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Minen MT, George A, Cuneo AZ. Factors Associated with Patient Adherence to Biofeedback Therapy Referral for Migraine: An Observational Study. Appl Psychophysiol Biofeedback 2024; 49:281-289. [PMID: 38386246 DOI: 10.1007/s10484-024-09622-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/30/2024] [Indexed: 02/23/2024]
Abstract
Biofeedback has Grade A evidence for the treatment of migraine, yet few studies have examined the factors associated with patients' decisions to pursue biofeedback treatment recommendations. We sought to examine reasons for adherence or non-adherence to referral to biofeedback therapy as treatment for migraine. Patients with migraine who had been referred for biofeedback by a headache specialist/behavioral neurologist were interviewed in person or via Webex. Patients completed an enrollment questionnaire addressing demographics and questions related to their headache histories. At one month, patients were sent a follow-up questionnaire via REDCap and asked if they had pursued the recommendation for biofeedback therapy, their reasons for their decision, and their impressions about biofeedback for those who pursued it. Nearly two-thirds (65%; 33/51) of patients responded at one month. Of these, fewer than half (45%, 15/33) had contacted biofeedback providers, and only 18% (6/33) completed a biofeedback session. Common themes emerged for patients who did not pursue biofeedback, including feeling that they did not have time, concern for financial obstacles (e.g., treatment cost and/or insurance coverage), and having difficulty scheduling an appointment due to limited provider availability. When asked about their preference between type of biofeedback provider (e.g., a physical therapist or psychologist), qualitative responses were mixed; many patients indicated no preference as long as they took insurance and/or were experienced, while others indicated a specific preference for a physical therapist or psychologist due to familiarity, or prior experiences with that kind of provider. Patients with migraine referred for biofeedback therapy face numerous obstacles to pursuing treatment.
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Affiliation(s)
- Mia T Minen
- Department of Neurology, NYU Langone Health, 222 East 41st Street, New York, NY, 10017, USA.
- Department of Population Health, NYU Langone Health, New York, NY, USA.
| | - Alexis George
- Department of Neurology, NYU Langone Health, 222 East 41st Street, New York, NY, 10017, USA
| | - Ami Z Cuneo
- Department of Neurology, University of Washington, Seattle, WA, USA
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Carta MG, Testa G, Stocchino S, Finco G, Sancassiani F, Littera MT, Deidda MC, Ventriglio A, Bhugra D, Cossu G. The efficacy of heart rate variability biofeedback training on sleep disorders and impact of fibromyalgia: Results of a phase II randomized controlled trial. J Psychosom Res 2024; 181:111664. [PMID: 38652978 DOI: 10.1016/j.jpsychores.2024.111664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/29/2024] [Accepted: 04/04/2024] [Indexed: 04/25/2024]
Abstract
OBJECTIVE Fibromyalgia syndrome (FMs) is a chronic, musculoskeletal pain disorder characterized by sleep disturbances, fatigue, and cognitive dysfunction. Heart rate variability biofeedback (HRV-BF) aiming to improve self-regulation and strengthen the parasympathetic nervous system has been shown to be effective in several pain syndromes, but its efficacy in FMs has not been adequately investigated. This Phase II trial aimed to assess the feasibility and preliminary measurement of the improvement induced by HRV-BF in FMs. METHODS Sixty-four patients with FMs were recruited. Patients were randomly assigned to either the experimental group (EG) or the control group (CG). The EG received 10 HRV-BF training sessions in addition to pharmacological standard therapy. The CG received standard therapies for 10 weeks. The FMs impact on daily life, sleep regularity, sense of coherence, depression symptoms and pain has been assessed as primary outcomes, quality of life as secondary. RESULT 23 (71.9%) of EG patients completed the intervention and 20 (62.5%) of the CG were re-evaluated at time T1. No side effects were reported. It was not found any statistical differences between groups over time in primary and secondary outcomes. CONCLUSIONS The HRV-BF intervention did not demonstrate efficacy in both primary and secondary outcomes. However, it is quite feasible in terms of drop-out rate and side effects. Further studies with larger sample sizes are needed to determine its actual efficacy. CLINICALTRIALS gov with code: NCT04121832.
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Affiliation(s)
| | - Giorgia Testa
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Serena Stocchino
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | - Gabriele Finco
- Department of Medical Sciences and Public Health, University of Cagliari, Italy
| | | | - Maria Teresa Littera
- Department of Pedagogy, Psychological Sciences and Philosophy, University of Cagliari, Cagliari, Italy
| | - Maria Cristina Deidda
- University Hospital of Cagliari, Center for Palliative Care and Pain Management, Cagliari, Italy
| | - Antonio Ventriglio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Dinesh Bhugra
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom
| | - Giulia Cossu
- Department of Medical Sciences and Public Health, University of Cagliari, Italy.
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3
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Lazaridou A, Paschali M, Bernstein C, Curiel M, Moore S, Edwards RR. sEMG Biofeedback for Episodic Migraines: A Pilot Randomized Clinical Trial. Appl Psychophysiol Biofeedback 2024; 49:271-279. [PMID: 38280149 DOI: 10.1007/s10484-023-09615-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2023] [Indexed: 01/29/2024]
Abstract
The aim of this study was to assess the feasibility and potential effectiveness of a 6-week virtual sEMG biofeedback intervention for patients with episodic migraines. Patients with episodic migraines were randomized to treatment with a novel surface EMG (sEMG) at-home biofeedback device or a treatment as usual control group; they completed validated baseline and post-intervention assessments of migraine related disability (migraine-specific quality of life, anxiety and depression). Participants also underwent a series of Quantitative Sensory Testing (QST) procedures referring to several different tests that quantitatively assess responses to mechanical stimuli during two separate visits (baseline and post intervention). No adverse events were reported during the study. Compared to the treatment as usual comparison group, patients in the sEMG biofeedback group reported lower migraine disability (p < 0.05). Compared to baseline, participants in the sEMG biofeedback group demonstrated statistically significant reductions in anxiety (p < 0.01), and significant increases in quality of life (p < 0.001), and significant decreases in temporal summation (p < 0.05) assessed by QST. No significant changes were observed in any of the outcomes in the control comparison group (p > 0.05). No significant changes were observed in migraine frequency in either of the two groups (p > 0.05). In addition, mediation analyses revealed that changes in migraine related quality of life mediated group effects on changes in migraine disability. Virtual sEMG biofeedback shows promise as a potential therapy for reducing disability, anxiety and depression and improving quality of life in individuals with episodic migraines. These results demonstrate the feasibility of a digital intervention for migraines and set the basis for conducting a future, larger scale randomized controlled trial to confirm these preliminary findings.
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Affiliation(s)
- Asimina Lazaridou
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA.
- Fielding Graduate University, Santa Barbara, CA, USA.
| | - Myrella Paschali
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Carolyn Bernstein
- Department of Neurology, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Marie Curiel
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Sara Moore
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
| | - Robert R Edwards
- Department of Anesthesiology, Perioperative & Pain Medicine, Harvard Medical School, Brigham & Women's Hospital, Boston, USA
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Emerson ND, Lavretsky H, Pittman WQ, Viswanathan N, Siddarth P. An open trial of biofeedback for long COVID. J Psychosom Res 2024; 179:111625. [PMID: 38458016 DOI: 10.1016/j.jpsychores.2024.111625] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 02/21/2024] [Accepted: 02/21/2024] [Indexed: 03/10/2024]
Abstract
OBJECTIVE Biofeedback is a therapeutic treatment model that teaches self-regulation of autonomic functions to alleviate stress-related symptoms. "Long COVID" refers to chronic physical and cognitive sequelae post-SARS-CoV-2 infection. This study examined the efficacy of a six-week intervention, consisting of weekly one-hour sessions combining heart rate variability and temperature biofeedback, for alleviating mood symptoms, somatic symptoms and sleep disturbance of patients diagnosed with long COVID. METHODS Data were collected from 20 adult participants aged 22-63 (Mage = 44.1, SDage = 12.2) with varying long COVID symptoms. Within this single arm design, 16 of the 20 participants completed all six sessions of biofeedback; 14 completed an assessment at the three-month post-treatment time point. RESULTS Participants self-reported significant improvements in somatic, anxiety, and depressive symptoms, sleep quality, quality of life, and number of "bad days" immediately after the intervention and three months later (Cohen's d effect size (ES) = 1.09-0.46). Reduced number of medical doctor visits (ES = 0.85) and prescription drug use over the last month (odds ratio = 0.33), as well as improved emotional wellbeing (ES = 0.97) were observed at the three-month time point only. CONCLUSION Results suggest that this short, readily scalable intervention can be potentially efficacious in alleviating symptoms of long COVID. Despite notable improvements, the major limitation of this study is its lack of control group. While a randomized trial merits study, biofeedback appears to be a brief, effective, non-invasive, and low-cost treatment option for patients with chronic somatic symptoms secondary to SARS-CoV-2 infection. CLINICALTRIALS govID: NCT05120648.
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Affiliation(s)
- Natacha D Emerson
- UCLA Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, United States.
| | - Helen Lavretsky
- UCLA Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, United States
| | - William Q Pittman
- UCLA Department of Medicine, David Geffen School of Medicine, United States
| | - Nisha Viswanathan
- UCLA Department of Medicine, David Geffen School of Medicine, United States
| | - Prabha Siddarth
- UCLA Psychiatry & Biobehavioral Sciences, David Geffen School of Medicine, United States
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Takagishi SC, Grinberg AS, Lindsey H, Goldman RE, Baird SA, Burrone L, Sico JJ, Damush TM. Headache Specialists' Perceptions of the Role of Health Psychologists in Headache Management: A Qualitative Study. Cureus 2024; 16:e56175. [PMID: 38618328 PMCID: PMC11015910 DOI: 10.7759/cureus.56175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2024] [Indexed: 04/16/2024] Open
Abstract
Background Since headache specialists cannot treat all the patients with headache disorders, multidisciplinary teams that include health psychologists are becoming more prevalent. Health psychologists mainly use a form of cognitive-behavioral therapy (CBT), along with biofeedback on occasion, to effectively address patients' pain and headache disorders. The Veterans Health Administration (VHA) is one setting that routinely includes a health psychologist with advanced training in pain disorders in their pain care to its veterans. The VHA has established Headache Centers of Excellence (HCoE) around the country to provide multidisciplinary treatment for patients with headache disorders, which enables headache specialists to regularly interact with health psychologists. Objective The study's objective is to evaluate headache specialists' views of health psychologists in the treatment of patients with headache disorders. Method Semi-structured interviews were conducted with headache specialists in academic-based healthcare settings, the community, and VHA HCoE sites. The interviews were audio-recorded and de-identified so they could be transcribed and analyzed using content matrix analysis. Results Four themes emerged: headache specialists desired to work with health psychologists and included them as members of multidisciplinary teams; valued health psychologists because they provided non-pharmacological treatments, such as CBT and biofeedback; preferred in-person communication with health psychologists; and used multiple titles when referring to health psychologists. Conclusion Headache specialists valued health psychologists as providers of behavioral and non-pharmacological treatments and considered them essential members of multidisciplinary teams. Headache specialists should strive to work with a headache psychologist, not just a general health psychologist. By committing to this, headache specialists can foster changes in the quality of care, resource allocation, and training experiences related to health psychologists.
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Affiliation(s)
- Stanley Curtis Takagishi
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Psychology, James A. Haley Veterans' Hospital, Tampa, USA
| | - Amy S Grinberg
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
| | - Hayley Lindsey
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
| | - Roberta E Goldman
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Anthropology & Family Medicine, Warren Alpert Medical School of Brown University, Providence, USA
- Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, USA
| | - Sean A Baird
- Health Research & Development Service, Richard L. Roudebush VA (Veterans Affairs) Medical Center, Indianapolis, USA
| | - Laura Burrone
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
| | - Jason J Sico
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Neurology, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Pain Research, Informatics, Multi-morbidities, and Education (PRIME) Center, VA (Veterans Affairs) Connecticut Healthcare System, West Haven, USA
- Neurology, Yale School of Medicine, New Haven, USA
| | - Teresa M Damush
- Headache Centers of Excellence (HCoE) Research & Evaluation Center, Veterans Health Administration, Department of Veterans Affairs, Orange, USA
- Health Research & Development Service, Richard L. Roudebush VA (Veterans Affairs) Medical Center, Indianapolis, USA
- Center for Health Services and Outcomes Research, Indiana University School of Medicine, Indianapolis, USA
- Center for Health Services and Outcomes Research, Regenstrief Institute, Inc., Indianapolis, USA
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Oh A, Koehler A, Yonker M, Troester M. Sleep Disorders and Chronic Pain Syndromes in the Pediatric Population. Semin Pediatr Neurol 2023; 48:101085. [PMID: 38065632 DOI: 10.1016/j.spen.2023.101085] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2023] [Revised: 08/18/2023] [Accepted: 09/13/2023] [Indexed: 12/18/2023]
Abstract
Sleep problems are widespread in children and adolescents suffering from chronic pain disorders. Sleep loss intensifies the experience of pain and is detrimental to the budding self-efficacy of a young individual with limitless horizons. Addressing sleep disorders may prevent the chronification of pain and prevent adverse health outcomes, such as functional impairment, psychiatric comorbidities and overall poor quality of life. This review will explore the cyclical nature between sleep, pain and mood, as well as the functional impact of this relationship on children and adolescents. There will be a discussion about sleep assessment and diagnostic testing, followed by a description of sleep disturbances found in specific pain conditions, ranging from headache, musculoskeletal/abdominal pain, to rheumatologic disorders. Finally, there will be a brief review of pharmacologic and behavioral interventions designed to improve sleep quality, and when possible, to alleviate pain.
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Affiliation(s)
- Ann Oh
- Division of Neurology, UCSF Pediatric Headache Center, University of California, San Francisco, UCSF Benioff Children's Hospital, Mission Hall, 550 16th Street, 5th Floor, San Francisco, CA 94158, USA.
| | - Angelina Koehler
- Division of Neurology, Pediatric Headache Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
| | - Marcy Yonker
- Division of Neurology, Pediatric Headache Program, Children's Hospital Colorado, University of Colorado School of Medicine, Aurora, Colorado
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Wang H, Hou Y, Zhan S, Li N, Liu J, Song P, Wang Y, Wang H. EEG Biofeedback Decreases Theta and Beta Power While Increasing Alpha Power in Insomniacs: An Open-Label Study. Brain Sci 2023; 13:1542. [PMID: 38002502 PMCID: PMC10670123 DOI: 10.3390/brainsci13111542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/27/2023] [Accepted: 10/30/2023] [Indexed: 11/26/2023] Open
Abstract
Insomnia, often associated with anxiety and depression, is a prevalent sleep disorder. Biofeedback (BFB) treatment can help patients gain voluntary control over physiological events such as by utilizing electroencephalography (EEG) and electromyography (EMG) power. Previous studies have rarely predicted biofeedback efficacy by measuring the changes in relative EEG power; therefore, we investigated the clinical efficacy of biofeedback for insomnia and its potential neural mechanisms. We administered biofeedback to 82 patients with insomnia, of whom 68 completed 10 sessions and 14 completed 20 sessions. The average age of the participants was 49.38 ± 12.78 years, with 26 men and 56 women. Each biofeedback session consisted of 5 min of EMG and 30 min of EEG feedback, with 2 min of data recorded before and after the session. Sessions were conducted every other day, and four scale measures were taken before the first, fifth, and tenth sessions and after the twentieth session. After 20 sessions of biofeedback treatment, scores on the Pittsburgh Sleep Quality Index (PSQI) were significantly reduced compared with those before treatment (-5.5 ± 1.43,t = -3.85, p = 0.006), and scores on the Beck Depression Inventory (BDI-II) (-7.15 ± 2.43, t = -2.94, p = 0.012) and the State-Trait Anxiety Inventory (STAI) (STAI-S: -12.36 ± 3.40, t = -3.63, p = 0.003; and STAI-T: -9.86 ± 2.38, t = -4.41, p = 0.001) were significantly lower after treatment than before treatment. Beta and theta power were significantly reduced after treatment, compared with before treatment (F = 6.25, p = 0.014; and F = 11.91, p = 0.001). Alpha power was increased after treatment, compared with before treatment, but the difference was not prominently significant (p > 0.05). EMG activity was significantly decreased after treatment, compared with before treatment (F = 2.11, p = 0.015). Our findings suggest that BFB treatment based on alpha power and prefrontal EMG relieves insomnia as well as anxiety and depression and may be associated with increased alpha power, decreased beta and theta power, and decreased EMG power.
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Affiliation(s)
- Huicong Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
| | - Yue Hou
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
- Hebei Hospital of Xuanwu Hospital, Capital Medical University, Shijiazhuang 050030, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang 050030, China
| | - Shuqin Zhan
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
| | - Ning Li
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
| | - Jianghong Liu
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
| | - Penghui Song
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
| | - Yuping Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
- Hebei Hospital of Xuanwu Hospital, Capital Medical University, Shijiazhuang 050030, China
- Neuromedical Technology Innovation Center of Hebei Province, Shijiazhuang 050030, China
| | - Hongxing Wang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing 100053, China; (H.W.); (Y.H.); (S.Z.); (N.L.); (J.L.); (P.S.)
- Beijing Key Laboratory of Neuromodulation, Beijing 100053, China
- Center of Epilepsy, Beijing Institute for Brain Disorders, Capital Medical University, Beijing 100053, China
- Center for Sleep and Consciousness Disorders, Beijing Institute for Brain Disorders, Beijing 100053, China
- Collaborative Innovation Center for Brain Disorders, Capital Medical University, Beijing 100053, China
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Selvakumar K, Lee Fan T, Chai Nien F, Hou Kit M. Preliminary efficacy of aerobic training among university students with migraine symptoms: Study protocol for a pilot randomized controlled trial. PLoS One 2023; 18:e0291534. [PMID: 37747888 PMCID: PMC10519594 DOI: 10.1371/journal.pone.0291534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Accepted: 08/20/2023] [Indexed: 09/27/2023] Open
Abstract
BACKGROUND Migraine is a primary neurological headache. Treatment of this condition includes medications; however, these medications, when given for a longer duration, can have side effects. If migraine is left untreated or undiagnosed, it is reported that around 2.5% of individuals with migraine may develop to have a chronic condition. This study aims to analyse the preliminary effectiveness of aerobic training on migraine pain level, sleep quality, quality of life, and resting-state brain waves among university students with migraine symptoms. METHODOLOGY 88 university students with migraine symptoms are the target participants. 4 of 5 on the Migraine Screen Questionnaire, 5 of 7 on the International Classification of Headache Disorders 3rd edition (ICHD-3), and both genders aged 18-40 years will be included. The participants with a score of more than or equal to 5 on the visual aura rating scale, diagnosed with a secondary headache, pregnancy, medication for neurological and cardiorespiratory conditions, and unwilling to participate will be excluded. Based on the disability questionnaire, the participants will be randomly assigned to either of the three groups. The primary outcome is resting-state electroencephalography (EEG) brain, and the secondary outcomes are sleep quality, quality of life, and migraine pain level. The post-test assessments will be performed at week 6. RESULT After the primary EEG analysis using MATLAB, the amplitude, frequency, frequency band ratio, and power spectrum density will be analysed. Mixed design analysis and intention-to-treat analysis will be used to assess the efficacy of aerobic training. DISCUSSION Migraines can be unpredictable, sometimes occurring without symptoms. If underdiagnosed or over-looked, it encompasses a serious of long-term effects. Hence with appropriate intervention, the symptoms can be prevented from worsening. But there is an unmet need for evidence-based non-pharmacological approaches to complement pharmacotherapy in migraine prevention. Moreover, an exercise intervention may be more suitable for people with migraine considering their tendency toward inactivity. Although some studies developed exercise programs for untrained patients with migraine, the outcome was primarily in terms of exercise capacity rather than the primary characteristics and secondary brain wave/ sleep quality changes, indicating the need for this study.
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Affiliation(s)
- Kiruthika Selvakumar
- M. Kandiah Faculty of Medicine and Health Sciences, Department of Physiotherapy, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Tan Lee Fan
- Department of Mechatronics and BioMedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Foo Chai Nien
- M. Kandiah Faculty of Medicine and Health Sciences, Department of Population Medicine, Universiti Tunku Abdul Rahman, Selangor, Malaysia
| | - Mun Hou Kit
- Department of Mechatronics and BioMedical Engineering, Lee Kong Chian Faculty of Engineering and Science, Universiti Tunku Abdul Rahman, Selangor, Malaysia
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Onan D, Younis S, Wellsgatnik WD, Farham F, Andruškevičius S, Abashidze A, Jusupova A, Romanenko Y, Grosu O, Moldokulova MZ, Mursalova U, Saidkhodjaeva S, Martelletti P, Ashina S. Debate: differences and similarities between tension-type headache and migraine. J Headache Pain 2023; 24:92. [PMID: 37474899 PMCID: PMC10360340 DOI: 10.1186/s10194-023-01614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 06/16/2023] [Indexed: 07/22/2023] Open
Abstract
Tension-type headache (TTH) and migraine are two common primary headaches distinguished by clinical characteristics according to the 3rd edition of the International Classification of Headache Disorders. Migraine is identified by specific features such as being more prevalent in females, being aggravated by physical activity, certain genetic factors, having photophobia, phonophobia, nausea, vomiting, or aura, and responding to specific drugs. Nonetheless, TTH and migraine share some common characteristics, such as onset occurring in the 20 s, and being triggered by psychological factors like stress, moderate pain severity, and mild nausea in chronic TTH. Both conditions involve the trigeminovascular system in their pathophysiology. However, distinguishing between TTH and migraine in clinical practice, research, and epidemiological studies can be challenging, as there is a lack of specific diagnostic tests and biomarkers. Moreover, both conditions may coexist, further complicating the diagnostic process. This review aims to explore the similarities and differences in the pathophysiology, epidemiology, burden and disability, comorbidities, and responses to pharmacological and non-pharmacological treatments of TTH and migraine. The review also discusses future research directions to address the diagnostic challenges and improve the understanding and management of these conditions.
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Affiliation(s)
- Dilara Onan
- Spine Health Unit, Faculty of Physical Therapy and Rehabilitation, Institute of Health Sciences, Hacettepe University, Ankara, Turkey
| | - Samaira Younis
- Danish Headache Center, Department of Neurology, Rigshospitalet Glostrup, Copenhagen, Denmark
| | | | - Fatemeh Farham
- Department of Headache, Iranian Centre of Neurological Researchers, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Saulius Andruškevičius
- Center of Neurology and Center of Anesthesiology, Intensive Care and Pain Management, Vilnius University Hospital SantarosKlinikos, Vilnius, Lithuania
| | - Ana Abashidze
- Department of Neuroscience, Caucasus Medical Centre, Tbilisi, Georgia
| | - Asel Jusupova
- Department of Neurology and Clinical Genetics, Kyrgyz State Medical Academy, Bishkek, Kyrgyzstan
| | | | - Oxana Grosu
- Diomid Gherman Institute of Neurology and Neurosurgery, Headache Center, Chisinau, Moldova
| | | | | | - Saida Saidkhodjaeva
- Department of Neurology, Child Neurology and Medical Genetics, Tashkent Pediatric Medical Institute, Tashkent, Uzbekistan
| | - Paolo Martelletti
- Department of Clinical and Molecular Medicine, Sapienza University, Rome, Italy
| | - Sait Ashina
- Department of Neurology and Department of Anesthesia, Critical Care and Pain Medicine, BIDMC Comprehensive Headache Center, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA, USA.
- Department of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark.
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10
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Cuneo A, Yang R, Zhou H, Wang K, Goh S, Wang Y, Raiti J, Krashin D, Murinova N. The Utility of a Novel, Combined Biofeedback-Virtual Reality Device as Add-on Treatment for Chronic Migraine: A Randomized Pilot Study. Clin J Pain 2023; 39:286-296. [PMID: 37026763 DOI: 10.1097/ajp.0000000000001114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 03/23/2023] [Indexed: 04/08/2023]
Abstract
OBJECTIVES To determine if the frequent use of a combined biofeedback-virtual reality device improves headache-related outcomes in chronic migraine. MATERIALS AND METHODS In this randomized, controlled pilot study, 50 adults with chronic migraine were randomized to the experimental group (frequent use of a heart rate variability biofeedback-virtual reality device plus standard medical care; n=25) or wait-list control group (standard medical care alone; n=25). The primary outcome was a reduction in mean monthly headache days between groups at 12 weeks. Secondary outcomes included mean change in acute analgesic use frequency, depression, migraine-related disability, stress, insomnia, and catastrophizing between groups at 12 weeks. Tertiary outcomes included change in heart rate variability and device-related user experience measures. RESULTS A statistically significant reduction in mean monthly headache days between groups was not demonstrated at 12 weeks. However, statistically significant decreases in the mean frequency of total acute analgesic use per month (65% decrease in the experimental group versus 35% decrease in the control group, P <0.01) and depression score (35% decrease in the experimental group versus 0.5% increase in the control group; P <0.05) were shown at 12 weeks. At study completion, more than 50% of participants reported device satisfaction on a 5-level Likert scale. DISCUSSION Frequent use of a portable biofeedback-virtual reality device was associated with decreases in the frequency of acute analgesic use and in depression in individuals with chronic migraine. This platform holds promise as an add-on treatment for chronic migraine, especially for individuals aiming to decrease acute analgesic use or interested in nonmedication approaches.
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11
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Sturgeon JA, Ehde DM, Darnall BD, Barad MJ, Clauw DJ, Jensen MP. Psychological Approaches for Migraine Management. Anesthesiol Clin 2023; 41:341-355. [PMID: 37245946 PMCID: PMC10513739 DOI: 10.1016/j.anclin.2023.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2023]
Abstract
Migraine headaches are among the most prevalent and disabling pain conditions worldwide. Best-practice migraine management is multidisciplinary and includes the psychological approaches to address cognitive, behavioral, and affective factors that worsen pain, distress, and disability. The psychological interventions with the strongest research support are relaxation strategies, cognitive-behavioral therapy, and biofeedback, though the quality of clinical trials for all psychological interventions needs continued improvement. The efficacy of psychological interventions may be improved by validating technology-based delivery systems, developing interventions for trauma and life stress, and precision medicine approaches matching treatments to patients based on specific clinical characteristics.
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Affiliation(s)
- John A Sturgeon
- Department of Anesthesiology, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA.
| | - Dawn M Ehde
- Department of Rehabilitation Medicine, University of Washington School of Medicine, 325 Ninth Avenue, Box 359612, Seattle, WA 98104, USA
| | - Beth D Darnall
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 430 Broadway Street, Pavilion C, 3rd Floor MC6343, Redwood City, CA 94063, USA
| | - Meredith J Barad
- Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, 1070 Arastradero, Suite 200, MC 5596, Palo Alto, CA 94304, USA
| | - Daniel J Clauw
- Department of Anesthesiology, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Psychiatry, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA; Department of Internal Medicine-Rheumatology, University of Michigan Medical School, 24 Frank Lloyd Wright Drive, Ann Arbor, MI 48105, USA
| | - Mark P Jensen
- Department of Rehabilitation Medicine, University of Washington School of Medicine, 325 Ninth Avenue, Box 359612, Seattle, WA 98104, USA
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12
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Abstract
Migraine is a global neurologic disease that is highly prevalent, especially in women. Studies have observed a predisposition for the development of migraine in women, although the mechanisms involved have yet to be fully elucidated. This review aimed to summarize the recent evidence regarding the epidemiology, pathophysiology, and treatment of migraine and highlight key sex differences. We also identify gaps in care for both women and men living with migraine and discuss the presence of migraine-related stigma and how this may impact the efficacy of clinical care.
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13
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Verhaak A, Bakaysa S, Johnson A, Veronesi M, Williamson A, Grosberg B. Migraine treatment in pregnancy: A survey of comfort and treatment practices of women's healthcare providers. Headache 2023; 63:211-221. [PMID: 36695287 DOI: 10.1111/head.14436] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 09/16/2022] [Accepted: 09/22/2022] [Indexed: 01/26/2023]
Abstract
OBJECTIVE The objective of this study was to assess women's healthcare providers' treatment practices for pregnant women with migraine. BACKGROUND Migraine is associated with several maternal and fetal complications during pregnancy, including preeclampsia and preterm birth. Migraine treatment during pregnancy can present significant challenges due to lack of controlled clinical trials and risks associated with specific medications. METHODS Women's healthcare providers were queried regarding practice patterns and comfort with use of acute and preventive migraine treatments during pregnancy. The survey was distributed online. RESULTS The survey was completed by 92 women's healthcare providers (response rate 22.9% [92/402]), with most specializing in general obstetrics and gynecology (91% [83/92]). Approximately one-fourth (26% [24/92]) of respondents indicated they counseled women on migraine treatment in pregnancy as early as before pregnancy contemplation, while over one-third (35% [32/92]) counseled on migraine treatment once the patient became pregnant. The majority of respondents reported feeling somewhat or very comfortable with recommending (63% [58/92]) or continuing (64% [59/92]) acute treatments for pregnant patients with migraine, with highest comfort levels for acetaminophen (100% [92/92] for prescribing or continuing) and caffeine (94% [85/90] prescribing, 91% [82/90] continuing). Higher levels of discomfort were reported with triptans (88% [80/91] rarely or never prescribe during pregnancy). Survey respondents felt less comfortable with recommending preventive migraine treatments to pregnant patients (40% [37/92] somewhat or very comfortable), compared with a higher comfort level with continuing preventive medications (63% [58/92] somewhat or very comfortable). Highest comfort levels were reported with use of magnesium (69% [63/91] comfortable prescribing, 82% [75/92] comfortable continuing) and non-pharmacologic approaches (70% [62/89] comfortable prescribing, 84% [75/89] comfortable continuing). Nearly 40% (35/92) of respondents reported that they typically refer to neurologists or headache specialists for migraine treatment during pregnancy. CONCLUSION This survey of women's healthcare providers revealed varying levels of comfort regarding migraine management during pregnancy, and highlights the need for additional education regarding migraine treatment safety data during pregnancy.
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Affiliation(s)
- Allison Verhaak
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, Connecticut, USA.,Division of Health Psychology, The Institute of Living/Hartford Hospital, Hartford, Connecticut, USA.,Department of Neurology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Stephanie Bakaysa
- Department of Maternal Fetal Medicine, Hartford Healthcare, West Hartford, Connecticut, USA
| | - Amy Johnson
- Department of Obstetrics and Gynecology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.,Department of Obstetrics and Gynecology, Hartford HealthCare, West Hartford, Connecticut, USA
| | - Maria Veronesi
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, Connecticut, USA
| | - Anne Williamson
- Research Department, Hartford Hospital, Hartford, Connecticut, USA
| | - Brian Grosberg
- Hartford Healthcare Headache Center, Ayer Neuroscience Institute, West Hartford, Connecticut, USA.,Department of Neurology, University of Connecticut School of Medicine, Farmington, Connecticut, USA
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Haghdoost F, Togha M. Migraine management: Non-pharmacological points for patients and health care professionals. Open Med (Wars) 2022; 17:1869-1882. [PMID: 36475060 PMCID: PMC9691984 DOI: 10.1515/med-2022-0598] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 09/16/2022] [Accepted: 10/11/2022] [Indexed: 07/22/2023] Open
Abstract
Migraine is a highly prevalent disorder with an enormous burden on societies. Different types of medications are used for controlling both acute attacks and prevention. This article reviews some non-pharmacological recommendations aiming to manage migraine disorder better and prevent headache attacks. Different triggers of migraine headache attacks, including environmental factors, sleep pattern changes, diet, physical activity, stress and anxiety, some medications, and hormonal changes, are discussed. It is advised that they be identified and managed. Patients should learn the skills to cope with the trigger factors that are difficult to avoid. In addition, weight control, management of migraine comorbidities, lifestyle modification, behavioural treatment and biofeedback, patient education, using headache diaries, and improving patients' knowledge about the disease are recommended to be parts of migraine management. In addition, using neuromodulation techniques, dietary supplements such as riboflavin, coenzyme Q10 and magnesium, and acupuncture can be helpful. Non-pharmacological approaches should be considered in migraine management. Furthermore, the combination of pharmacological and non-pharmacological approaches is more effective than using each separately.
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Affiliation(s)
- Faraidoon Haghdoost
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran, Iran
- The George Institute for Global Health, University of New South Wales, Sydney, Australia
| | - Mansoureh Togha
- Headache Department, Iranian Center of Neurological Research, Neuroscience Institute, Tehran, Iran
- Headache Department, Neurology Ward, Sina Hospital, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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15
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The Role of the Autonomic Nervous System in Headache: Biomarkers and Treatment. Curr Pain Headache Rep 2022; 26:767-774. [PMID: 36063265 PMCID: PMC9442588 DOI: 10.1007/s11916-022-01079-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
Abstract
Purpose of Review In this review, the role of the autonomic nervous system in tension-type headache and migraine is reviewed. Recent Findings A pathophysiological model for tension-type headache is proposed that is compatible with most physiological and behavioral literature. Summary A treatment protocol is described that follows from this model. For migraine, incorporating autonomic factors into the pathophysiology offers rationales for behavioral interventions that have been shown to be useful in migraine treatment and a biofeedback protocol is proposed.
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16
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Ciancarelli I, Morone G, Tozzi Ciancarelli MG, Paolucci S, Tonin P, Cerasa A, Iosa M. Identification of Determinants of Biofeedback Treatment's Efficacy in Treating Migraine and Oxidative Stress by ARIANNA (ARtificial Intelligent Assistant for Neural Network Analysis). Healthcare (Basel) 2022; 10:941. [PMID: 35628078 PMCID: PMC9141187 DOI: 10.3390/healthcare10050941] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Revised: 05/16/2022] [Accepted: 05/17/2022] [Indexed: 11/24/2022] Open
Abstract
Migraines are a public health problem that impose severe socioeconomic burdens and causes related disabilities. Among the non-pharmacological therapeutic approaches, behavioral treatments such as biofeedback have proven effective for both adults and children. Oxidative stress is undoubtedly involved in the pathophysiology of migraines. Evidence shows a complex relationship between nitric oxide (NO) and superoxide anions, and their modification could lead to an effective treatment. Conventional analyses may fail in highlighting the complex, nonlinear relationship among factors and outcomes. The aim of the present study was to verify if an artificial neural network (ANN) named ARIANNA could verify if the serum levels of the decomposition products of NO-nitrite and nitrate (NOx)-the superoxide dismutase (SOD) serum levels, and the Migraine Disability Assessment Scores (MIDAS) could constitute prognostic variables predicting biofeedback's efficacy in migraine treatment. Twenty women affected by chronic migraine were enrolled and underwent an EMG-biofeedback treatment. The results show an accuracy for the ANN of 75% in predicting the post-treatment MIDAS score, highlighting a statistically significant correlation (R = -0.675, p = 0.011) between NOx (nitrite and nitrate) and MIDAS only when the peroxide levels in the serum were within a specific range. In conclusion, the ANN was proven to be an innovative methodology for interpreting the complex biological phenomena and biofeedback treatment in migraines.
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Affiliation(s)
- Irene Ciancarelli
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (I.C.); (M.G.T.C.)
| | - Giovanni Morone
- Department of Life, Health and Environmental Sciences, University of L’Aquila, 67100 L’Aquila, Italy; (I.C.); (M.G.T.C.)
| | | | | | - Paolo Tonin
- S. Anna Rehabilitation Institute, RAN-Research on Advanced Neurorehabilitation, 88900 Crotone, Italy; (P.T.); (A.C.)
| | - Antonio Cerasa
- S. Anna Rehabilitation Institute, RAN-Research on Advanced Neurorehabilitation, 88900 Crotone, Italy; (P.T.); (A.C.)
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy, 98164 Messina, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health Science and Nutrition, University of Calabria, 87036 Rende, Italy
| | - Marco Iosa
- Santa Lucia Foundation IRCSS, 00179 Roma, Italy; (S.P.); (M.I.)
- Department of Psychology, Sapienza University of Rome, 00185 Rome, Italy
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17
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Klan T, Gaul C, Liesering-Latta E, Both B, Held I, Hennemann S, Witthöft M. Efficacy of Cognitive-Behavioral Therapy for the Prophylaxis of Migraine in Adults: A Three-Armed Randomized Controlled Trial. Front Neurol 2022; 13:852616. [PMID: 35572937 PMCID: PMC9101654 DOI: 10.3389/fneur.2022.852616] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/28/2022] [Indexed: 11/13/2022] Open
Abstract
BackgroundBehavioral approaches are central to the preventive treatment of migraine but empirical evidence regarding efficacy and effectiveness is still sparse. This study aimed to evaluate the efficacy of a newly developed migraine-specific, integrative cognitive-behavioral therapy program (miCBT) combining several approaches (trigger and stress management, coping with fear of attacks, relaxation training) by comparing it with a single behavioral approach (relaxation training, RLX) as an active control group and a waiting-list control group (WLC).MethodsIn a three-armed open-label randomized controlled trial, 121 adults with migraine were assigned to either miCBT, RLX or WLC. The outpatient group therapy (miCBT or RLX) consisted of seven sessions each 90 min. Participants who completed the WLC were subsequently randomized to one of the two treatment groups. Primary outcomes were headache days, headache-related disability, emotional distress, and self-efficacy. The baseline was compared to post-treatment, and followed by assessments 4- and 12-months post-treatment to compare miCBT and RLX.ResultsMixed-model analyses (intention-to-treat sample, 106 participants) showed significantly stronger pre-post improvements in self-efficacy (assessed by the Headache Management Self-Efficacy Scale, HMSE-G-SF) in both treatment groups compared to the WLC (mean difference at post; miCBT: 4.67 [0.55–8.78], p = 0.027; RLX: 4.42 [0.38 to 8.46], p = 0.032), whereas no other significant between-group differences were observed. The follow-up analyses revealed significant within-group improvements from baseline to 12-month follow-up in all four primary outcomes for both treatments. However, between-group effects (miCBT vs. RLX) were not significant at follow-up.ConclusionThe miCBT has no better treatment effects compared to RLX in migraine-prophylaxis. Both treatments effectively increase patients' self-efficacy.Trial RegistrationGerman Clinical Trials Register (www.drks.de; DRKS-ID: DRKS00011111).
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Affiliation(s)
- Timo Klan
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
- *Correspondence: Timo Klan
| | - Charly Gaul
- Headache Center Frankfurt, Frankfurt, Germany
| | | | - Bernhard Both
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Isabella Held
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Severin Hennemann
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
| | - Michael Witthöft
- Department of Psychology, Johannes Gutenberg University of Mainz, Mainz, Germany
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18
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Dudeney J, Sharpe L, McDonald S, Menzies RE, McGuire B. Are psychological interventions efficacious for adults with migraine? A systematic review and meta‐analysis. Headache 2022; 62:405-419. [DOI: 10.1111/head.14260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 12/16/2021] [Indexed: 01/31/2023]
Affiliation(s)
- Joanne Dudeney
- eCentreClinic, School of Psychological Sciences Macquarie University Sydney New South Wales Australia
| | - Louise Sharpe
- School of Psychology The University of Sydney Sydney New South Wales Australia
| | - Sarah McDonald
- Discipline of Clinical Psychology, Graduate School of Health University of Technology Sydney Sydney New South Wales Australia
| | - Rachel E. Menzies
- School of Psychology The University of Sydney Sydney New South Wales Australia
| | - Brian McGuire
- School of Psychology National University of Ireland Galway Ireland
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19
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Seng EK, Lipton RB. Do behavioral treatments work for migraine prevention? Headache 2022; 62:402-404. [DOI: 10.1111/head.14290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 11/27/2022]
Affiliation(s)
- Elizabeth K. Seng
- Ferkauf Graduate School of Psychology Yeshiva University Bronx New York USA
- Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx New York USA
- Montefiore Headache Center Montefiore Medical Center Bronx New York USA
| | - Richard B. Lipton
- Saul R. Korey Department of Neurology Albert Einstein College of Medicine Bronx New York USA
- Montefiore Headache Center Montefiore Medical Center Bronx New York USA
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20
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Fiľo P, Janoušek O. Differences in the Course of Physiological Functions and in Subjective Evaluations in Connection With Listening to the Sound of a Chainsaw and to the Sounds of a Forest. Front Psychol 2022; 13:775173. [PMID: 35265000 PMCID: PMC8900745 DOI: 10.3389/fpsyg.2022.775173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
We explored differences in the course of physiological functions and in the subjective evaluations in response to listening to a 7-min recording of the sound of a chainsaw and to the sounds of a forest. A Biofeedback 2000x-pert apparatus was used for continual recording of the following physiological functions in 50 examined persons: abdominal and thoracic respiration and their amplitude and frequency, electrodermal activity (skin conductance level), finger skin temperature, heart rate (pulse, blood volume pulse and blood volume pulse amplitude) and heart rate variability (HRV). The group of 25 subjects listening to the sound of a chainsaw exhibited significantly lower values of blood volume pulse amplitude, lower values in peak alpha frequency HRV and higher values in peak high-frequency HRV. In the time interval from 80 s to 209 s, in which the two groups showed the greatest differences, lower values of blood volume pulse were also recorded while listening to the sound of a chainsaw. Listening to the sound of a chainsaw is associated with a greater feeling of fatigue and higher tension, while listening to the sounds of a forest is even considered to elicit feelings of improved learning abilities. The assumption that listening to the sound of a chainsaw results in higher defense arousal was confirmed. The greater variability which is exhibited by a majority of physiological functions while listening to the forest sounds may also be an innovative finding. It seems that there are two types of arousal (sympathetic and parasympathetic) following from correlations between physiological functions and subjective assessment. Low values of blood volume pulse amplitude are especially important from the health perspective. They correspond to the amount of vasoconstriction which occurs in the endothelial dysfunction related to increased mortality, incidence of myocardial infarction, leg atherosclerosis and topically to COVID-19.
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Affiliation(s)
- Petr Fiľo
- Department of Social Sciences and Sport Management, Faculty of Sports Studies, Masaryk University, Brno, Czechia
| | - Oto Janoušek
- Department of Biomedical Engineering, Faculty of Electrical Engineering and Communication, Brno University of Technology, Brno, Czechia
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21
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Azimova Y, Amelin A, Alferova V, Artemenko A, Akhmadeeva L, Golovacheva V, Danilov A, Ekusheva E, Isagulian E, Koreshkina M, Kurushina O, Latysheva N, Lebedeva E, Naprienko M, Osipova V, Pavlov N, Parfenov V, Rachin A, Sergeev A, Skorobogatykh K, Tabeeva G, Filatova E. Clinical guidelines "Migraine". Zh Nevrol Psikhiatr Im S S Korsakova 2022. [DOI: 10.17116/jnevro20221220134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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22
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Limmer A, Laser M, Schütz A. Mobile Heart Rate Variability Biofeedback as a Complementary Intervention After Myocardial Infarction: a Randomized Controlled Study. Int J Behav Med 2022; 29:230-239. [PMID: 34008159 PMCID: PMC9001243 DOI: 10.1007/s12529-021-10000-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND To enhance effective prevention programs after myocardial infarction (MI), the study examined the effects and feasibility of mobile biofeedback training on heart rate variability (HRV-BF). METHODS Forty-six outpatients aged 41 to 79 years with a documented MI were randomized to HRV-BF versus usual care. Generalized estimating equation (GEE) analyses were performed to test improvements in measures of short- and long-time HRV, namely, the standard deviation of the normal-to-normal intervals (SDNN) and well-being after 12 weeks of HRV-BF. RESULTS There were intervention effects for short-time HRV (d > 0.4, p < 0.04), which were partly replicated in the GEE models that accounted for control variables: In the HRV-BF group, the high-frequency HRV (group × time interaction: β = 0.59, p = 0.04) compensated for significantly lower baseline levels than the group with usual care. In an optimal dose sample (on average two HRV-BF sessions a day), SDNN significantly increased after HRV-BF (p = 0.002) but not in the waitlist control group. Compensatory trends of HRV-BF were also found for high-frequency HRV and self-efficacy. No adverse effects of the intervention were found but neither were effects on long-time HRV measures. CONCLUSION The results showed the feasibility of self-guided HRV-BF for almost all post-MI patients. HRV-BF as an adjunctive behavioral treatment increased HRV, which is an indicator of lower cardiovascular risk, and self-efficacy, which suggests heightened psychological resilience. These benefits warrant confirmation and tests of sustainability in larger studies. TRIAL REGISTRATION The trial has not been registered due to its starting point in 2017 predating the publication of the applicable CONSORT extension for reporting social and psychological intervention trials in 2018.
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Affiliation(s)
- Anja Limmer
- Department of Psychology, University of Bamberg, Bamberg, Germany
- Praxis Dr. med. Martin Laser, Nuremberg, Germany
| | - Martin Laser
- Praxis Dr. med. Martin Laser, Nuremberg, Germany
| | - Astrid Schütz
- Department of Psychology, University of Bamberg, Bamberg, Germany.
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23
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Tabata CY, Copenhaver PF, McCartney S, Vazinkhoo S, Copperman T. Beneficial Effects of Kiatsu™ with Ki Training on Episodic Migraine: An Exploratory Study. Pain Res Manag 2021; 2021:3290879. [PMID: 34745397 PMCID: PMC8570882 DOI: 10.1155/2021/3290879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/26/2021] [Accepted: 10/09/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To conduct an exploratory study of KiatsuTM with Ki training as a potential therapy for treating episodic migraine in women. BACKGROUND Current therapies for migraine have proven partially effective, highlighting the need for alternative treatment options. In preparation for development of a randomized controlled study, the authors conducted a single arm pilot exploratory study to evaluate the effect of Kiatsu with Ki training in adult females with episodic migraine. METHODS Study subjects established a baseline migraine frequency over 4 weeks. During the following 4 weeks, each subject received instruction in Ki training (to improve concentration, balance, and relaxation), accompanied by Kiatsu (a focused touch method that reduces tension, swelling, and pain). Subjects then participated in one session a month for additional 6 months. The initial session was 1 hour; subsequent sessions averaged 30 minutes. Subjects documented migraine frequency, migraine-specific quality of life scores, and medication use. RESULT Sixty-nine subjects met the study inclusion criteria, and 21 completed the study. Subjects reported a significant reduction in migraine frequency after 1 month (from 7.2 to 3.8 migraines/month; p < 0.05), with an overall 53% reduction at 6 months (p < 0.001). Significant improvements in quality of life (QoL) were reported after 1 month, with continued improvements until study completion (p < 0.0001). A moderate reduction in medication use was also documented (p < 0.03), corresponding to improved QoL scores. CONCLUSION Kiatsu with Ki training may be an effective treatment option for females with migraines, either in combination with medications or as a potential alternative to medications for patients who do not benefit from conventional therapies. The results of this pilot study justify the development of a randomized controlled study designed to investigate the potential benefits of this novel therapeutic method for treating migraine.
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Affiliation(s)
| | - Philip F. Copenhaver
- Oregon Ki Society, Tigard, OR, USA
- Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR 97239, USA
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Laborde S, Allen MS, Borges U, Iskra M, Zammit N, You M, Hosang T, Mosley E, Dosseville F. Psychophysiological effects of slow-paced breathing at six cycles per minute with or without heart rate variability biofeedback. Psychophysiology 2021; 59:e13952. [PMID: 34633670 DOI: 10.1111/psyp.13952] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 08/06/2021] [Accepted: 09/13/2021] [Indexed: 12/20/2022]
Abstract
Heart rate variability (HRV) biofeedback, referring to slow-paced breathing (SPB) realized while visualizing a heart rate, HRV, and/or respiratory signal, has become an adjunct treatment for a large range of psychologic and medical conditions. However, the underlying mechanisms explaining the effectiveness of HRV biofeedback still need to be uncovered. This study aimed to disentangle the specific effects of HRV biofeedback from the effects of SPB realized alone. In total, 112 participants took part in the study. The parameters assessed were emotional (valence, arousal, and control) and perceived stress intensity as self-report variables and the root mean square of the successive differences (RMSSD) as a physiologic variable. A main effect of condition was found for emotional valence only, valence being more positive overall in the SPB-HRVB condition. A main effect of time was observed for all dependent variables. However, no main effects for the condition or time x condition interaction effects were observed. Results showed that for PRE and POST comparisons (referring, respectively, to before and after SPB), both SPB-HRVB and SPB-NoHRVB conditions resulted in a more negative emotional valence, lower emotional arousal, higher emotional control, and higher RMSSD. Future research might investigate psychophysiological differences between SPB-HRVB and SPB-NoHRVB across different time periods (e.g., long-term interventions), and in response to diverse psychophysiological stressors.
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Affiliation(s)
- Sylvain Laborde
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.,Normandie Université, UFR STAPS, EA 4260 CESAMS, Caen, France
| | - Mark S Allen
- School of Psychology, University of Wollongong, Wollongong, New South Wales, Australia
| | - Uirassu Borges
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany.,Department of Health & Social Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Maša Iskra
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Nina Zammit
- Department of Performance Psychology, Institute of Psychology, German Sport University Cologne, Cologne, Germany
| | - Min You
- Normandie Université, UFR Psychologie, EA3918 CERREV, Caen, France
| | - Thomas Hosang
- Experimental Psychology Unit, Helmut Schmidt University/University of the Federal Armed Forces, Hamburg, Germany
| | - Emma Mosley
- Department of Sport Science and Performance, School of Sport, Health and Social Science, Solent University Southampton, Southampton, UK
| | - Fabrice Dosseville
- Normandie Université, UMR-S 1075 COMETE, Caen, France.,INSERM, UMR-S 1075 COMETE, Caen, France
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25
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Ingvaldsen SH, Tronvik E, Brenner E, Winnberg I, Olsen A, Gravdahl GB, Stubberud A. A Biofeedback App for Migraine: Development and Usability Study. JMIR Form Res 2021; 5:e23229. [PMID: 34319243 PMCID: PMC8367148 DOI: 10.2196/23229] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Revised: 03/17/2021] [Accepted: 05/31/2021] [Indexed: 12/04/2022] Open
Abstract
Background Biofeedback is effective in treating migraines. It is believed to have a beneficial effect on autonomous nervous system activity and render individuals resilient to stressors that may trigger a migraine. However, widespread use of biofeedback is hampered by the need for a trained therapist and specialized equipment. Emerging digital health technology, including smartphones and wearables (mHealth), enables new ways of administering biofeedback. Currently, mHealth interventions for migraine appear feasible, but development processes and usability testing remain insufficient. Objective The objective of this study was to evaluate and improve the feasibility and usability of an mHealth biofeedback treatment app for adults with migraine. Methods In a prospective development and usability study, 18 adults with migraine completed a 4-week testing period of self-administered therapist-independent biofeedback treatment consisting of a smartphone app connected to wearable sensors (Cerebri, Nordic Brain Tech AS). The app included biofeedback training, instructions for self-delivery, and a headache diary. Two wearable sensors were used to measure surface electromyographic voltage at the trapezius muscle and peripheral skin temperature and heart rate at the right second fingertip. Participants were instructed to complete a daily headache diary entry and biofeedback session of 10 minutes duration. The testing period was preceded by a preusability expectation interview and succeeded by a postusability experience interview. In addition, an evaluation questionnaire was completed at weeks 2 and 4. Adherence was calculated as the proportion of 10-minute sessions completed within the first 28 days of treatment. Usability and feasibility were analyzed and summarized quantitatively and qualitatively. Results A total of 391 biofeedback sessions were completed with a median of 25 (IQR 17-28) per participant. The mean adherence rate was 0.76 (SD 0.26). The evaluation questionnaire revealed that functionality and design had the highest scores, whereas engagement and biofeedback were lower. Qualitative preexpectation analysis revealed that participants expected to become better familiar with physical signals and gain more understanding of their migraine attacks and noted that the app should be simple and understandable. Postusability analysis indicated that participants had an overall positive user experience with some suggestions for improvement regarding the design of the wearables and app content. The intervention was safe and tolerable. One case of prespecified adverse events was recorded in which a patient developed a skin rash from the sticky surface electromyography electrodes. Conclusions The app underwent a rigorous development process that indicated an overall positive user experience, good usability, and high adherence rate. This study highlights the value of usability testing in the development of mHealth apps.
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Affiliation(s)
- Sigrid Hegna Ingvaldsen
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway
| | - Erling Tronvik
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Eiliv Brenner
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Ingunn Winnberg
- National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim, Norway
| | - Gøril Bruvik Gravdahl
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
| | - Anker Stubberud
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Trondheim, Norway.,National Advisory Unit on Headaches, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim, Norway
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Radat F. What is the link between migraine and psychiatric disorders? From epidemiology to therapeutics. Rev Neurol (Paris) 2021; 177:821-826. [PMID: 34325915 DOI: 10.1016/j.neurol.2021.07.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/07/2023]
Abstract
The association between migraine and psychiatric disorders is well documented through numerous population-based studies. The results of these studies are coherent and show an increased risk of suffering from depression, bipolar disorders, numerous anxiety disorders, especially post-traumatic stress disorder. This raises the question of stress as a precipitating factor for migraine illness. Psychiatric comorbidity is even more frequent in chronic migraine than in episodic migraine patients. Many prospective studies have shown that psychiatric comorbidity could be considered as a risk factor for migraine chronicization. Psychiatric comorbidity is also responsible for an increase of the frequency of anti-migraine drug intake, a worsening of quality of life and a worsening of functional impairment. It is also responsible for an increase in the direct and indirect costs of migraine. The reason why psychiatric comorbidity is so high in migraineurs is not unambiguous. Multiple causal relationships and common etiological factors are linked. Recently, genome-wide association studies gave leads to a genetic common heritability between major depressive disorder and migraine. For clinicians, an important topic remains how to treat migraineurs with psychiatric comorbidity. These patients suffer frequently from severe migraine or refractory migraine. Antidepressant and anti-convulsive drugs can be useful, as well as psychological therapies. But moreover, it is of utmost importance to propose an integrated multidisciplinary approach to these difficult patients.
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Affiliation(s)
- F Radat
- Cabinet medical, 107, rue Judaïque, 33000 Bordeaux, France.
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Milling LS, Valentine KE, LoStimolo LM, Nett AM, McCarley HS. Hypnosis and the Alleviation of Clinical Pain: A Comprehensive Meta-Analysis. Int J Clin Exp Hypn 2021; 69:297-322. [PMID: 34038322 DOI: 10.1080/00207144.2021.1920330] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This is the first comprehensive meta-analysis in approximately 20 years of all controlled studies of the use of hypnosis for relieving clinical pain. To be included, studies were required to utilize a between-subjects or mixed model design in which a hypnosis intervention was compared with a control condition in alleviating any form of clinical pain. Of 523 records screened, 42 studies incorporating 45 trials of hypnosis met the inclusion criteria. Our most conservative estimates of the impact of hypnosis on pain yielded mean weighted effect sizes of 0.60 (p ≤ .001) for 40 post trials and 0.61 (p ≤ .001) for 9 follow-up trials. These effect sizes fall in the medium range according to Cohen's guideline and suggest the average participant receiving hypnosis reduced pain more than about 73% of control participants. Hypnosis was moderated by the overall methodological quality of trials-the mean weighted effect size of the 19 post trials without high risk ratings on any of the Cochrane Risk of Bias dimensions was 0.77 (p ≤ .001). Hypnosis was also moderated by hypnotic suggestibility, with 6 post trials producing a mean weighted effect size of r = 0.53 (p ≤ .001). Our findings strengthen the assertion that hypnosis is a very efficacious intervention for alleviating clinical pain.
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Affiliation(s)
- Leonard S Milling
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
| | - Keara E Valentine
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
| | - Lindsey M LoStimolo
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
| | - Alyssa M Nett
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
| | - Hannah S McCarley
- Department of Psychology, University of Hartford, West Hartford, Connecticut, USA
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Barmherzig R, Rajapakse T. Nutraceuticals and Behavioral Therapy for Headache. Curr Neurol Neurosci Rep 2021; 21:33. [PMID: 33970348 DOI: 10.1007/s11910-021-01120-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE OF REVIEW Headache affects and disables at least 1 billion people worldwide. Patients and providers seek new therapies to relieve headache without the side effects and financial burden of current treatments. This narrative review highlights recent treatment advances in integrative headache medicine: nutraceuticals and behavioral therapies. RECENT FINDINGS Growing use of complementary and alternative medicine (CAM) therapies for headache (riboflavin, coenzyme Q10, magnesium, vitamin D, melatonin) alongside mainstream treatments is increasing with improving evidence of quality, safety, and tolerability. Increasing interest in medical cannabis is tempered by lack of evidence regarding safety and efficacy. Behavioral therapies including cognitive behavioral therapy (CBT), biofeedback, mindfulness-based stress reduction (MBSR), and acceptance and commitment therapy (ACT) improve patient resiliency and self-efficacy outcomes and reduce disability. The body of evidence for nutraceutical and behavioral CAM interventions for headache continues to grow and improve in quality. Providers and patients should educate themselves regarding CAM therapies as part of integrative headache management. Future studies should examine combinatorial trials of CAM therapies against current standards of headache care.
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Affiliation(s)
- Rebecca Barmherzig
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Thilinie Rajapakse
- Department of Pediatrics, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada. .,Stollery Children's Hospital, Women & Children's Research Institute, Edmonton, AB, Canada.
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Abstract
Restrained eating is a popular weight loss strategy for young women that tends to have limited effectiveness over extended periods of time. Although previous studies have explored and identified possible personality and behavior differences between successful and unsuccessful restrained eaters (REs), there has been a paucity of research on neurophysiological differences.Towards addressing this gap, we assessed brain resting state (Rs) differences in groups of unsuccessful REs (N = 39) and successful REs (N = 31). In line with hypotheses, unsuccessful REs displayed reduced regional homogeneity in brain regions involved in cognitive control (inferior parietal lobe) compared to successful REs. Regions involved in conflict monitoring (anterior cingulate cortex) were also observed to be comparatively less active in the unsuccessful RE group. Finally, based on analyses of independent components and seed-based functional connectivity, regions involved in conflict monitoring and cognitive control, especially those localized within the frontoparietal network, showed weaker connectivities among unsuccessful REs compared to their successful counterparts.These results underscore specific brain Rs differences between successful REs and unsuccessful REs in regions implicated in cognitive control and conflict monitoring.
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Campo M, Zadro JR, Pappas E, Monticone M, Secci C, Scalzitti D, Findley JL, Graham PL. The effectiveness of biofeedback for improving pain, disability and work ability in adults with neck pain: A systematic review and meta-analysis. Musculoskelet Sci Pract 2021; 52:102317. [PMID: 33461043 DOI: 10.1016/j.msksp.2021.102317] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Revised: 12/15/2020] [Accepted: 01/02/2021] [Indexed: 12/29/2022]
Abstract
BACKGROUND Biofeedback is used to optimise muscle activation patterns in people with neck pain. OBJECTIVES To evaluate the safety and efficacy of electromyographic and pressure biofeedback on pain, disability and work ability in adults with neck pain. DESIGN Systematic review and meta-analysis. METHODS We searched key databases and trial registries to September 2020, using terms synonymous with 'neck pain' and 'biofeedback'. We included randomised controlled trials (RCTs) evaluating biofeedback (against any comparison) for adults with neck pain. Outcomes included pain, disability, work ability and adverse events. Two authors independently selected the studies, extracted data, and evaluated risk of bias. GRADE was applied to each meta-analysis. Data were pooled using random-effects models to determine the standardised mean change (SMC). RESULTS We included 15 RCTs (n = 990). Moderate-quality evidence suggests biofeedback has a moderate effect on reducing short-term disability (SMC = -0.42, 95%CI: 0.59 to -0.26, nine trials, n = 627), and a small effect on reducing intermediate-term disability (SMC = -0.30, 95%CI: 0.53 to -0.06, five trials, n = 458). Biofeedback had no effect on pain or work ability in the short- and intermediate-term (low-to moderate-quality evidence). One study reported headaches in 6.7% of participants, but headache frequency was not reported by group. LIMITATIONS There were a variety of control interventions across studies. Few studies compared biofeedback with no treatment or placebo. CONCLUSION Biofeedback appears to have a small-to-moderate effect on reducing neck pain disability in the short- and intermediate-term, but no effect on pain or work ability. More trials reporting adverse events and comparing biofeedback to placebo are needed.
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Affiliation(s)
- Marc Campo
- School of Health and Natural Sciences, Mercy College, Dobbs Ferry, NY, USA
| | - Joshua R Zadro
- Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
| | - Evangelos Pappas
- Discipline of Physiotherapy, Faculty of Medicine and Health, The University of Sydney, Lidcombe, Australia
| | - Marco Monticone
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Department of Neuroscience and Rehabilitation, Neurorehabilitation Unit, G. Brotzu Hospital, Cagliari, Italy
| | - Claudio Secci
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
| | - David Scalzitti
- Department of Physical Therapy, George Washington University, Washington, DC, USA
| | | | - Petra L Graham
- Centre for Economic Impacts of Genomic Medicine (GenIMPACT), Macquarie Business School and Department of Mathematics and Statistics, Faculty of Science and Engineering, Macquarie University, Sydney, Australia
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Raucci U, Boni A, Evangelisti M, Della Vecchia N, Velardi M, Ursitti F, Terrin G, Di Nardo G, Reale A, Villani A, Parisi P. Lifestyle Modifications to Help Prevent Headache at a Developmental Age. Front Neurol 2021; 11:618375. [PMID: 33603708 PMCID: PMC7884344 DOI: 10.3389/fneur.2020.618375] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 12/29/2020] [Indexed: 12/17/2022] Open
Abstract
Headache is the world's seventh most significant cause of disability-adjusted-life in people aged between 10 and 14 years. Therapeutic management is based on pharmacological approaches and lifestyle recommendations. Many studies show associations between each migraine-promoting lifestyle, behavioral triggers, frequency, and intensity of headaches. Nevertheless, the overall aspects of this topic lack any definitive evidence. Educational programs advise that pediatric patients who suffer from migraines follow a correct lifestyle and that this is of the utmost importance in childhood, as it will improve quality of life and assist adult patients in avoiding headache chronicity, increasing general well-being. These data are important due to the scarcity of scientific evidence on drug therapy for prophylaxis during the developmental age. The "lifestyle recommendations" described in the literature include a perfect balance between regular sleep and meal, adequate hydration, limited consumption of caffeine, tobacco, and alcohol, regular physical activity to avoid being overweight as well as any other elements causing stress. The ketogenic diet is a possible new therapeutic strategy for the control of headache in adults, however, the possible role of dietary factors requires more specific studies among children and adolescents. Educational programs advise that the improvement of lifestyle as a central element in the management of pediatric headache will be of particular importance in the future to improve the quality of life of these patients and reduce the severity of cephalalgic episodes and increase their well-being in adulthood. The present review highlights how changes in different aspects of daily life may determine significant improvements in the management of headaches in people of developmental age.
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Affiliation(s)
- Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | | | - Melania Evangelisti
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Nicoletta Della Vecchia
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Margherita Velardi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Fabiana Ursitti
- Division of Neurology, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Gianluca Terrin
- Department of Gynecological Obstetric and Urological Sciences, Faculty of Medicine and Dentistry, Sapienza University of Rome, Rome, Italy
| | - Giovanni Di Nardo
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
| | - Antonino Reale
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Alberto Villani
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, Institute for Research, Hospitalization and Health Care (IRCCS), Rome, Italy
| | - Pasquale Parisi
- Department of Pediatrics, Department of Neuroscience, Mental Health & Sense Organs (NESMOS), Faculty of Medicine & Psychology, c/o Sant'Andrea Hospital, Sapienza University, Rome, Italy
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Stubberud A, Linde M, Brenner E, Heier M, Olsen A, Aamodt AH, Gravdahl GB, Tronvik E. Self‐administered biofeedback treatment app for pediatric migraine: A randomized pilot study. Brain Behav 2020. [PMCID: PMC7882181 DOI: 10.1002/brb3.1974] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
Objective To investigate the effect size, safety, and tolerability of a therapist‐independent biofeedback treatment app among adolescent with migraine. Materials and Methods This was a prospective, 3:1 ratio randomized, sham‐controlled, double‐blind, pilot study with 16 adolescents diagnosed with migraine randomized to eight weeks of biofeedback treatment (n = 12) or sham biofeedback (n = 4), carried out at two university hospitals in Norway. The prespecified and primary objective of the study was to observe changes in outcomes within the active treatment group. The sham control group was included in a minor ratio primarily to evaluate its feasibility. The primary outcome was change in headache frequency. A modified intention to treat analysis was performed, including participants completing at least seven biofeedback sessions in weeks 1–4 (n = 12 vs. n = 4) and weeks 5–8 (n = 7 vs. n = 2). Results Adherence was poor with 40% (136/336) of planned biofeedback sessions completed during weeks 5–8. Within the biofeedback group, a not statistically significant reduction in headache frequency was observed at weeks 1–4 (2.92 days/month, 95% CI −1.00 to 6.84, p = .145) and weeks 5–8 (1.85 days/month, 95% CI −2.01 to 5.72, p = .395). The biofeedback group experienced a median of one fewer headache days/month versus sham that did not reach significance (95% CI −4.0 to 9.0, p = .760). Conclusions We observed a small reduction in headache frequency in the active treatment group. Findings were likely undermined by low adherence and underpowered analyses but indicate that a therapist‐independent biofeedback treatment app has the potential to be an effective, tolerable, and inexpensive treatment option.
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Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement ScienceNTNU Norwegian University of Science and TechnologyTrondheimNorway
| | - Mattias Linde
- Department of Neuromedicine and Movement ScienceNTNU Norwegian University of Science and TechnologyTrondheimNorway
- Norwegian Advisory Unit on Headaches, Department of NeurologySt. Olavs HospitalTrondheimNorway
| | - Eiliv Brenner
- Department of Neuromedicine and Movement ScienceNTNU Norwegian University of Science and TechnologyTrondheimNorway
- Norwegian Advisory Unit on Headaches, Department of NeurologySt. Olavs HospitalTrondheimNorway
| | - Martin Heier
- Department of Clinical Neuroscience for ChildrenOslo University HospitalOsloNorway
| | - Alexander Olsen
- Department of PsychologyNTNU Norwegian University of Science and TechnologyTrondheimNorway
- Department of Physical Medicine and RehabilitationSt. Olavs HospitalTrondheimNorway
| | | | - Gøril B. Gravdahl
- Department of Neuromedicine and Movement ScienceNTNU Norwegian University of Science and TechnologyTrondheimNorway
- Norwegian Advisory Unit on Headaches, Department of NeurologySt. Olavs HospitalTrondheimNorway
| | - Erling Tronvik
- Department of Neuromedicine and Movement ScienceNTNU Norwegian University of Science and TechnologyTrondheimNorway
- Norwegian Advisory Unit on Headaches, Department of NeurologySt. Olavs HospitalTrondheimNorway
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33
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Dresler T, Guth AL, Lüpke J, Kropp P. [Psychological treatment of headache in times of COVID-19]. Schmerz 2020; 34:503-510. [PMID: 33030591 PMCID: PMC7543037 DOI: 10.1007/s00482-020-00507-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Revised: 08/17/2020] [Accepted: 09/03/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has substantially changed life worldwide in 2020. This also influences the psychological treatment options of patients with headache. AIM The present article intends to illustrate the different psychological forms of treatment for headache patients and their implementation during the COVID-19 pandemic. MATERIAL AND METHODS Literature review and case reports. RESULTS Even during the COVID-19 pandemic, psychological treatment enables the increased stress level in headache patients to be counteracted by using cognitive behavioral therapy and relaxation techniques. The changed living conditions are often unfavorable but sometimes also favorable in the course of disease. It can be shown that even during the pandemic, such favorable changes can be used to support patients to cope with their headache. CONCLUSION The digital implementation of psychological approaches makes a major contribution to maintaining psychological treatment of headache patients, so that the individually changed needs can be addressed. With respect to content, stress regulation techniques and increased acceptance gain in importance. Regarding biofeedback there are limitations, which may be overcome by improved technical devices.
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Affiliation(s)
- T Dresler
- Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Calwerstr. 14, 72076, Tübingen, Deutschland.
- Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Tübingen, Deutschland.
| | - A-L Guth
- Migräne- und Kopfschmerzklinik Königstein, Königstein, Deutschland
| | - J Lüpke
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
| | - P Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Rostock, Deutschland
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Uhlmann C, Flammer E, Jaeger S, Schmid P. Review zur Wirksamkeit von Biofeedback und Neurofeedback bei Depression. VERHALTENSTHERAPIE 2020. [DOI: 10.1159/000510477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
<b><i>Hintergrund:</i></b> Biofeedbackverfahren haben sich für unterschiedliche psychische und somatische Erkrankungen als wirksam erwiesen. Für depressive Störungen als weitverbreitetes Störungsbild liegen mittlerweile zwar mehrere Studienergebnisse vor, die Bewertung der wissenschaftlichen Evidenz ist jedoch weiterhin ausstehend. <b><i>Material und Methoden:</i></b> Eine systematische Literaturrecherche wurde in den Datenbanken PubMed, PsycINFO und CINAHL mit den Begriffen “Neurofeedback” oder “Biofeedback” und “Depression” durchgeführt. Von den insgesamt 971 identifizierten Publikationen gingen nach Durchsicht 12 in die Arbeit ein. <b><i>Ergebnisse:</i></b> Die Effektstärken lagen für den Vergleich Prä- versus Post-Intervention bei einer Range von 0,31 bis 4,08 und für den Vergleich zwischen Biofeedback und Kontrollgruppe bei –0,77 bis 2,38 für beide Arten des angewendeten Feedbacktrainings: Neurofeedback und Feedback der Herzratenvariabilität. Beinhalteten Kontrollinterventionen Entspannungstechniken oder Placebo-Feedback, zeigten sich auch hier überraschend gute Ergebnisse. <b><i>Diskussion:</i></b> Die Aussagekraft der Ergebnisse wird gemindert durch meist kleine Stichproben, nur wenige Katamnesedaten und vor dem Hintergrund von nur drei Studien mit festgestellt geringem Verzerrungsrisiko. Dies in die Interpretation einbezogen, sind die Studienergebnisse jedoch immer noch beachtlich gut. <b><i>Schlussfolgerungen:</i></b> Symptomverbesserungen mit teilweise hohen Effektstärken zeigen, dass Biofeedbackverfahren für die Behandlung von depressiven Störungen eventuell geeignete Methoden sind. Unspezifische Wirkfaktoren wie Entspannungs- und Erwartungseffekte gilt es unbedingt zu berücksichtigen. Eine vielversprechende Perspektive könnte die Kombination aus verhaltenstherapeutischem Ansatz und Feedbacktraining sein.
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35
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Pieczynski J, Cosio D, Pierce W, Serpa JG. Mind-Body Interventions for Rehabilitation Medicine: Promoting Wellness, Healing, and Coping with Adversity. Phys Med Rehabil Clin N Am 2020; 31:563-575. [PMID: 32981579 DOI: 10.1016/j.pmr.2020.07.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Physical medicine providers work to cure organic aspects of disease while simultaneously enhancing quality of life and well-being. Mind-body interventions are evidence-based, cost-effective approaches to serve these aims. This article enhances provider knowledge and acceptance of the most effective and prevalent mind-body modalities: meditation, guided imagery, clinical hypnosis, and biofeedback. The scientific evidence is strongest for mind-body applications for chronic pain, primary headache, cardiac rehabilitation, and cancer rehabilitation, with preliminary evidence for traumatic brain injury and cerebrovascular events. Mind-body interventions are well-tolerated by patients and should be considered part of standard care in physical medicine and rehabilitation settings.
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Affiliation(s)
- Jessica Pieczynski
- Greater Los Angeles VA Healthcare System, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA.
| | - David Cosio
- Jesse Brown VA Medical Center, 820 South Damen Avenue, Chicago, IL 60612, USA
| | - Whitney Pierce
- VA St. Louis Healthcare System, 915 North Grand Boulevard, St Louis, MO 63106, USA
| | - J Greg Serpa
- Greater Los Angeles VA Healthcare System, UCLA Department of Psychology, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA
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Müller M, Bräscher AK. [Psychotherapy in the Context of Interdisciplinary Multimodal Pain Therapy: Update]. Anasthesiol Intensivmed Notfallmed Schmerzther 2020; 55:536-548. [PMID: 32916737 DOI: 10.1055/a-1022-3051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Interdisciplinary multimodal pain therapy (IMPT) is based on the biopsychosocial model of pain and describes an integrated treatment for patients with chronic pain. IMPT incorporates a close cooperation of different disciplines, including physicians, psychotherapists, physiotherapists, and others. IMPT mainly aims to restore and increase patients' physical, social and psychological functional capacity. The efficacy of IMPT has been evidenced by systematic reviews and meta-analyses. A number of studies further indicate IMPT's cost-efficiency. Psychotherapy is an essential component of IMPT. Its main goal within the framework of IMPT is to identify and modify dysfunctional patterns of pain coping, and to diagnose and potentially treat psychological comorbidities. Pain psychotherapy comprises mostly cognitive-behavioral interventions which address dysfunctional coping at the three levels of the pain experience (i.e., cognitive, emotional, and behavioral). Research into the efficacy of pain psychotherapy is rather sparse and studies have mostly focused on chronic back pain, yet existing results show promising evidence both for psychotherapy within IMPT and for psychotherapy as a monotherapy. This paper aims at providing an overview of (a) commonly employed cognitive-behavioral psychotherapeutic approaches and strategies in the treatment of chronic pain, and (b) the existing empirical evidence of pain psychotherapy both within the framework of IMPT and as a monotherapy. Future research should include a wider range of pain diagnoses and also investigate the potential benefit of individually-tailored treatments.
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Filatova EG, Osipova VV, Tabeeva GR, Parfenov VA, Ekusheva EV, Azimova YE, Latysheva NV, Naprienko MV, Skorobogatykh KV, Sergeev AV, Golovacheva VA, Lebedeva ER, Artyomenko AR, Kurushina OV, Koreshkina MI, Amelin AV, Akhmadeeva LR, Rachin AR, Isagulyan ED, Danilov AB, Gekht AB. Diagnosis and treatment of migraine: Russian experts' recommendations. NEUROLOGY, NEUROPSYCHIATRY, PSYCHOSOMATICS 2020. [DOI: 10.14412/2074-2711-2020-4-4-14] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Migraine is one of the most common types of headache, which can lead to a significant decrease in quality of life. Researchers identify migraine with aura, migraine without aura, and chronic migraine that substantially reduces the ability of patients to work and is frequently concurrent with mental disorders and drug-induced headache. The complications of migraine include status migrainosus, persistent aura without infarction, migrainous infarction (stroke), and a migraine aura-induced seizure. The diagnosis of migraine is based on complaints, past medical history, objective examination data, and the diagnostic criteria as laid down in the International Classification of Headache Disorders, 3 rd edition. Add-on trials are recommended only in the presence of red flags, such as the symptoms warning about the secondary nature of headache. Migraine treatment is aimed at reducing the frequency and intensity of attacks and the amount of analgesics taken. It includes three main approaches: behavioral therapy, seizure relief therapy, and preventive therapy. Behavioral therapy focuses on lifestyle modification. Nonsteroidal anti-inflammatory drugs, simple and combined analgesics, triptans, and antiemetic drugs for severe nausea or vomiting are recommended for seizure relief. Preventive therapy which includes antidepressants, anticonvulsants, beta-blockers, angiotensin II receptor antagonists, botulinum toxin type A-hemagglutinin complex and monoclonal antibodies to calcitonin gene-related peptide or its receptors, is indicated for frequent or severe migraine attacks and for chronic migraine. Pharmacotherapy is recommended to be combined with non-drug methods that involves cognitive behavioral therapy; progressive muscle relaxation; mindfulness; biofeedback; post-isometric relaxation; acupuncture; therapeutic exercises; greater occipital nerve block; non-invasive high-frequency repetitive transcranial magnetic stimulation; external stimulation of first trigeminal branch; and electrical stimulation of the occipital nerves (neurostimulation).
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Affiliation(s)
- E. G. Filatova
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - V. V. Osipova
- Z.P. Solovyev Research and Practical Center of Psychoneurology, Moscow Healthcare Department; University Headache Clinic
| | - G. R. Tabeeva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - V. A. Parfenov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - E. V. Ekusheva
- Academy of Postgraduate Education «Federal Research and Clinical Center for Specialized Medical Care Types and Medical Technologies, Federal Biomedical Agency of Russia»
| | | | - N. V. Latysheva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - M. V. Naprienko
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | | | - A. V. Sergeev
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - V. A. Golovacheva
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - E. R. Lebedeva
- Ural State Medical University, Ministry of Health of Russia
| | - A. R. Artyomenko
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - O. V. Kurushina
- Volgograd State Medical University, Ministry of Health of Russia
| | | | - A. V. Amelin
- Acad. I.P. Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia
| | | | - A. R. Rachin
- National Medical Research Center for Rehabilitation and Balneology, Ministry of Health of Russia
| | - E. D. Isagulyan
- Academician N.N. Burdenko National Medical Research Center of Neurosurgery
| | - Al. B. Danilov
- I.M. Sechenov First Moscow State Medical University (Sechenov University), Ministry of Health of Russia
| | - A. B. Gekht
- Z.P. Solovyev Research and Practical Center of Psychoneurology, Moscow Healthcare Department
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Fernández-de-las-Peñas C, Florencio LL, Plaza-Manzano G, Arias-Buría JL. Clinical Reasoning Behind Non-Pharmacological Interventions for the Management of Headaches: A Narrative Literature Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17114126. [PMID: 32527071 PMCID: PMC7312657 DOI: 10.3390/ijerph17114126] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 06/05/2020] [Accepted: 06/08/2020] [Indexed: 12/13/2022]
Abstract
Headache is the clinical syndrome most commonly observed by neurologists in daily practice. Pharmacological and non-pharmacological treatments are commonly used for the management of headaches; however, the clinical reasoning behind these interventions is not properly applied. We conducted a narrative literature review using as data sources for academic PubMed, MEDLINE, EMBASE, AMED, CINAHL, EBSCO, PEDro, Cochrane Database of Systematic Reviews, Cochrane Collaboration Trials Register, and SCOPUS. This narrative literature review mainly considered systematic reviews, meta-analyses, randomised clinical trials, and expert opinions published after the year 2000 discussing clinical reasoning for application of non-pharmacological interventions in individuals with tension-type, migraine, and cervicogenic headaches. After the data extraction, we organized the literature thematically as follows: (1) mapping of theoretical aspects of non-pharmacological interventions; (2) summarizing most updated literature about effectiveness of non-pharmacological interventions grouped by targeted tissue and headache; (3) identifying research gaps in the existing literature and proposing hypotheses for better understanding of current clinical reasoning. We found that there are many non-pharmacological treatment strategies used for headaches, including beyond the tissue-based impairment treatments (bottom-up) and strategies targeting the central nervous system (top down). Bottom-up strategies include joint-biased, soft-tissue biased, or needling interventions, whereas top-down strategies include exercise and cognitive interventions. Evidence shows that the effectiveness of these interventions depends on the application of proper clinical reasoning, since not all strategies are effective for all headaches. For instance, evidence of non-pharmacological interventions is more controversial for migraines than for tension-type or cervicogenic headaches, since migraine pathogenesis involves activation of sub-cortical structures and the trigemino- vascular system, whereas pathogenesis of tension-type or cervicogenic headaches is most associated to musculoskeletal impairments of the cervical spine. We conclude that current literature suggests that not all non-pharmacological interventions are effective for all headaches, and that multimodal, not isolated, approaches seem to be more effective for patients with headaches. Most published studies have reported small clinical effects in the short term. This narrative literature review provides some hypotheses for discrepancies in the available literature and future research. Clinical reasoning should be applied to better understand the effects of non-pharmacological interventions.
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Affiliation(s)
- César Fernández-de-las-Peñas
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (L.L.F.); (J.L.A.-B.)
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
- Correspondence:
| | - Lidiane L. Florencio
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (L.L.F.); (J.L.A.-B.)
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
| | - Gustavo Plaza-Manzano
- Radiology, Rehabilitation and Physiotherapy Department, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Instituto de Investigación Sanitaria del Hospital Clínico San Carlos, 28040 Madrid, Spain
| | - José L. Arias-Buría
- Department of Physical Therapy, Occupational Therapy, Physical Medicine and Rehabilitation, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain; (L.L.F.); (J.L.A.-B.)
- Cátedra Institucional en Docencia, Clínica e Investigación en Fisioterapia, Terapia Manual, Punción Seca y Ejercicio Terapéutico, Universidad Rey Juan Carlos, Alcorcón, 28922 Madrid, Spain
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Stubberud A, Tronvik E, Olsen A, Gravdahl G, Linde M. Biofeedback Treatment App for Pediatric Migraine: Development and Usability Study. Headache 2020; 60:889-901. [DOI: 10.1111/head.13772] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2019] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 01/18/2023]
Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement Science NTNU Norwegian University of Science and Technology Trondheim Norway
| | - Erling Tronvik
- Department of Neuromedicine and Movement Science NTNU Norwegian University of Science and Technology Trondheim Norway
- National Advisory Unit on Headaches Department of Neurology and Clinical Neurophysiology St. Olavs Hospital Trondheim Norway
| | - Alexander Olsen
- Department of Psychology NTNU Norwegian University of Science and Technology Trondheim Norway
- Department of Physical Medicine and Rehabilitation St. Olavs Hospital Trondheim Norway
| | - Gøril Gravdahl
- Department of Neuromedicine and Movement Science NTNU Norwegian University of Science and Technology Trondheim Norway
- National Advisory Unit on Headaches Department of Neurology and Clinical Neurophysiology St. Olavs Hospital Trondheim Norway
| | - Mattias Linde
- Department of Neuromedicine and Movement Science NTNU Norwegian University of Science and Technology Trondheim Norway
- National Advisory Unit on Headaches Department of Neurology and Clinical Neurophysiology St. Olavs Hospital Trondheim Norway
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Abstract
BACKGROUND Previous reviews indicate that the effect of auricular acupuncture on migraine. However, a systematic review is not available. Therefore, this protocol was conducted to evaluate the efficacy and safety of auricular acupuncture on migraine, by conducting a systematic review and meta-analysis. METHODS The following databases will be searched from their inception to October 2019: Chinese National Knowledge Infrastructure (CNKI), Chinese Biomedical Literature Database (CBM), Wan Fang Database, the Chongqing VIP Chinese Science and Technology Periodical Database (VIP), Cochrane Library, EMBASE, EBSCO, PubMed. The randomized controlled trials (RCTs) in English or Chinese associated with auricular acupuncture for migraines will be included. Eligible study conference abstracts and reference lists of manuscripts will be searched. The data collection and analysis will be conducted independently by 2 reviewers. Meta-analysis will be performed using Rev Man V.5.3.5 statistical software. RESULTS This systematic review will be conducted to evaluate the efficacy and safety of auricular acupuncture in the treatment of migraine. Therefore, auricular acupuncture in the treatment of migraine needs to be further clarified. CONCLUSIONS In summary, this review will determine whether the impact of auricular acupuncture for intelligence on the treatment of migraines. A better approach may be established for migraine base on this review. It provides reliable evidence for its extensive application. ETHICS AND DISSEMINATION The private information from individuals will not publish. This systematic review also will not involve endangering participant rights. Ethical approval is not available. The results may be published in a peer-reviewed journal or disseminated in relevant conferences. OSF REGISTRATION NUMBER DOI 10.17605/OSF.IO/7ZR8Q.
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Affiliation(s)
- Feng Zhang
- Sichuan Integrative Medicine Hospital
- Acupuncture and Tuina School
| | - Yifeng Shen
- Clinical Medicine School, Chengdu University of Chinese Medicine, Chengdu, China
| | - Hongjuan Fu
- Sichuan Integrative Medicine Hospital
- Acupuncture and Tuina School
| | - Hao Zhou
- Sichuan Integrative Medicine Hospital
| | - Chao Wang
- Sichuan Integrative Medicine Hospital
- Acupuncture and Tuina School
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Short AL. Enhancing migraine self-efficacy and reducing disability through a self-management program. J Am Assoc Nurse Pract 2019; 33:20-28. [PMID: 31738274 DOI: 10.1097/jxx.0000000000000323] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 08/09/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Chronic migraine is a primary headache disorder affecting approximately 3-7 million individuals in the United States. This condition is associated with significant individual and societal consequences, causing impaired function and high levels of health care utilization. PURPOSE The aim of this quasi-experimental single cohort study was to determine if an 8-week outpatient self-management program for chronic migraine would decrease migraine disability and enhance self-efficacy. METHODS This was a prospective, single cohort, pre- and postintervention pilot study. Fifteen adults aged 18-65 years who met the criteria for diagnosis of chronic migraine were enrolled in the study through convenience sampling. Participants participated in an evidence-based self-management program with multimodal formats including verbal, written, video, and online materials. Outcome measures included migraine disability (using Migraine Disability Assessment tool [MIDAS]), headache self-efficacy (using Headache Management Self-Efficacy Scale [HMSE]), acute medication use, and migraine frequency. Participants also completed a postintervention survey to assess satisfaction. RESULTS Findings showed a reduction in MIDAS scores, acute medication use, and frequency of migraine. Outcomes also included an increase in HMSE scores and a trend of improved health behaviors. Acute medication use decreased by more than 50%, and frequency of migraine and headache days reduced by close to 40%. IMPLICATIONS FOR PRACTICE Despite high rates of disability, patient education and self-management programs for chronic migraine are not readily available. The findings of this study encourage use of a hybrid clinic and web-based self-management model to improve migraine disability and self-efficacy.
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Abstract
BACKGROUND Migraine is a chronic disabling neurologic condition that can be treated with a combination of both pharmacologic and complementary and integrative health options. EVIDENCE ACQUISITION With the growing interest in the US population in the use of nonpharmacologic treatments, we reviewed the evidence for supplements and behavioral interventions used for migraine prevention. RESULTS Supplements reviewed included vitamins, minerals, and certain herbal preparations. Behavioral interventions reviewed included cognitive behavioral therapy, biofeedback, relaxation, the third-wave therapies, acupuncture, hypnosis, and aerobic exercise. CONCLUSIONS This article should provide an appreciation for the wide range of nonpharmacologic therapies that might be offered to patients in place of or in addition to migraine-preventive medications.
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Affiliation(s)
- Palak S Patel
- Departments of Neurology (PSP, MTM) and Population Health (MTM), NYU Langone Health, New York, New York
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Sharpe L, Dudeney J, Williams ACDC, Nicholas M, McPhee I, Baillie A, Welgampola M, McGuire B. Psychological therapies for the prevention of migraine in adults. Cochrane Database Syst Rev 2019; 7:CD012295. [PMID: 31264211 PMCID: PMC6603250 DOI: 10.1002/14651858.cd012295.pub2] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Migraine is a common neurological problem associated with the highest burden amongst neurological conditions in terms of years lived with disability. Medications can be used as prophylaxis or rescue medicines, but are costly and not always effective. A range of psychological interventions have been developed to manage migraine. OBJECTIVES The objective was to evaluate the efficacy and adverse events of psychological therapies for the prevention of migraine in adults. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, PsycINFO and CINAHL from their inception until July 2018, and trials registries in the UK, USA, Australia and New Zealand for randomised controlled trials of any psychological intervention for adults with migraine. SELECTION CRITERIA We included randomised controlled trials (RCTs) of a psychological therapy for people with chronic or episodic migraine, with or without aura. Interventions could be compared to another active treatment (psychological or medical), an attention-placebo (e.g. supportive counselling) or other placebo, routine care, or waiting-list control. We excluded studies where fewer than 15 participants completed each arm. DATA COLLECTION AND ANALYSIS We extracted study characteristics and outcome data at post-treatment and the longest available follow-up. We analysed intervention versus control comparisons for the primary outcome of migraine frequency. We measured migraine frequency using days with migraines or number of migraine attacks measured in the four weeks after treatment. In addition, we analysed the following secondary outcomes: responder rate (the proportion of participants with a 50% reduction in migraine frequency between the four weeks prior to and the four weeks after treatment); migraine intensity; migraine duration; migraine medication usage; mood; quality of life; migraine-related disability; and proportion of participants reporting adverse events during the treatment. We included these variables, where available, at follow-up, the timing of which varied between the studies. We used the GRADE approach to judge the quality of the evidence. MAIN RESULTS We found 21 RCTs including 2482 participants with migraine, and we extracted meta-analytic data from 14 of these studies. The majority of studies recruited participants through advertisements, included participants with migraine according to the International Classification of Headache Disorders (ICHD) criteria and those with and without aura. Most intervention arms were a form of behavioural or cognitive-behavioural therapy. The majority of comparator arms were no treatment, routine care or waiting list. Interventions varied from one 20-minute session to 14 hours of intervention. No study had unequivocally low risk of bias; all had at least one domain at high risk of bias, and 20 had two to five domains at high risk. Reporting of randomisation procedures and allocation concealment were at high or unclear risk of bias. We downgraded the quality of evidence for outcomes to very low, due to very serious limitations in study quality and imprecision. Reporting in trials was poor; we found no preregistrations stipulating the outcomes, or demonstrating equivalent expectations between groups. Few studies reported our outcomes of interest, most only reported outcomes post treatment; follow-up data were sparse.Post-treatment effectsWe found no evidence of an effect of psychological interventions for migraine frequency in number of migraines or days with migraine (standardised mean difference (SMD) -0.02, 95% confidence interval (CI) -0.17 to 0.13; 4 studies, 681 participants; very low-quality evidence).The responder rate (proportion of participants with migraine frequency reduction of more than 50%) was greater for those who received a psychological intervention compared to control: 101/186 participants (54%) with psychological therapy; 37/152 participants (24%) with control (risk ratio (RR) 2.21, 95% CI 1.63 to 2.98; 4 studies, 338 participants; very low-quality evidence). We found no effect of psychological therapies on migraine intensity (SMD -0.13, 95% CI -0.28 to 0.02; 4 studies, 685 participants). There were no data for migraine duration (hours of migraine per day). There was no effect on migraine medication usage (SMD -0.06, 95% CI -0.35 to 0.24; 2 studies, 483 participants), mood (mean difference (MD) 0.08, 95% CI -0.33 to 0.49; 4 studies, 432 participants), quality of life (SMD -0.02, 95% CI -0.30 to 0.26; 4 studies, 565 participants), or migraine-related disability (SMD -0.67, 95% CI -1.34 to 0.00; 6 studies, 952 participants). The proportion of participants reporting adverse events did not differ between those receiving psychological treatment (9/107; 8%) and control (30/101; 30%) (RR 0.16, 95% CI 0.00 to 7.85; 2 studies, 208 participants). Only two studies reported adverse events and so we were unable to draw any conclusions.We rated evidence from all studies as very low quality.Follow-upOnly four studies reported any follow-up data. Follow-ups ranged from four months following intervention to 11 months following intervention. There was no evidence of an effect on any outcomes at follow-up (very low-quality evidence). AUTHORS' CONCLUSIONS This review identified 21 studies of psychological interventions for the management of migraine. We did not find evidence that psychological interventions affected migraine frequency, a result based on four studies of primarily brief treatments. Those who received psychological interventions were twice as likely to be classified as responders in the short term, but this was based on very low-quality evidence and there was no evidence of an effect of psychological intervention compared to control at follow-up. There was no evidence of an effect of psychological interventions on medication usage, mood, migraine-related disability or quality of life. There was no evidence of an effect of psychological interventions on migraine frequency in the short-term or long-term. In terms of adverse events, we were unable to draw conclusions as there was insufficient evidence. High and unclear risk of bias in study design and reporting, small numbers of participants, performance and detection bias meant that we rated all evidence as very low quality. Therefore, we conclude that there is an absence of high-quality evidence to determine whether psychological interventions are effective in managing migraine in adults and we are uncertain whether there is any difference between psychological therapies and controls.
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Affiliation(s)
- Louise Sharpe
- University of SydneySchool of PsychologySydneyAustralia
| | - Joanne Dudeney
- Seattle Children's Research InstituteCenter for Child Health, Behavior, and Development2001 8th Avenue, Suite 400SeattleWashingtonUSA
| | - Amanda C de C Williams
- University College LondonResearch Department of Clinical, Educational & Health PsychologyGower StreetLondonUKWC1E 6BT
| | - Michael Nicholas
- University of Sydney and Royal North Shore HospitalPain Management Research InstituteSydneyNSWAustralia2065
| | - Ingrid McPhee
- University of SydneySchool of PsychologySydneyAustralia
| | - Andrew Baillie
- Faculty of Health Sciences, The University of SydneyDiscipline of Behavioural and Social Sciences in HealthRoom J004, Block J75 East Street.LidcombeNSWAustralia2141
| | | | - Brian McGuire
- National University of IrelandSchool of Psychology and Centre for Pain ResearchRoom 2, Floor 4Woodquay CourtGalwayGalwayIreland
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Progressive Muskelrelaxation nach Jacobson bei der Migräneprophylaxe. MANUELLE MEDIZIN 2019. [DOI: 10.1007/s00337-019-0529-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Hayne DP, Martin PR. Relating Photophobia, Visual Aura, and Visual Triggers of Headache and Migraine. Headache 2019; 59:430-442. [PMID: 30737782 DOI: 10.1111/head.13486] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/16/2018] [Indexed: 12/31/2022]
Abstract
OBJECTIVE This study investigated a potential association between visual factors and symptoms related to migraine. It was predicted that photophobia and visual aura would be positively associated with interictal light sensitivity and visual headache triggers (flicker, glare, and eyestrain), and that these 2 visual symptoms would also be associated. BACKGROUND Previous studies have found independent neurophysiological associations between several visual factors and symptoms related to headache disorders. Many of these connections appear to be associated with increased cortical hypersensitivity, a phenomenon that might be in part due to repeated avoidance and reduced tolerance to triggers. If true, and if associations between visual factors and symptoms can be established, this may have implications for an exposure-based treatment for migraine symptoms. METHODS Four hundred and ninety-one participants (411 female, 80 male) were recruited through Griffith University (AUS), Headache Australia, Pain Australia, and through social media. Participants were grouped based on the presence of headache disorder symptoms and the presence or absence of photophobia and/or visual aura. A cross-sectional online survey design was utilized to gather information pertaining to interictal light sensitivity, visual triggers, and visual symptoms. RESULTS With respect to interictal light sensitivity and photophobia, a significant difference (P < .001, eta squared [η2 ] = 0.084) was found between the 3 groups, where headache disorder participants with photophobia (group A1; mean [M] = 2.5, standard deviation [SD] = 0.97) reported significantly greater light sensitivity than participants with headache disorder and no photophobia (A2; M = 1.68, SD = 0.62) and control group participants (A3; M = 1.82, SD = 0.85). This pattern was repeated for participants reporting flicker as a headache trigger (P < .001, η2 = 0.061), with group A1 (M = 2.45, SD = 1.24) significantly higher than groups A2 (M = 1.68, SD = 0.83) and A3 (M = 1.68, SD = 0.89), and was also seen for glare as a headache trigger (P < .001, η2 = 0.092), with group A1 (M = 2.92, SD = 0.96) significantly higher than A2 (M = 2.31, SD = 0.89) and A3 (M = 2.09, SD = 0.93). This pattern of results was not replicated for headache disorder participants with and without visual aura. A significant association (P < .001) was found between photophobia and visual aura in headache disorder participants based on a chi-square test of independence, with 86/136 participants reporting either both or neither visual symptom. CONCLUSIONS This study supports a link between certain visual phenomena in headache disorder populations, and supports future research into exposure-based treatments for migraine symptoms.
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Affiliation(s)
- Daniel P Hayne
- School of Psychology, University of New England, Armidale, Australia.,School of Applied Psychology, Griffith University, Mt Gravatt, Australia
| | - Paul R Martin
- Research School of Psychology, The Australian National University, Canberra, Australia
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Diener HC, Holle-Lee D, Nägel S, Dresler T, Gaul C, Göbel H, Heinze-Kuhn K, Jürgens T, Kropp P, Meyer B, May A, Schulte L, Solbach K, Straube A, Kamm K, Förderreuther S, Gantenbein A, Petersen J, Sandor P, Lampl C. Treatment of migraine attacks and prevention of migraine: Guidelines by the German Migraine and Headache Society and the German Society of Neurology. CLINICAL AND TRANSLATIONAL NEUROSCIENCE 2019. [DOI: 10.1177/2514183x18823377] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
In collaboration with some of the leading headache centres in Germany, Switzerland and Austria, we have established new guidelines for the treatment of migraine attacks and the prevention of migraine. A thorough literature research of the last 10 years has been the basis of the current recommendations. At the beginning, we present therapeutic novelties, followed by a summary of all recommendations. After an introduction, we cover topics like drug therapy and practical experience, non-effective medication, migraine prevention, interventional methods, non-medicational and psychological methods for prevention and therapies without proof of efficacy.
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Affiliation(s)
- Hans-Christoph Diener
- Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Dagny Holle-Lee
- Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Steffen Nägel
- Klinik für Neurologie und Westdeutsches Kopfschmerzzentrum, Universitätsklinikum Essen, Essen, Germany
| | - Thomas Dresler
- Klinik für Psychiatrie und Psychotherapie, Universität Tübingen, Tübingen, Germany
- Graduiertenschule & Forschungsnetzwerk LEAD, Universität Tübingen, Tübingen, Germany
| | - Charly Gaul
- Migräne- und Kopfschmerzklinik Königstein, Königstein im Taunus, Germany
| | | | | | - Tim Jürgens
- Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Klinik und Poliklinik für Neurologie, Rostock, Germany
| | - Peter Kropp
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Rostock, Germany
| | - Bianca Meyer
- Institut für Medizinische Psychologie und Medizinische Soziologie, Universitätsmedizin Rostock, Zentrum für Nervenheilkunde, Rostock, Germany
| | - Arne May
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg, Germany
| | - Laura Schulte
- Institut für Systemische Neurowissenschaften, Universitätsklinikum Hamburg Eppendorf (UKE), Hamburg, Germany
| | - Kasja Solbach
- Klinik für Neurologie, Universitätsklinikum Essen, Essen, Germany
| | - Andreas Straube
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Germany
| | - Katharina Kamm
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Germany
| | - Stephanie Förderreuther
- Neurologische Klinik, Ludwig-Maximilians-Universität München, Klinikum Großhadern, München, Germany
| | | | - Jens Petersen
- Klinik für Neurologie, Universitätsspital Zürich, Zürich, Swizterland
| | - Peter Sandor
- RehaClinic Bad Zurzach, Bad Zurzach, Swizterland
| | - Christian Lampl
- Ordensklinikum Linz, Krankenhaus der Barmherzigen Schwestern Linz Betriebsgesellschaft m.b.H., Linz, Austria
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Rastogi RG, Borrero-Mejias C, Hickman C, Lewis KS, Little R. Management of Episodic Migraine in Children and Adolescents: a Practical Approach. Curr Neurol Neurosci Rep 2018; 18:103. [DOI: 10.1007/s11910-018-0900-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Stubberud A, Linde M. Digital Technology and Mobile Health in Behavioral Migraine Therapy: a Narrative Review. Curr Pain Headache Rep 2018; 22:66. [PMID: 30066141 DOI: 10.1007/s11916-018-0718-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
PURPOSE OF REVIEW This article reviews the recent research and development of electronic health (eHealth) and, in particular, mobile health (mHealth) strategies to deliver behavioral treatment for migraine. Prospects for future development and research of mobile health in migraine are suggested. RECENT FINDINGS Advances in digital technology and mobile technology have led to an era where electronic and mobile approaches are applied to several aspects of healthcare. Electronic behavioral interventions for migraine seem to be acceptable and feasible, but efficacy measures are uncertain. Clinical trials on mHealth-based classical behavioral therapies, such as relaxation, biofeedback, and cognitive behavioral therapy are missing in the literature. Within mHealth, headache diaries are the most researched and scientifically developed. Still, there is a gap between commercially available apps and scientifically validated and developed apps. Digital technology and mobile health has not yet lived out its potential in behavioral migraine therapy. Application of proper usability and functionality designs towards the right market, together with appraisal of medical and technological recommendations, may facilitate rapid development of eHealth and mHealth, while also establishing scientific evidence.
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Affiliation(s)
- Anker Stubberud
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, NO-7489, Trondheim, Norway.
| | - Mattias Linde
- Department of Neuromedicine and Movement Science, NTNU Norwegian University of Science and Technology, NO-7489, Trondheim, Norway.,Norwegian Advisory Unit on Headache, Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, NO-7006, Trondheim, Norway
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