treatment principles. While the majority of points were located on the limbs, points also included local points of tenderness to the head, as well as the front and back of the torso. Ten 60-minute TCA sessions are administered over 6 weeks.
Procedure: Traditional Chinese Acupuncture (TCA)
An acupuncturist will examine and evaluate subjects before inserting thin, sterile stainless steel needles at specific points on their body. Patients will receive 10 treatments over a 6 week period.
All study participants continue to receive routine usual care for their TBI, headaches and associated symptoms as determined by their clinical team.
Other: Usual Care
Subjects do not receive acupuncture during the 6 week study time period. Instead, they continue to receive medical care for headaches and other symptoms. They can elect to receive up to 10 ear acupuncture treatments between the 6- and 12-week assessments.
This is a 12 week study. If eligible, participants will be randomly assigned to 1of 3 groups: ear acupuncture, Traditional Chinese Acupuncture, or the usual care group.
Subjects receiving acupuncture will:
- meet with one of the acupuncturists who will conduct her first assessment
- come to Walter Reed Army Medical Center (WRAMC) 10 times over a 6-week period to receive acupuncture treatments from a licensed acupuncturist
Subjects in the usual care group will:
- not receive any acupuncture treatments
- continue usual treatment plan
- be given the option to receive 10 acupuncture treatments between the 6- and 12-week period
All subjects will also:
- complete questionnaires at 3 different times: baseline (beginning of study), after 6 weeks, and after 12 weeks. These questionnaires will assess headaches, overall health and quality of life
- complete a daily headache diary
- continue to be treated for their headaches
- continue taking prescription and over-the-counter medications for any conditions being treated
Please refer to this study by its ClinicalTrials.gov identifier: NCT01338701
|United States, District of Columbia|
|Walter Reed Army Medical Center|
|Washington, D.C., District of Columbia, United States, 20307|
|United States, Virginia|
|Fort Belvoir Community Hospital|
|Alexandria, Virginia, United States, 22060|
|Principal Investigator:||Louis M French, PsyD||Walter Reed Army Medical Center|
|Principal Investigator:||Heechin Chae, MD||Fort Belvoir Community Hospital|